Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CRANIOPLASTY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed1997

Osteopromotion for cranioplasty: an experimental study in rats using acidic fibroblast growth factor.

BACKGROUND: Many growth factors influence the bone healing cascade. Furthermore, the occasional failure of bone repair may in part be due to perturbation in the activation of local growth factors. Local activation of fibroblast growth factors (FGFs) at the fracture site may serve to increase neovascularization, and induce early granulation formation that can affect bone healing. METHODS: We have performed a rat parietal (6 x 3 mm) critical size defect (CSD). Human recombinant acidic fibroblast growth factor (hraFGF) imbided in agarose was topically administered at the craniectomy site. Control animals received agarose alone in the same manner. Three weeks after surgery, osteopromotion was histologically evaluated. RESULTS: hraFGF-treated animals show a continuous bridge of regenerated bone extending from one edge of the defect to the other. None of the parietal defects that had been treated with agarose contained new bone in the central portion. CONCLUSION: Our results suggest an important role of FGFs to promote large cranioplasty repair and support the use of these proteins as an alternative choice for bone grafts and bone substitutes.

Animals↗
PubMed2002

[Reconstruction of large scalp and calvarium defects by using the semi-free latissimus dorsi flap associated with methylmethacrylate implant for cranioplasty].

The semi free latissimus dorsi flap is characterized by a temporary vascular anastomosis on a pedicle not belonging to the loco-regional anatomy of the skin defect; after a period of autonomy, the section of the flap pedicle is obligatory. Its advantage compared to the classic free flap is the great microsurgical security avoiding complex, and stressful supervision in the postoperative period. From June 1998 to January 2001, 7 patients ranging from 18 to 65 years old and suffering from large scalp defects going between 20 x 13 cm and 27 x 18 cm have benefited from this surgical method. The etiology of these defects was: in 4 cases dermatofibrosarcoma protuberans involving the periost, in 1 case destruction of the near entirety of the scalp and calvarium by electrical burn, in 1 case an instable scar of burn with osteomyelitis and in the last case an osteomyelitis on a frontal cranioplasty. Three stages have been used:--The thoraco-dorsal artery was anastomosed on the wrist to the radial artery in a termino-lateral way and the thoraco-dorsal vein to the superficiel radial vein in a termino-terminal way;--The flap was fixed to the forearm for 2 weeks, then, the debridement which has always exposed the dura was done; The flap was sutured to the defect after reconstruction of calvarial defect with the méthylmétacrylate implant;--After 3 weeks the pedicle was sectioned and the flap tailored exactly to the defect. No postoperative complications were reported. With a mean follow-up of 18 months, the scalp coverage was very satisfactory.

Adolescent↗
PubMed1983

Cranioplasty: a review of 10 cases.

Cranial defects can be the result of trauma or neoplasia. The need for repair of these defects has led to the development of many reconstructive techniques. Ten cases of cranial defects treated by various methods of cranioplasty are reported. Of the ten cases, four were treated by bone grafts, three by silastic plates, two by acrylic plates and one by a metal plate. The indications for and contra-indications to each technique are discussed.

Bone Plates↗
PubMed1998

Cranioplasty with split lateral skull plate segments for reconstruction of skull defects.

This paper reports the use of cranioplasty using segments of split lateral skull plate to correct large skull defects (larger than 8 x 8 cm). The subjects consisted of 10 patients with head trauma who had undergone decompression surgery, and two patients who had undergone tumour resection. Bone grafts were obtained by cutting approximately 2 cm wide strips from the lateral skull plate using a bone saw that was inserted from a free margin of the bone defects. By cutting strips laterally from the bone defect, the necessary amount of split lateral skull plate can be obtained without performing craniotomy. The pieces of split lateral skull plate are then fixed to the defect using wire or titanium mini-plates. At this point, the selection of bone grafts that match the curvature of the dura mater is important, so that no dead spaces are created between the dura mater and the bone grafts. Infection was not detected in any of the 12 patients, and all bone grafts took completely. One of the 12 patients suffered from a pathological fracture and bone resorption 6 months after surgery. The fracture occurred because the use of basket-shaped reconstruction plates resulted in large spaces between the plate segments, and in addition the intracranial pressure was kept low by a V-P shunt, thus rendering the patient more vulnerable to atmospheric pressure.

