Ono I, Tateshita T, Satou M, Sasaki T, Matsumoto M, Kodama N
Department of Dermatology, Fukushima Medical University School of Medicine, Japan.
Plast Reconstr Surg. 1999 Aug;104(2):339-49. doi: 10.1097/00006534-199908000-00003.
Hydroxyapatite ceramic implants were used in the reconstruction of very large and complex-form cranial bone defects in nine patients. The bone defects were the result of craniectomy after infections and other complications such as severe brain edema, after neurosurgery, and as a result of trauma, subdural hemorrhage, and surgery for brain tumor. The size, shape, and curvature of the hydroxyapatite ceramic implants were determined based on high-precision, full-scale models fabricated through a laser lithographic molding method by using computed tomographic data. The use of this method allowed the fabrication of hydroxyapatite ceramic implants of shapes that accurately matched the area of bone defect, allowing for a minimum of adjustment during the operation even with a complex-form implantation. Not only were good cranial contour reconstructed and aesthetically satisfactory results obtained in the cases treated by incorporating this series of techniques, but neurologic conditions present in some cases were also improved to some extent. The postoperative course has been steady for all nine patients, with no blood transfusions required during or after the operations and no implants requiring removal because of infection or other postoperative complications. The average length of postoperative hospitalization for the nine cases was 11.7 days, remarkably short considering the clinical conditions.
羟基磷灰石陶瓷植入物被用于9例非常大且形状复杂的颅骨缺损重建。这些颅骨缺损是由感染及其他并发症（如严重脑水肿）导致的开颅术后遗留，或是神经外科手术后、外伤、硬膜下出血以及脑肿瘤手术后的结果。羟基磷灰石陶瓷植入物的尺寸、形状和曲率是根据通过激光光刻成型法利用计算机断层扫描数据制作的高精度全尺寸模型来确定的。使用这种方法能够制造出形状与骨缺损区域精确匹配的羟基磷灰石陶瓷植入物，即便在进行复杂形状植入手术时，术中所需调整也最少。通过采用这一系列技术治疗的病例，不仅重建了良好的颅骨外形且获得了令人满意的美学效果，而且部分病例存在的神经状况也在一定程度上得到了改善。所有9例患者术后病程平稳，手术期间及术后均无需输血，也没有植入物因感染或其他术后并发症而需要取出。这9例患者术后平均住院时间为11.7天，考虑到临床情况，这一住院时间非常短。
