2018, Number 3
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Cir Cir 2018; 86 (3)
Cranial bone reconstruction with customized implants after trauma
Cienfuegos R, Fernández G, Cruz A, Sierra E
Language: Spanish
References: 12
Page: 289-295
PDF size: 573.00 Kb.
ABSTRACT
Introduction: Cranial defects due to trauma are frequent. They are usually repaired in a secondary fashion due to features
such as syndrome of the trephined, for brain protection and for cosmetic purposes. Historically, various materials have been
used for reconstruction.
Case reports: Five cases of patients reconstructed with customized polyetheretherketone (PEEK) o
polymethyl methacrylate (PMMA) implants are presented. Defects involved the frontal bone, superior orbital rim and orbital roof
in four cases, and the lateral area of the frontal bone, the temporoparietal area and the border of the occipital bone in one. In
four patients, reconstruction took place between 6 and 12 months after the injury; in one patient, after 25 years. Two cases
required tissue expansion before placing the implant.
Results: Four patients evolved favorably, with improvement in neurologic
symptoms and adequate shape and contour, plus adequate healing of the scalp flaps. One patient had an infection due to
Staphylococcus aureus¸ attributed to a mucocele and fistula between the airway and the cranial cavity, leading to removal of the implant.
Conclusions: Customized implants are a useful resource for cranial defects. They offer satisfactory results, both
functional and cosmetic. Precautions should be taken in treating injuries that involve the frontal sinus, to ensure there is no
communication between the airway and the cranial cavity.
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