BRIDGED DURAL SUSPENSION FOR CRANIOPLASTY BY USING THREE- DIMENSIONAL MOULDING TITANIUM MESH_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 ZHUQing , CHENAilin , WANGZhongyong , LANQing

Department of Neurosurgery, Second Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215004, P.R.China;

Corresponding author：

ZHUQing, Email: suzhouneurosurgeon@126.com

Keywords：

Skull defect; Cranioplasty; Dural suspension

DOI：

10.7507/1002-1892.20160145

Video：

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Objective To investigate the value of bridged dural suspension for cranioplasty by using three- dimensional moulding titanium mesh. Methods A retrospective analysis was made on the clinical data of 156 patients with skull defects, who underwent cranioplasty using three-dimensional moulding titanium mesh between April 2012 and October 2015. Bridged dural suspension was performed in 73 patients (bridging group) and routine cross mesh dural suspension in 83 patients (routine group). There was no significant difference in gender, age, and causes, duration, and area of skull defects between 2 groups (P > 0.05), and they were comparable. The operation time, hospitalization time, and postoperative complication were recorded for analysis. Results The operation time was (86.7±13.5) minutes in bridging group and was (84.3±16.3) minutes in routine group, showing no significant difference (t=1.061, P=0.290); but hospitalization time of bridging group [(16.8±2.7) days] was significantly shorter than that of routine group [(18.7±5.7) days] (t=-2.661, P=0.009). Postoperative complications occurred in 16 patients of routine group (19.3%), including epidural hydrops in 13 cases, epidural hematoma in 2 cases, and epidural infection in 1 case, while epidural hydrops occurred in 4 cases of bridging group (5.5%). There was significant difference in complication rate between 2 groups (χ²=6.616, P=0.010). All patients were followed up 5-46 months (mean, 25.2 months). The satisfactory cosmetic results of the skull were obtained, and CT images showed good coverage of defect. Conclusion Bridged dural suspension for cranioplasty is more simple and effective than routine cross mesh suspension, and it is beneficial to reduction of postoperative complications.

Citation： ZHUQing, CHENAilin, WANGZhongyong, LANQing. BRIDGED DURAL SUSPENSION FOR CRANIOPLASTY BY USING THREE- DIMENSIONAL MOULDING TITANIUM MESH. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(6): 712-715. doi: 10.7507/1002-1892.20160145 Copy

1.	Feroze AH, Walmsley GG, Choudhri O, et al. Evolution of cranioplasty techniques in neurosurgery: historical review, pediatric considerrations, and current trends. J Neurosurg, 2015, 123(4): 1098-1107.
2.	Goldstein JA, Paliga JT, Bartlett SP. Cranioplasty: indications and advances. Curr Opin Otolaryngol Head Neck Surg, 2013, 21(4): 400-409.
3.	Alibhai MK, Balasundaram I, Bridle C, et al. Is there a therapeutic role for cranioplasty? Int J Oral Maxillofac Surg, 2013, 42(5): 559-561.
4.	Schwarz F, Dünisch P, Walter J, et al. Cranioplasty after decompressive craniectomy: is there a rationale for an initial artificial bone-substitute implant? A single-center experience after 631 procedures. J Neurosurg, 2016, 124(3): 710-715.
5.	Liang ES, Tipper G, Hunt L, et al. Cranioplasty outcomes and associated complications: A single-centre observational study. Br J Neurosurg, 2016, 30(1): 122-127.
6.	郭西良, 钱锋, 马奎, 等. 颅骨修补术中“穿梭”缝合硬脑膜悬吊法介绍. 中华神经外科杂志, 2014, 30(3): 224.
7.	Chaturvedi J, Botta R, Prabhuraj AR, et al. Complications of cranioplasty after decomressive craniectomy for traumatic brain injury. Br J Neurosurg, 2016, 30(2): 264-268.
8.	Zanaty M, Chalouhi N, Starke RM, et al. Complications following cranioplasty: incidence and predictors in 348 cases. J Neurosurg, 2015, 123(1): 182-188.
9.	Kim SP, Kang DS, Cheong JH, et al. Clinical analysis of epidural fluid collection as a complication after cranioplasty. J Korean Neurosurg Soc, 2014, 56(5): 410-418.
10.	Lee L, Ker J, Quah BL, et al. A retrospective analysis and review of an institution’s experience with the complications of cranioplasty. Br J Neurosurg, 2013, 27(5): 629-635.
11.	Riordan MA, Simpson VM, Hall WA. Analysis of factors contributing to infections after cranioplasty: A single-institution retrospective chart review. World Neurosurg, 2016, 87: 207-213.
12.	Williams LR, Fan KF, Bentley RP. Custom-made titanium cranioplasty: early and late complications of 151 cranioplasties and review of the literature. Int J Oral Maxillofac Surg, 2015, 44(5): 599-608.
13.	Mukherjee S, Thakur B, Haq I, et al. Complications of titanium cranioplasty—a retrospective analysis of 174 patients. Acta Neurochir (Wien), 2014, 156(5): 989-998.
14.	Kim H, Sung SO, Kim SJ, et al. Analysis of the factors affecting graft infection after cranioplasty. Acta Neurochir (Wien), 2013, 155(11): 2171-2176.
15.	Bonfield CM, Kumar AR, Gerszten PC. The history of military cranioplasty. Neurosurg Focus, 2014, 36(4): E18.
16.	Tsang AC, Hui VK, Lui WM, et al. Complications of post-craniectomy cranioplasty: risk factor analysis and implications for treatment planning. J Clin Neurosci, 2015, 22(5): 834-837.
17.	Krause-Titz UR, Warneke N, Freitag-Wolf S, et al. Factors influencing the outcome (GOS) in reconstructive cranioplasty. Neurosurg Rev, 2016, 39(1): 133-139.
18.	余钻标, 赵峰, 胡亮, 等. 体位准备及硬脑膜悬吊对降低重度颅骨缺损修补术后早期并发症的探讨. 中国医师进修杂志, 2015, 38(8): 603-605.