Adolescent↗
PubMed2002

Titanium mesh and hydroxyapatite cement cranioplasty: a report of 20 cases.

PURPOSE: This article describes the use of titanium mesh and hydroxyapatite cement constructs for the treatment of large through-and-through calvarial defects. PATIENTS AND METHODS: Twenty consecutive calvarial defects (10 to 156 cm(2)) that resulted from surgical removal of neoplasms or were secondary to trauma were reviewed retrospectively after reconstruction with titanium mesh and hydroxyapatite cement. All patients were followed up by clinical examination and periodic radiographic studies for a minimum of 6 months (range, 6 months to 3 years). Three patients underwent biopsy of the construct at various points during their follow-up. RESULTS: There was no evidence of adverse healing, wound infection, or implant exposure or extrusion in any of the patients reviewed. Adequate 3-dimensional aesthetic restoration of calvarial contour was noted in each case. There was evidence of osseous ingrowth into the titanium mesh and hydroxyapatite cement construct in all 3 patients who underwent biopsy. CONCLUSION: Titanium mesh and hydroxyapatite cement cranioplasty appears to be a reasonable method for the reconstruction of significant calvarial defects.

Bone Cements↗
PubMed2001

Pseudoankylosis of the mandible as a result of methyl methacrylate-induced inflammatory cicatricial contracture of the temporal muscle after cranioplasty.

Pseudoankylosis of the mandible after intracranial surgical procedure has been widely reported, and is usually caused by fibrosis of the temporal muscle as a result of injury during the operation. We present an unusual case of mandibular pseudoankylosis as a result of methyl methacrylate-induced aseptic inflammatory cicatricial contracture of the temporal muscle after cranioplasty.

Adult↗
PubMed1979

Cranioplasty with pre-formed methyl methacrylate onlay plates.

The available manufactured plates for cranioplasty of large skull defects are not always satisfactory. Recently we have used preformed methyl methacrylate plates, in combination with Proplast. This plate prepared adjusted and sterilized before the operation is both cosmetically and mechanically satisfactory.

Adult↗
PubMed2000

[A simple and cosmetically ideal method large cranioplasty].

Repair of large skull defects is indicated as well to improve cosmetic as to protect the brain. A simply and easy to use procedure for exact duplication of cranial bone flaps used in cranioplasty is described. The original bone flap must be available to produce the definitive prosthesis.

Humans↗
PubMed2003

Delayed minimally invasive cranioplasty.

Minimally invasive cranioplasty is presented. Stereolithography is a new technology applied for the manufacture of custom-made cranial prosthesis that can provide an accurate reproduction of difficult anatomical contours of large cranial defects. The pre-operative development of perfect-fit prostheses permits a significant decrease in the operative time, in the overall costs of surgery, as well as on the rate of complications observed in patients with large cranial defects. At the end, this paper reviews the current concepts of application of engineering into medicine.

Brain Diseases↗
PubMed1988

The prognosis of cranioplasty following large craniectomy in children.

The experience acquired during 10 years treatment of 33 children having undergone a large craniectomy with an average follow-up time of 5.3 years is presented. Different methods of primary and delayed closure of the skull defect are documented and discussed. Whenever possible the deep frozen conserved skull flap was reimplanted. The problem of skull flap resorption and insufficient spontaneous ossification and the alternative of a heterologous cranioplasty with methylmethacrylate (MMA) in cases of insufficient reossification is considered. The decision to use MMA as a secondary skull defect graft should be delayed at least one year after craniectomy, since a spontaneous reossification of the defect is possible until adolescence.

Adolescent↗
PubMed1997

Relief of headache by cranioplasty after skull base surgery.

Headache after skull base surgery can cause profound morbidity in certain patients, resulting in significant impairment of their quality of life. Several methods to prevent postoperative headache have been described, including a modification of the skin/muscle incision replacing the craniotomy bone flap replacing the bone flap and filling in the residual defect with methyl methacrylate, using hydroxyapatite cement (HAC) to fill the craniectomy defect, and wiring hardened methyl methacrylate (MMA) into the defect. Ten patients with severe headache following craniectomy for a posterior fossa lesion underwent cranioplasty with MMA, which was placed exactly within the craniectomy defect and secured rigidly with miniplates and screws. The headache decreased in severity in all patients and resolved completely in 90%. Also, 78% of patients with dizziness improved. The procedure and its effect on headache and dizziness will be described.

