Takeuchi Hiroaki, Higashino Yoshifumi, Hosoda Tetsuya, Yamada Shinsuke, Arishima Hidetaka, Kodera Toshiaki, Kitai Ryuhei, Kikuta Ken-Ichiro
Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan.
Acta Neurochir (Wien). 2016 Mar;158(3):571-5. doi: 10.1007/s00701-015-2679-y. Epub 2016 Jan 6.
Autologous bone flaps adequately preserved can be used successfully for repair of cranial bone defects with biological and economic advantages. However, the effect or advantages of cryopreservation of autologous bone flaps using cryoprotectant solutions have not been investigated. The aim of this study was to investigate the utility of autologous bone flaps frozen with glycerol in cranioplasty after decompressive craniectomy.
We evaluated postoperative complications and clinical and aesthetic results in 40 consecutive patients who underwent delayed cranioplasty using autologous bone flaps frozen with glycerol following decompressive craniectomy between 2001 and 2010. Bone flaps removed at the time of external decompression were dipped in 20 % glycerol solution with a sterilized plastic vessel and stored at -84 °C in an ultra-low temperature freezer. The bone flaps were thawed in the vessel at room temperature for 12 h. The bone flaps were taken out of melting glycerol, replaced in their original positions, and fixed with silk sutures or titanium plates. Follow-up periods ranged from 35 to 3745 days (median, 558 days).
Mild resorption of the bone flap occurred in one case. However, there were no cases with local infection and no cases requiring reoperation for complications during the follow-up period.
Cryopreservation with glycerol is a simple and safe method for preservation of autologous bone grafts. The clinical and aesthetic results of delayed cranioplasty using autologous bone flaps frozen with glycerol solution were satisfactory.
充分保存的自体骨瓣可成功用于颅骨缺损修复，具有生物学和经济优势。然而，使用冷冻保护剂溶液对自体骨瓣进行冷冻保存的效果或优势尚未得到研究。本研究的目的是探讨甘油冷冻保存的自体骨瓣在减压性颅骨切除术后颅骨成形术中的应用价值。
我们评估了2001年至2010年间40例连续接受减压性颅骨切除术后使用甘油冷冻保存的自体骨瓣进行延迟颅骨成形术患者的术后并发症、临床及美学效果。在进行外减压时取下的骨瓣浸入装有20%甘油溶液的无菌塑料容器中，并储存在-84°C的超低温冰箱中。骨瓣在容器中于室温下解冻12小时。将骨瓣从融化的甘油中取出，放回原位，并用丝线缝合或钛板固定。随访时间为35至3745天（中位数为(558)天）。
1例出现骨瓣轻度吸收。然而，随访期间无局部感染病例，也无因并发症需要再次手术的病例。
甘油冷冻保存是一种简单、安全的自体骨移植保存方法。使用甘油溶液冷冻保存的自体骨瓣进行延迟颅骨成形术的临床及美学效果令人满意。
