Adult Cranioplasty Reconstruction With Customized Cranial Implants: Preferred Technique, Timing, and Biomaterials

The Journal of Craniofacial Surgery
Amir WolffChad Gordon

Abstract

Complex cranial defects requiring delayed reconstruction present numerous challenges. Delayed cranioplasties accompany frequent complications approaching an incidence of 35 to 40%. Therefore, the authors sought to collate their experience in hopes of sharing their perspective on several topics including technique, timing, and preferred biomaterials. The authors' 5-year consecutive experience over 430 customized cranial implants is described herein. Since its inception in 2012, the authors' team has employed the pericranial-onlay cranioplasty technique instead of the standard epidural approach. Optimal timing for cranioplasty is determined using objective criteria such as scalp healing and parenchymal edema, close collaboration with neuroplastic surgery, conversion from autologous bone to sterile implant in instances of questionable viability/storage, and the first-line use of solid poly(methylmethacrylate) implants for uncomplicated, delayed cases, first-line porous polyethylene (MEDPOR) implants for single-stage cranioplasty, and first-line polyether-ether-ketone implants for cases with short notice. Furthermore, the use of the pterional design algorithm with temporal bulking for all customized implants has helped to correct a...Continue Reading

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Citations

Feb 5, 2019·Acta neurochirurgica·Anna BjornsonPeter J Hutchinson
Dec 12, 2018·The Journal of Craniofacial Surgery·Gabriel F SantiagoChad Gordon
Jan 25, 2019·The Journal of Craniofacial Surgery·Angela Ridwan-PramanaSaskia Peerdeman
Nov 30, 2018·Journal of Neurosurgery·Gabriel F SantiagoChad R Gordon
Sep 6, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Tamir ShayChad R Gordon
Nov 13, 2019·The Journal of Craniofacial Surgery·Thomas ZegersMariel Ter Laak-Poort
Dec 29, 2019·The Laryngoscope·Weitao WangYadranko Ducic
Jan 10, 2020·The Journal of Craniofacial Surgery·Tamir ShayChad R Gordon
Mar 10, 2020·The Journal of Craniofacial Surgery·Matteo ZoliDiego Mazzatenta
May 29, 2020·Plastic and Reconstructive Surgery·Kerry-Ann MitchellChad Gordon
Feb 29, 2020·Plastic Surgery·Adam BinhammerPaul Binhammer
Oct 20, 2020·The Journal of Craniofacial Surgery·Malke AsaadBasel Sharaf
Sep 25, 2020·The Journal of Craniofacial Surgery·Victor Hugo da Costa BenaliaGuilherme Brasileiro de Aguiar
Nov 7, 2020·The Journal of Craniofacial Surgery·Chad R Gordon
Dec 22, 2020·Annals of Plastic Surgery·Anna Barbara Di StefanoFrancesca Toia
Jun 29, 2021·Plastic and Reconstructive Surgery·Michal BrichacekLeo da Costa
Oct 16, 2020·The Journal of Craniofacial Surgery·Danielle H RochlinHermann Peter Lorenz

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