Journal Article↗
PubMed2002

Hydroxyapatite cement cranioplasty in translabyrinthine acoustic neuroma surgery.

OBJECTIVES: Hydroxyapatite cement cranioplasty (HAC) after translabyrinthine resection of acoustic neuroma is a promising new technique for wound reconstruction. This study reviews the efficacy of HAC for the prevention of cerebrospinal fluid (CSF) leakage and the long-term wound outcomes of HAC versus abdominal fat graft (AFG) reconstruction. METHODS: This retrospective study of l08 consecutive acoustic neuromas operated on by Pittsburgh Ear Associates uses chart review, telephone interview, and mail questionnaire data. Fifty-four patients received AFG dural repair, and 54 patients received HAC. RESULTS: Seven AFG patients (12.5%) had CSF leaks versus 2 (3.7%) of the overall group of 54 HAC patients. However, none (0%) of the 47 HAC patients had CSF leakage with current HAC techniques. HAC also produced significantly less postauricular wound depression and superior cosmetic results in comparison with AFG. Although HAC patients experienced less postoperative discomfort, wound complications requiring medical or surgical intervention were extremely uncommon in both groups. CONCLUSION: HAC offers significant CSF leakage control and long-term cosmetic and comfort advantages over AFG alone. We recommend HAC as the standard closure technique for translabyrinthine acoustic neuroma surgery.

Abdomen↗
PubMed1984

Cranioplasty for traumatic deformities of the frontoorbital area.

Cranioplasties of the frontoorbital area pose a major challenge to the surgeon because of the proximity to the globe, the sinuses, and the eyebrows and eyelids. The choice of material for reconstruction includes autogenous and alloplastic materials. A modification of the fixation technique of split rib graft to avoid depression deformities at the periphery of the defect is described. Sixteen patients were reconstructed with different treatment modalities, including the use of alloplastic materials or autogenous bone or a combination of both. The results are reported as are the complications. Limitations encountered with these difficult reconstructions are discussed.

Adolescent↗
PubMed2001

Mental development after modified pi procedure: dynamic cranioplasty for sagittal synostosis.

A prospective developmental assessment was performed on 26 patients operated on with dynamic cranioplasty for sagittal synostosis. Because this technique entails the application of compressive force, it was of great concern to assess the effect of surgery on development and mental status. The surgical technique used was a modified pi procedure. Perioperative variables were recorded. Six patients underwent preoperative intracranial pressure (ICP) measurements. To evaluate objectively the developmental outcome, the Griffiths' Mental Development Scales was used for analysis before and after surgery. A parental questionnaire was used for subjective outcome measurement. Preoperative ICP recordings during sleep ranged from 12.8 to 22.8 mmHg (mean, 16.1 mmHg). The mean age at the time for surgery was 6.9 months (range, 4-16 months; standard deviation [SD], 2.32 months). The surgical technique included shortening of the anteroposterior diameter of the skull by a mean of 16.6 mm. The mean global development quotient (GDQ) preoperatively was 104.5 (range, 82-144; SD, 12.4) and the mean GDQ postoperatively was 101.4 (range, 62-129; SD, 13.6). Mean age at follow-up was 16.3 months (range, 9-40 months; SD, 4.04 months). There was no significant correlation between the amount of intraoperative shortening and mental development. In comparison of means, the GDQ preoperatively did not differ significantly from the GDQ postoperatively. The modified pi procedure is safe and efficient. When surgery was performed before 1 year of age, no significant (p = 0.33) effect on mental development-either detrimental or beneficial-was demonstrated.

Child Development↗
PubMed2002

Osteogaleal flaps in pediatric cranioplasty.

