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A. A pre-op CT scan of the head revealed significant metallic artifact, limiting initial evaluation of the tissue and plate.
Source publication
No clear consensus exists regarding the best material and technique for use in pediatric cranioplasty. The immature bone in pediatric patients poses several challenges, such as rapid growth, skull growth restriction, plate migration, and tissue erosion. We present a pediatric cranioplasty from the 1940s, and examine the characteristics of the plati...
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Background
Intracranial meningioma with bone involvement and primary intraosseous meningioma is uncommon. There is currently no consensus for optimal management. This study aimed to describe the management strategy and outcomes for a 10-year illustrative cohort, and propose an algorithm to aid clinicians in selecting cranioplasty material in such p...
Citations
... The majority of complications emerge during the first three months after operation (Coulter et al., 2014;De Bonis et al., 2012). However, complications may occur later, even some decades after the procedure (Kahn et al., 2014). Resorption of cryopreserved bone flap and surgical site infection (SSI) are the most prominent reasons for cranioplasty failure. ...
... This observation was in accordance with findings of other authors who have investigated complications related to cranioplasty with other biomaterials (Coulter et al., 2014;De Bonis et al., 2012). However, a complication of cranioplasty may occur even decades after the operation (Kahn et al., 2014). Complications related to cranioplasty include hematoma and CSF leak, which are prone to infection. ...
A cranial bone defect may result after an operative treatment of trauma, infection, vascular insult, or tumor. New biomaterials for cranial bone defect reconstructions are needed for example to mimic the biomechanical properties and structure of cranial bone. A novel glass fiber-reinforced composite implant with bioactive glass particulates (FRC–BG, fiber-reinforced composite–bioactive glass) has osteointegrative potential in a preclinical setting.
The aim of the first and second study was to investigate the functionality of a FRC–BG implant in the reconstruction of cranial bone defects. During the years 2007–2014, a prospective clinical trial was conducted in two tertiary level academic institutions (Turku University Hospital and Oulu University Hospital) to evaluate the treatment outcome in 35 patients that underwent a FRC–BG cranioplasty. The treatment outcome was good both in adult and pediatric patients. A number of conventional complications related to cranioplasty were observed.
In the third study, a retrospective outcome evaluation of 100 cranioplasty procedures performed in Turku University Hospital between years 2002–2012 was conducted. The experimental fourth study was conducted to test the load-bearing capacity and fracture behavior of FRC–BG implants under static loading. The interconnective bars in the implant structure markedly increased the load-bearing capacity of the implant. A loading test did not demonstrate any protrusions of glass fibers or fiber cut. The fracture type was buckling and delamination.
In this study, a postoperative complication requiring a reoperation or removal of the cranioplasty material was observed in one out of five cranioplasty patients. The treatment outcomes of cranioplasty performed with different synthetic materials did not show significant difference when compared with autograft. The FRC–BG implant was demonstrated to be safe and biocompatible biomaterial for large cranial bone defect reconstructions in adult and pediatric patients.
