Intraoperative fabrication of patient-specific moulded implants for skull reconstruction: single-centre experience of 28 cases

Stieglitz, Lennart Henning; Gerber, Nicolas; Schmid, Thomas; Mordasini, Pasquale; Fichtner, Jens; Fung, Christian; Murek, Michael; Weber, Stefan; Raabe, Andreas; Beck, Jürgen (2014). Intraoperative fabrication of patient-specific moulded implants for skull reconstruction: single-centre experience of 28 cases. Acta neurochirurgica, 156(4), pp. 793-803. Springer 10.1007/s00701-013-1977-5

[img] Text
art%3A10.1007%2Fs00701-013-1977-5.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (904kB) | Request a copy

BACKGROUND Intraoperatively fabricated polymethylmethacrylate (PMMA) implants based on computer-designed moulds were used to improve cosmetic results after hard tissue replacement. To assess the implant's cosmetic and functional results we performed both subjective and objective assessments. METHODS This retrospective analysis was performed using a cohort of 28 patients who received PMMA implants between February 2009 and March 2012. The cosmetic and functional results were assessed using a patient questionnaire. Furthermore an objective volumetric subtraction score (0-100) was applied and implant thickness, as well as gaps and tiers, were measured. RESULTS Patients mainly judged their cosmetic result as "good". Two of the 28 patients found their cosmetic result unfavourable. The functional result and stability was mainly judged to be good. Measurements of implant thickness showed a very high correlation with the thickness of the contralateral bone. Volumetric subtraction led to a median quality of 80 on a scale from 0 to 100. Median gaps around the margins of the implant were 1.5 mm parietally, 1.7 mm frontally and 3.5 mm fronto-orbitally, and median tiers were 1.2 mm, 0 mm and 0 mm respectively. The overall rate of surgical revisions was 10.7 % (three patients). Two patients suffered from wound healing disturbances (7.1 %). The overall complication rate was comparable to other reports in the literature. CONCLUSIONS Implantation of intraoperatively fabricated patient-specific moulded implants is a cost-effective and safe technique leading to good clinical results with a low complication rate.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy > ARTORG Center - Artificial Hearing Research
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy
06 Faculty of Humanities > Department of History and Archaeology > Institute of History > Medieval History

UniBE Contributor:

Stieglitz, Lennart; Gerber, Nicolas; Schmid, Thomas; Mordasini, Pasquale; Fichtner, Jens; Fung, Christian; Murek, Michael; Weber, Stefan; Raabe, Andreas and Beck, Jürgen

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology
900 History > 940 History of Europe

ISSN:

0001-6268

Publisher:

Springer

Language:

English

Submitter:

Nicole Söll

Date Deposited:

18 Aug 2014 09:36

Last Modified:

01 Dec 2017 11:35

Publisher DOI:

10.1007/s00701-013-1977-5

PubMed ID:

24442601

Uncontrolled Keywords:

hemicraniectomy, PMMA, PSI, PSMI, Skull reconstruction

BORIS DOI:

10.7892/boris.45810

URI:

https://boris.unibe.ch/id/eprint/45810

Actions (login required)

Edit item Edit item
Provide Feedback