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1.
World Neurosurg ; 117: 142-143, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29920388

ABSTRACT

It is a common assumption that the human skull and solid skull implants are impermeable to diagnostic ultrasound. We demonstrated in 2 patients that frontoparietal polyetheretherketone cranioplasties allowed useful imaging of intracranial parenchymal and vascular structures with higher ultrasound frequencies than the 2 MHz used for the temporal bone window. This knowledge about additional imaging properties may be helpful in emergency situations and for vascular monitoring. The decision for a polyether ether ketone cranioplasty may contribute to patient safety.


Subject(s)
Ketones , Plastic Surgery Procedures , Polyethylene Glycols , Prostheses and Implants , Skull/diagnostic imaging , Skull/surgery , Ultrasonography , Benzophenones , Craniotomy , Humans , Male , Middle Aged , Polymers , Ultrasonography/methods
2.
World Neurosurg ; 105: 783-789, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28434964

ABSTRACT

OBJECT: Reconstruction of a cranial vault defect is a frequent challenge in neurosurgery. Polyetheretherketone (PEEK) is used in many types of prostheses and has been employed for 10 years in our institution (University Hospital of Toulouse, France). The objectives of this study are to describe the benefits and drawbacks of reconstructing the cranial vault defect with a PEEK prosthesis. METHODS: Clinical data of the 37 patients who received a reconstruction with a custom-made PEEK prosthesis from 2007-2015 were retrospectively analysed. Operative technique, postoperative complications, and patient's satisfaction with the aesthetic result-on a scale ranging from 1 (very dissatisfied) to 5 (very satisfied)-were studied. RESULTS: Average follow-up was 4.3 years (from 2 months-9 years). The placement of the prosthesis was performed 195 days on average (from 0-1051 days, standard deviation 258 days) after the initial bone flap removal. One infection (2.7%), which required the removal of the prosthesis, was described. Six patients (16%) were reoperated by the maxillofacial surgery team to treat a lack of temporal projection related to muscle atrophy, using a fat cell autograft taken from the abdominal region. Overall, 30 patients (81%) answered the question about their aesthetic satisfaction, with good results on the satisfaction scale (average 4.5; from 3-5). CONCLUSION: The use of a PEEK prosthesis in cranial vault defect reconstruction is a reliable technique with a high patient satisfaction rate and few complications. Corrections of the temporal muscle atrophy by fat grafting may be performed in addition, without increasing the rate of complications.


Subject(s)
Ketones , Polyethylene Glycols , Prostheses and Implants , Prosthesis Implantation , Skull/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Benzophenones , Biocompatible Materials/therapeutic use , Child , Female , Humans , Ketones/adverse effects , Male , Middle Aged , Polyethylene Glycols/adverse effects , Polymers , Postoperative Complications , Prostheses and Implants/adverse effects , Prosthesis Implantation/adverse effects , Plastic Surgery Procedures/methods , Reoperation/adverse effects , Retrospective Studies , Surgical Flaps/surgery , Young Adult
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