scholarly journals On the issue of closure of defects of the skull and cerebral frills with free plastics

2021 ◽  
Vol 22 (7) ◽  
pp. 810-814
Author(s):  
Yu. Ratner
Keyword(s):  
Skull Defects

The practical surgeon often has to decide on the method of closing the skull defects, as is known, which do not have the ability to close on their own due to the insignificant plastic abilities of pericranium.

Autologous Calvarial Bone Remodeling Technique for Small to Medium-Sized Cranial Defects in Young Children: The “Switch-Cranioplasty” Technique

2021 ◽  
pp. 1-6
Author(s):  
Sonal Jain ◽  
Shelly Wang ◽  
Carolina Sandoval-Garcia ◽  
George M. Ibrahim ◽  
Walker L. Robinson ◽  
...  
Keyword(s):  
Bone Growth ◽  
Autologous Bone Graft ◽  
Dural Defect ◽  
Skull Defect ◽  
Calvarial Bone ◽  
Leptomeningeal Cyst ◽  
Case Presentation ◽  
Skull Defects ◽  
Calvarial Defects ◽  
Autologous Bone

<b><i>Introduction:</i></b> Reconstruction of cranial defects in children less than 2 years of age, particularly when there is an associated dural defect, is challenging due to the need to accommodate active skull growth, limited options for autologous bone graft and thin calvarial bones. We use a simple remodeling technique that exploits the normal dura’s inherent potential for new bone growth while covering the dural defect with adjacent skull. <b><i>Case Presentation:</i></b> We describe an alternating, two-piece craniotomy or “switch-cranioplasty technique” to repair an occipital meningocele. The two pieces of craniotomy bone flap created around the existing skull and dural defect are switched in the horizontal plane in order to cover the site of the defect and the abnormal dura of the meningocele closure. The area of the original skull defect is transposed laterally over the normal dura. The healing of the lateral skull defects is facilitated with autologous bone chips and dust and covered by periosteal flaps that stimulate spontaneous re-ossification. <b><i>Discussion:</i></b> The advantages of this technique are the use of autologous bone adjacent to the skull defect, incorporation of the autologous bone into the growing skull, an acceptable cosmetic and functional outcome in a simple manner. The indications can be extended to include small to medium-sized calvarial defects secondary to leptomeningeal cyst and trauma.

scholarly journals Aplasia Cutis Congenita and Skull Defects after Exposure to Methimazole in Utero

2005 ◽  
Vol 44 (11) ◽  
pp. 1202-1203 ◽  
Author(s):  
Shigenori NAKAMURA ◽  
Tomoko NISHIKAWA ◽  
Mako ISAJI ◽  
Masatoshi ISHIMORI ◽  
Nobuo SHIMIZU ◽  
...  
Keyword(s):  
In Utero ◽  
Aplasia Cutis Congenita ◽  
Skull Defects ◽  
Aplasia Cutis

scholarly journals Low-Cost Customized Cranioplasty with Polymethyl Methacrylate Using 3D Printer Generated Mold: An Institutional Experience and Review of Literature

2021 ◽  
Author(s):  
Ankit Chaudhary ◽  
Virendra Deo Sinha ◽  
Sanjeev Chopra ◽  
Jitendra Shekhawat ◽  
Gaurav Jain
Keyword(s):  
Polymethyl Methacrylate ◽  
Bone Fractures ◽  
Low Cost ◽  
Operating Time ◽  
Three Dimensional ◽  
Wound Dehiscence ◽  
3D Printer ◽  
Skull Defects ◽  
Aesthetic Appearance ◽  
The Mean

Abstract Background Cranioplasty is performed to repair skull defects and to restore normal skull anatomy. Optimal reconstruction remains a topic of debate. Autologous bone flap is the standard option but it may not be available due to traumatic bone fractures, bone infection, and resorption. The authors present their experience with prefabrication of precise and low-cost polymethyl methacrylate (PMMA) mold using three-dimensional (3D) digital printing. Methods A total of 30 patients underwent cranioplasty between March 2017 and September 2019 at Sawai Man Singh Medical College Jaipur, India. Preoperative data included diagnosis for which decompressive craniectomy was done and Glasgow coma scale score. Intraoperative data included operating time. Postoperative data included cosmetic outcome in the form of cranial contour and margins, complications such as infection, seroma, implant failure, wound dehiscence, and hematoma. Results Patient age at cranioplasty ranged from 12 to 63 years with a mean age of 36.7 years. The mean operating time was 151.6 minutes (range 130–190 minutes). The mean follow-up period was 8 months (range 6–13 months). Postoperative wound dehiscence developed in one case (3.3%). Cranial contour and approximation of the margins were excellent and aesthetic appearance improved in all patients. Conclusion Low-cost PMMA implant made by digital 3D printer mold is associated with reconstruction of the deformed skull contour giving satisfactory results to the patient and his family members, at a low cost compared with other commercially available implants. This technique could be a breakthrough in cranioplasty.

scholarly journals Endoscopic-assisted surgery for skull defects with subdural effusion

2020 ◽  
Author(s):  
Jian-Yun Zhou ◽  
Xin Zhang ◽  
Hai-Bin Gao ◽  
Ze Cao ◽  
Wei Sun
Keyword(s):  
Subdural Effusion ◽  
Skull Defects

scholarly journals Patterns of care: burr-hole cover application for chronic subdural hematoma trepanation

