Titanium Mesh for the Repair of Skull Base Bone Defects

SummaryIn this case report, we describe the use of a cylindrical titanium mesh cage combined with cancellous bone graft to surgically manage large segmental bone defects in a dog. A seven-year-old, neutered male cross-breed dog, with highly comminuted fractures of the right femur and the left radius and ulna, was referred for treatment. Previous open reduction and internal fixation of these fractures had failed. Following implant removal and debridement of each bone, a 71 mm segmental femoral defect and a 27 mm segmental radial defect were present. A commercially available cylindrical titanium mesh cage was filled with ß-tricalcium phosphate crystals mixed with an equal volume of autogenous cancellous bone graft. The mesh cage was aligned with the proximal and distal parts of each bone using an intramedullary pin passing through the cage, and a locking plate was applied to the proximal and distal fracture fragments to produce compression against the titanium cage. The dog had a successful long-term clinical outcome, and radiographic examination at 22 and 63 weeks after surgery showed the formation of remodelling bridging callus that was continuous across the titanium cage in each of the fractures. Due to the relative simplicity of the technique and the favourable outcome in this case, it should be considered an option when managing comminuted fractures with large bone defects.

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A Case of Posterior Ethmoidal Sinus Cyst Involving Anterior Skull Base Bone Defects

Practica Oto-Rhino-Laryngologica ◽

10.5631/jibirin.103.431 ◽

2010 ◽

Vol 103 (5) ◽

pp. 431-437

Author(s):

Yoshiya Ishida ◽

Akihiro Katayama ◽

Masaaki Adachi ◽

Yasuaki Harabuchi

Keyword(s):

Skull Base ◽

Bone Defects ◽

Anterior Skull Base ◽

Ethmoidal Sinus

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The Value of Titanium Mesh in Cranio-Maxillofacial Reconstructive Surgery

Revista de Chimie ◽

10.37358/rc.19.8.7478 ◽

2019 ◽

Vol 70 (8) ◽

pp. 3021-3023

Author(s):

Victor Vlad Costan ◽

Otilia Boisteanu ◽

Daniel Timofte ◽

Marius Dabija

Keyword(s):

Reconstructive Surgery ◽

Donor Site ◽

Chemical Properties ◽

Individual Case ◽

Bone Defects ◽

Titanium Mesh ◽

Advantages And Disadvantages ◽

Optimal Material ◽

The Individual ◽

Donor Site Defect

Cranio-maxillofacial defects are often challenging to reconstruct due to the difficulty of selecting the most appropriate material for the individual case while ensuring good outcomes with minimal complications. The chemical properties of titanium regarding biocompatibility coupled with the physical properties of the mesh design, make titanium mesh an optimal material that is increasingly used in reconstructive surgery. We present our experience regarding the use of titanium mesh for the reconstruction of 14 cranio-maxillofacial bone defects of various etiologies, including 8 defects following oncologic resection, 4 posttraumatic sequelae defects, one osteofascial flap donor site defect and one defect following treatment for osteomyelitis. The advantages and disadvantages of this reconstructive method are discussed.

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Short-Term Evaluation of Guided Bone Reconstruction with Titanium Mesh Membranes and CGF Membranes in Immediate Implantation of Anterior Maxillary Tooth

BioMed Research International ◽

10.1155/2021/4754078 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Xianli Wang ◽

Guoqing Wang ◽

Xibo Zhao ◽

Yanchuan Feng ◽

Huijuan Liu ◽

...

Keyword(s):