1. Feroze AH, Walmsley GG, Choudhri O, et al. Evolution of cranioplasty techniques in neurosurgery: historical review, pediatric considerrations, and current trends. J Neurosurg, 2015, 123(4): 1098-1107.
2. Goldstein JA, Paliga JT, Bartlett SP. Cranioplasty: indications and advances. Curr Opin Otolaryngol Head Neck Surg, 2013, 21(4): 400-409.
3. Alibhai MK, Balasundaram I, Bridle C, et al. Is there a therapeutic role for cranioplasty? Int J Oral Maxillofac Surg, 2013, 42(5): 559-561.
4. Schwarz F, Dünisch P, Walter J, et al. Cranioplasty after decompressive craniectomy: is there a rationale for an initial artificial bone-substitute implant? A single-center experience after 631 procedures. J Neurosurg, 2016, 124(3): 710-715.
5. Liang ES, Tipper G, Hunt L, et al. Cranioplasty outcomes and associated complications: A single-centre observational study. Br J Neurosurg, 2016, 30(1): 122-127.
6. 郭西良, 钱锋, 马奎, 等. 颅骨修补术中“穿梭”缝合硬脑膜悬吊法介绍. 中华神经外科杂志, 2014, 30(3): 224.
7. Chaturvedi J, Botta R, Prabhuraj AR, et al. Complications of cranioplasty after decomressive craniectomy for traumatic brain injury. Br J Neurosurg, 2016, 30(2): 264-268.
8. Zanaty M, Chalouhi N, Starke RM, et al. Complications following cranioplasty: incidence and predictors in 348 cases. J Neurosurg, 2015, 123(1): 182-188.
9. Kim SP, Kang DS, Cheong JH, et al. Clinical analysis of epidural fluid collection as a complication after cranioplasty. J Korean Neurosurg Soc, 2014, 56(5): 410-418.
10. Lee L, Ker J, Quah BL, et al. A retrospective analysis and review of an institution’s experience with the complications of cranioplasty. Br J Neurosurg, 2013, 27(5): 629-635.
11. Riordan MA, Simpson VM, Hall WA. Analysis of factors contributing to infections after cranioplasty: A single-institution retrospective chart review. World Neurosurg, 2016, 87: 207-213.
12. Williams LR, Fan KF, Bentley RP. Custom-made titanium cranioplasty: early and late complications of 151 cranioplasties and review of the literature. Int J Oral Maxillofac Surg, 2015, 44(5): 599-608.
13. Mukherjee S, Thakur B, Haq I, et al. Complications of titanium cranioplasty—a retrospective analysis of 174 patients. Acta Neurochir (Wien), 2014, 156(5): 989-998.
14. Kim H, Sung SO, Kim SJ, et al. Analysis of the factors affecting graft infection after cranioplasty. Acta Neurochir (Wien), 2013, 155(11): 2171-2176.
15. Bonfield CM, Kumar AR, Gerszten PC. The history of military cranioplasty. Neurosurg Focus, 2014, 36(4): E18.
16. Tsang AC, Hui VK, Lui WM, et al. Complications of post-craniectomy cranioplasty: risk factor analysis and implications for treatment planning. J Clin Neurosci, 2015, 22(5): 834-837.
17. Krause-Titz UR, Warneke N, Freitag-Wolf S, et al. Factors influencing the outcome (GOS) in reconstructive cranioplasty. Neurosurg Rev, 2016, 39(1): 133-139.
18. 余钻标, 赵峰, 胡亮, 等. 体位准备及硬脑膜悬吊对降低重度颅骨缺损修补术后早期并发症的探讨. 中国医师进修杂志, 2015, 38(8): 603-605.

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BRIDGED DURAL SUSPENSION FOR CRANIOPLASTY BY USING THREE- DIMENSIONAL MOULDING TITANIUM MESH

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