Reconstruction of cranial defects larger than 2 to 3 cm in diameter and frontal defects of any size is indicated for mechanical protection and cosmetic reasons. The authors used osteogaleal flaps for cranioplasty in 2 pediatric patients with the aim of decreasing infection risk and maximizing bone healing. In the first patient, bone was harvested from the diploë. Children's cranial bones are thin, and in the second patient the authors used full-thickness grafts of adjacent bone, splitting this into three pieces to cover the recipient and donor sites. The postoperative period was uneventful for both children. Scintigraphic studies performed the first week after surgery revealed uptake in the flaps. Computed tomography demonstrated rapid bone healing with good contouring. The scintigraphic findings and rapid bone healing suggest that the bone component of the osteogaleal flap nourishes the graft site with blood from the galea and the periosteum. These flaps are an ideal choice for reconstruction of cranial defects because of their membranous origin, ease of harvest, applicability to any part of the calvarium, and reliable vascularity.

Adolescent↗
PubMed2002

Cranioplasty using allogeneic perforated demineralized bone matrix with autogenous bone paste.

The efficacy of allogeneic perforated demineralized bone matrix with autogenous bone paste in the treatment of full-thickness cranial defects was evaluated in 10 consecutive patients between June 1998 and December 1998. The skull defects resulted from trauma in 9 patients and removal of a cranial tumor in 1 patient. The size of the skull defects ranged from 8 x 6 cm to 11 x 12.5 cm. Follow-up averaged 33 months for all patients. Postimplantation evaluations included serial photographs, repeated physical examination, and three-dimensional computed tomography for all patients. Visual inspection of the implanted biomaterial 6 months later was possible in 1 patient. The contour of the reconstructed skull was acceptable aesthetically without any secondary depression noted during the follow-up period. Three-dimensional computed tomographic scans taken 2 years after implantation indicated that the allogeneic perforated demineralized bone matrix provided a matrix for new bone formation with remarkable osteoinductive potential for new bone formation. The autogenous bone paste was able to caulk the demineralized bone matrix and fill the contour irregularities and gaps of the reconstructed cranium. The results from this clinical study indicated that allogeneic perforated demineralized bone matrix with autogenous bone paste is a promising alternative to an autogenous bone graft and or alloplastic material for cranioplasty.

Adult↗
PubMed1994

Treatment of positional plagiocephaly with dynamic orthotic cranioplasty.

Dynamic orthotic cranioplasty (DOC) was developed to treat asymmetrical head shape of a nonsynostotic origin, which is defined by the term positional plagiocephaly. These positional deformations have been found to correlate with a number of environmental factors. Infants with positional plagiocephaly may exhibit complex multistructural asymmetry affecting the cranial vault, face, and skull base, or expression may be local in nature. Between 1988 and 1993, we performed DOC on 124 infants with positional plagiocephaly. Through clinical, anthropometric, radiographic, and statistical evaluation, we found that DOC corrects positional deformation of the cranial vault, skull base, and upper face, with no evident relapse following treatment. The design and the global approach to deformation address a wide spectrum of abnormal head shapes. The procedure is dynamic and customized, and it does not rely on passive growth alone for improvement.

Birth Injuries↗
PubMed1998

Treatment of craniofacial asymmetry with dynamic orthotic cranioplasty.

Dynamic Orthotic Cranioplasty (DOC) was developed to treat craniofacial deformities associated with positional plagiocephaly. This investigation describes the treatment of more than 750 patients with the DOC Band since 1988. All patients undergoing DOC treatment were fit with a custom fabricated orthosis made from a plaster impression taken from the infant's head. When the orthosis was applied, the corrective pressure was directed to hold growth at the calvarial prominences and redirect symmetrical growth. A detailed medical history was obtained and anthropometric measurements were taken at start, exit, 12, 18, and 24 months follow-up. This information was recorded in a database created in Microsoft Excel. Mean length of treatment was 4.3 months with an average entrance age of 6.9 months. Analysis of anthropometric data showed significant reduction in mean cranial vault, skull base, and facial asymmetries. Correction of the more difficult skull base was documented with computed tomography. Our anthropometric and clinical observations document complete or near complete correction of asymmetry for a wide variety of head shapes. Based on the results of this investigation, we are able to support the earlier claims of our pilot study, which concluded that DOC is effective in the treatment of positional plagiocephaly.

Anthropometry↗