Prospective Study ◽

Bone Regeneration ◽

Bone Defects ◽

Mesh Exposure ◽

Titanium Mesh ◽

Bone Thickness ◽

Second Stage ◽

Maxillary Tooth ◽

One Year ◽

Immediate Implantation

Purpose. The aim of the present prospective study was to evaluate the effect of titanium mesh and concentrated growth factor (CGF) membranes in reconstructing severe labial bone defects during immediate implantation of anterior maxillary tooth. Methods. Patients with severe defects presenting on the anterior labial bone plate of maxillary were enrolled in this study. During immediate implantation, the titanium mesh was used to maintain the space of bone graft, collagen membrane, and xenograft bone that were used to guide bone regeneration (GBR). Cone beam computed tomography (CBCT) was used to measure the height and the labial bone thickness around the implant at the time of the second stage surgery, 6 months, 1 year, and 2 years after restoration. The pink esthetic score (PES) was used to evaluate the esthetic outcomes after restoration. Results. 18 patients were enrolled in this study. The survival rate of implants was 100%, and no complication was observed, except for 1 case of titanium mesh exposure which did not affect osteogenesis. In the second stage of surgery, the labial bone was completely reconstructed, and the top of the implant was covered with a small amount of new bone. The thickness of the labial bone was 3.01 mm (±0.23), 2.96 mm (±0.21), 2.93 mm (±0.19), and 2.92 mm (±0.16) at the time of the second stage surgery, 6 months, 1 year, and 2 years after restoration, respectively. The height of the marginal bone around implants was above the top of implant at the time of the second stage surgery and then reduced 0.72 mm (±0.07), 0.91 mm (±0.08), and 0.90 mm (±0.07) at the time point of 6 months, 1 year, and 2 years after restoration, respectively. The changes of bone thickness and height were statistically significant within one year, but stable after one year. The PES values showed the same tendency. Conclusions. With the limitation of the present prospective study, the combination of titanium mesh and CGF membrane could provide space maintenance for bone augmentation of alveolar bone defects and improve the bone regeneration in patients with severe labial bone defect when immediate implant of anterior maxillary.

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Use of titanium mesh for reconstruction of large anterior cranial base defects

Journal of Neurosurgery ◽

10.3171/jns.2000.93.4.0711 ◽

2000 ◽

Vol 93 (4) ◽

pp. 711-714 ◽

Cited By ~ 30

Author(s):

Behnam Badie ◽

J. Keith Preston ◽

Gregory K. Hartig

Keyword(s):

Skull Base ◽

Anterior Skull Base ◽

Fistula Formation ◽

Reconstruction Technique ◽

Titanium Mesh ◽

Csf Rhinorrhea ◽

Content Type ◽

Dural Defects ◽

Skull Base Defects ◽

Fine Print

✓ The authors evaluated the role of titanium mesh used in combination with vascularized pericranium to provide rigid support during reconstruction of anterior skull base defects.Thirteen patients with large anterior skull base defects caused by tumor invasion or traumatic injury involving the cribriform plate, orbital roof, and planum sphenoidale were included in the study. The reconstruction technique involved placement of titanium mesh between two layers of continuous vascularized pericranium. Surgical glue and routine lumbar cerebrospinal fluid (CSF) drainage were not used in any patient.At a mean postoperative follow-up time of 22 months (range 8–39 months), none of the patients had developed infection or meningocele. Postoperative CSF rhinorrhea occurred in two patients with extensive dural defects, which resolved with temporary lumbar drainage.Use of titanium mesh and a two-layer vascularized pericranial graft is a safe, reproducible, and feasible method for reconstructing the anterior skull base. Patients with large dural defects may need temporary CSF diversion to avoid postoperative fistula formation.

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Treatment of a Large Traumatic Encephalocele with Titanium Mesh

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0036-1582452 ◽

2017 ◽

Vol 10 (2) ◽

pp. 145-150

Author(s):

Alan Motta do Canto ◽

Manuela Monteiro Pinotti ◽

Fernando Alves Maciel ◽

Alexandre Bossi Todeschini ◽

Guilherme Brasileiro Aguiar ◽

...

Keyword(s):

Skull Base ◽

Bone Defect ◽

Endoscopic Treatment ◽

Rare Case ◽

Anterior Skull Base ◽

Titanium Mesh ◽

Fat Grafts ◽

Reduced Dimensions ◽

Extensive Defect

Encephalocele is defined as protrusion of cranial contents beyond the normal confines of the skull. Although most encephalocele cases have a congenital etiology, fractures of the skull base can cause traumatic encephalocele. In most encephalocele cases, the bone defect presents reduced dimensions and the endoscopic treatment is generally performed to reconstruct the area using mucosal and/or fat grafts. This article sought to report on a rare case of traumatic encephalocele associated with an extensive defect of the anterior skull base. This case was treated via transcranial access, and reconstruction was performed using titanium mesh in conjunction with a pericranium flap.

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