Volume : IX, Issue : II, February - 2019

A Comparative Study on the various methods of Cranioplasty.

G Prabakaran, T. Suresh Babu

Abstract :

Introduction Cranioplasty is a reconstructive operation to restore the large defects in the skull. In addition to cosmesis. Cranioplasty provides support, protects vital structures, and restores normal cereospinal fluid (CSF) flow dynamics. The ideal cranioplasty material is nonmagnetic, radiolucent, light, sterilizable, and easily affixed to the skull. The types of cranioplasty materials discussed in this study include autologous bone, bone cement– polymethylmethacrylate and titanium mesh. Unfortunately, like for decompressive craniectomies, very few prospective studies are available about cranial reconstruction. Cranioplasty can be performed by using autologous bone or heterologous materials. Autologous bone graft is often preferred to allograft devices because of its biological characteristics, the optimal matching to the bony defect, and the low cost. There is not a single material which has all the characteristics of biocompatibility, hardness, and lack of interference with radiological and neurophysiological investigations. A direct comparision of autologous bone graft, bone cement and titanium mesh cranioplasty is very difficult because the indications between series is different and there have been no prospective randomized controlled trials with long–term follow–up. Hence in this study we have tried to analyze the characteristics of various cranioplasty materials, their indications, duration to cranioplasty and results to identify the best material for cranioplasty in our institution. Materials and methods After obtaining institutional ethical committee approval, this study was conducted on patients with cranial defects who underwent surgery immediately or thereafter within a period of 1 week at Institute of Neurosurgery, GGH&MMC, Chennai. All the patients who underwent cranioplasty from October 2012 to September 2014 were included in the study. The patient details were collected and the Institute of Neuro Surgery. These patients were analyzed to ascertain the best material for cranioplasty, complications due to the procedure and the outcome of the procedure. . Results– The incidence of superficial infections has been shown in our study to be the highest in the autologous bone graft group and this has been found to be statistically significant and has been proven in others studies as well. Osteomyelitis was found to be exclusive to the autologous bone graft group . There is an increase incidence in seroma formation in the bone cement group. Residual defect post cranioplasty was also exclusive to the autologous bone graft group .In our study hematoma formation was higher in the PMMC group.Seizures as a complication of cranioplasty occurred in all there materials used for cranioplasty and there was no statistical significance in the incidence of seizures amongst the three materials studied. Titanium mesh by far in the study has proved to be superior material for cranioplasty with regard to wound infection and seroma formation in our institution.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

A COMPARATIVE STUDY ON THE VARIOUS METHODS OF CRANIOPLASTY., G Prabakaran, T.Suresh Babu INDIAN JOURNAL OF APPLIED RESEARCH : Volume-9 | Issue-2 | February-2019

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