Is Cranial Reconstruction With a Hard-Tissue Replacement Patient-Matched Implant as Safe as Previously Reported? A 3-Year Experience and Review of the Literature
Purpose
This study aimed to verify the low complication rates (0% to 11%) previously reported in cranial reconstruction using hard-tissue replacement patient-matched implant (HTR-PMI).
Patients and Methods
A 3-year multidisciplinary experience involving 21 patients undergoing HTR-PMI reconstruction of large cranial defects was reviewed. Complications were defined as implant exposure, implant infection, or soft-tissue infection.
Results
A statistically higher rate of complications was observed, compared with previous series (P = .043). We also determined whether previous bone infection, a history of diabetes, or smoking were risk factors for the development of complications. Diabetes, smoking, and pre-existing bone/implant infections were not significant risk factors for HTR-PMI failure. The higher rate of complications can be partially attributed to a diverse and complicated patient population, with multiple comorbid conditions and various indications for HTR-PMI reconstruction. In particular, decompressive craniectomies in trauma patients can be risky indications for the use of HTR-PMI.
Conclusion
Larger studies are suggested to verify our findings.
⁎Neuroscience Graduate Program, Oregon Health and Science University School of Medicine, Portland, OR
†Department of Surgery, Oregon Health and Science University School of Medicine, Portland, OR
‡Assistant Professor of Surgery, Division of Oral and Maxillofacial Surgery, Department of Surgery, Oregon Health and Science University, Portland, OR
Address correspondence and reprint requests to Mr Cleary: Neuroscience Graduate Program, Oregon Health and Science University School of Medicine, Mail Code L102, 3181 SW Sam Jackson Park Road, Portland, OR 97239
There are no sources of financial support for this paper. The authors report no conflicts of interest.
ABSTRACT