Rammos Charalambos K, Cayci Cenk, Castro-Garcia Jose A, Feiz-Erfan Iman, Lettieri Salvatore C
*Department of Plastic Surgery, Mayo Clinic, Rochester, MN †Division of Neurosurgery ‡Division of Plastic Surgery, Maricopa Medical Center, Phoenix, AZ.
J Craniofac Surg. 2015 May;26(3):631-3. doi: 10.1097/SCS.0000000000001413.
Large cranial defects represent reconstructive challenges. Polyetheretherketone (PEEK) implants are preoperatively tailored to the exact size of the defect and exhibit an excellent combination of strength, durability, and environmental resistance. This study presents our experience with patient-specific PEEK implants with computer modeling.
A retrospective chart review was conducted on all patients who underwent cranioplasty treated by a PEEK implant between 2007 and 2012. Analysis of the preoperative and perioperative data as well as outcome analysis was performed.
A total of 11 patients were included. Mean age was 46 years. The indication for cranioplasty was bone flap infection and subsequent removal in 8 patients, traumatic bone loss in 2 patients, and acquired defect due to cancer resection in 1 patient. The mean time to PEEK cranioplasty since the patient's last operation was 16 months. The mean defect size was 74 cm(2). The mean surgical blood loss was 124 mL. The mean length of stay was 3 days. Complications included 1 postoperative bleeding that required reoperation, but the PEEK implant was successfully salvaged. The mean time to follow-up was 6 months.
Use of patient-specific PEEK implants is a good alternative for alloplastic cranioplasty. It is associated with low morbidity as reported in our series, with additional advantages including strength, stiffness, durability, and inertness. It would be beneficial to assess the longer-term outcomes; however, it appears at first glance that PEEK implants show great promise in calvarial reconstruction.
大型颅骨缺损的修复颇具挑战。聚醚醚酮（PEEK）植入物可在术前根据缺损的确切尺寸进行定制，并且在强度、耐用性和耐环境性方面表现出色。本研究介绍了我们使用计算机建模定制PEEK植入物治疗患者的经验。
对2007年至2012年间接受PEEK植入物颅骨成形术的所有患者进行回顾性病历审查。对术前和围手术期数据进行分析，并进行结果分析。
共纳入11例患者。平均年龄为46岁。颅骨成形术的适应证为：8例患者因骨瓣感染及随后的骨瓣移除，2例患者因创伤性骨质流失，1例患者因癌症切除导致获得性缺损。自患者上次手术至PEEK颅骨成形术的平均时间为16个月。平均缺损面积为74平方厘米。平均手术失血量为124毫升。平均住院时间为3天。并发症包括1例术后出血，需再次手术，但PEEK植入物成功保留。平均随访时间为6个月。
使用定制的PEEK植入物是异体颅骨成形术的良好替代方案。如我们系列报道所示，其发病率较低，还具有强度、硬度、耐用性和惰性等额外优点。评估其长期结果将是有益的；然而，乍一看，PEEK植入物在颅骨重建中显示出巨大的前景。