2019 ◽  
Vol 47 (5) ◽  
pp. E14 ◽  
Author(s):  
Julia Velz ◽  
Flavio Vasella ◽  
Kevin Akeret ◽  
Sandra F. Dias ◽  
Elisabeth Jehli ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Department Chairs ◽  
Chronic Subdural Hematoma ◽  
Technical Difficulty ◽  
Patterns Of Care ◽  
Burr Hole ◽  
Aesthetic Result ◽  
Skull Defects ◽  
Practice Variations ◽  
The Aesthetic

OBJECTIVESkin depressions may appear as undesired effects after burr-hole trepanation for the evacuation of chronic subdural hematomas (cSDH). Placement of burr-hole covers to reconstruct skull defects can prevent skin depressions, with the potential to improve the aesthetic result and patient satisfaction. The perception of the relevance of this practice, however, appears to vary substantially among neurosurgeons. The authors aimed to identify current practice variations with regard to the application of burr-hole covers after trepanation for cSDH.METHODSAn electronic survey containing 12 questions was sent to resident and faculty neurosurgeons practicing in different parts of the world, as identified by an Internet search. All responses completed between September 2018 and December 2018 were considered. Descriptive statistics and logistic regression were used to analyze the data.RESULTSA total of 604 responses were obtained, of which 576 (95.4%) provided complete data. The respondents’ mean age was 42.4 years (SD 10.5), and 86.5% were male. The sample consisted of residents, fellows, junior/senior consultants, and department chairs from 79 countries (77.4% Europe, 11.8% Asia, 5.4% America, 3.5% Africa, and 1.9% Australasia). Skin depressions were considered a relevant issue by 31.6%, and 76.0% indicated that patients complain about skin depressions more or less frequently. Burr-hole covers are placed by 28.1% in the context of cSDH evacuation more or less frequently. The most frequent reasons for not placing a burr-hole cover were the lack of proven benefit (34.8%), followed by additional costs (21.9%), technical difficulty (19.9%), and fear of increased complications (4.9%). Most respondents (77.5%) stated that they would consider placing burr-hole covers in the future if there was evidence for superiority of the practice. The use of burr-hole covers varied substantially across countries, but a country’s gross domestic product per capita was not associated with their placement.CONCLUSIONSOnly a minority of neurosurgeons place burr-hole covers after trepanation for cSDH on a regular basis, even though the majority of participants reported complaints from patients regarding postoperative skin depressions. There are significant differences in the patterns of care among countries. Class I evidence with regard to patient satisfaction and safety of burr-hole cover placement is likely to have an impact on future cSDH management.

Comparison of manually shaped and computer-shaped titanium mesh for repairing large frontotemporoparietal skull defects after traumatic brain injury

2012 ◽  
Vol 33 (1) ◽  
pp. E13 ◽  
Author(s):  
JianMing Luo ◽  
Bin Liu ◽  
ZeYu Xie ◽  
Shan Ding ◽  
ZeRui Zhuang ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Muscle Pain ◽  
Fluid Collection ◽  
Titanium Mesh ◽  
Temporal Muscle ◽  
Advantages And Disadvantages ◽  
Skull Defects ◽  
Computer Aided ◽  
Materials Used

Object The object of this study was to compare the effects and complications of manual and computer-aided shaping of titanium meshes for repairing large frontotemporoparietal skull defects following traumatic brain injury. Methods From March 2005 to June 2011, 161 patients with frontotemporoparietal skull defects were observed. Patients were divided into 2 groups according to the repair materials used for cranioplasty: 83 cases used computer-aided shaping for the titanium mesh, whereas the remaining 78 cases used a manually shaped titanium mesh. The advantages and disadvantages of the 2 methods were compared. Results No case of titanium mesh loosening occurred in either group. Subcutaneous fluid collection, titanium mesh tilt, and temporal muscle pain were the most common complications. In the manually shaped group, there were 14 cases of effusion, 10 cases of titanium mesh tilt, and 15 cases of temporal muscle pain. In the computer-aided group, there were 6 cases of effusion, 3 cases of titanium mesh tilt, and 6 cases of temporal muscle pain. The differences were significant between the 2 groups (p < 0.05). Other common complications were scalp infection, exposure of titanium mesh, epidural hematoma, and seizures. In the computer-aided group, the operative time decreased (p < 0.01), the number of screws used was reduced (p < 0.01), and the satisfaction of patients was significantly increased (p < 0.05). Conclusions Computer-aided shaping of titanium mesh for repairing large frontotemporoparietal skull defects decreases postoperative complications and the operative duration, reduces the number of screws used, increases the satisfaction of patients, and restores the appearance of the patient's head, making it an ideal choice for cranioplasty.

Compression cranioplasty for surgical treatment of purulent wounds

1985 ◽  
Vol 66 (6) ◽  
pp. 444-445
Author(s):  
N. M. Mrasov ◽  
L. I. Nikoshin
Keyword(s):  
Surgical Treatment ◽  
Primary Closure ◽  
Antibacterial Agents ◽  
Positive Outcomes ◽  
Compression Method ◽  
Skull Defects ◽  
Purulent Wounds

The presence of powerful antibacterial agents and the positive outcomes of using a blind suture after surgical treatment of purulent wounds of the skull and brain gave us the basis in an experiment on 36 dogs to find out the possibility of primary closure of skull defects using the compression method of cranioplasty developed at the Department.

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