Zegers Thomas, Ter Laak-Poort Mariel, Koper David, Lethaus Bernd, Kessler Peter
Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, P. Debeyelaan 25, 6202AZ Maastricht, The Netherlands.
Department of Neurosurgery, Maastricht University Medical Center, P. Debeyelaan 25, 6202AZ Maastricht, The Netherlands.
J Craniomaxillofac Surg. 2017 Jan;45(1):82-86. doi: 10.1016/j.jcms.2016.10.016. Epub 2016 Nov 2.
Patient specific implants have been used for the reconstruction of large skull bone defects. Several therapeutic effects have been suggested in current literature but were never objectified. The aim of the current study was to evaluate the change in quality of life, pain, aesthetics, and the surgical and medical outcomes after reconstruction of large skull bone defects with titanium or polyetheretherketone (PEEK) implants.
We retrospectively evaluated 29 consecutive patients receiving a patient specific skull implant between November 2004 and December 2015. Twenty-one patients received PEEK implants and eight received titanium implants. Data was acquired regarding quality of life, aesthetics, pain, demographics and complications. Quality of life was measured using the Glasgow Benefit Inventory (GBI). Additional questions were asked concerning pain, satisfaction and aesthetics.
The mean total GBI-score was +26.1 (95%CI 16.8-35.4, p < 0.001). Headache complaints or pain in the operation site improved in 75.0% and 77.8% of these patients, respectively. In 8.0% an increase was seen with regard to both variables.
Reconstruction of skull bone defects with PEEK and titanium patient specific implants gave a statistically significant improvement in quality of life. Furthermore, it decreased pain and headaches and gave aesthetically good results.
定制型植入物已用于大型颅骨缺损的重建。目前文献中提出了几种治疗效果,但从未得到客观证实。本研究的目的是评估使用钛或聚醚醚酮(PEEK)植入物重建大型颅骨缺损后生活质量、疼痛、美观度以及手术和医疗结果的变化。
我们回顾性评估了2004年11月至2015年12月期间连续接受定制型颅骨植入物的29例患者。21例患者接受了PEEK植入物,8例接受了钛植入物。收集了有关生活质量、美观度、疼痛、人口统计学和并发症的数据。使用格拉斯哥效益量表(GBI)测量生活质量。还询问了有关疼痛、满意度和美观度的其他问题。
GBI总分平均值为+26.1(95%CI 16.8 - 35.4,p < 0.001)。这些患者中,分别有75.0%和77.8%的患者头痛主诉或手术部位疼痛有所改善。8.0%的患者在这两个变量上均有所增加。
使用PEEK和钛定制型植入物重建颅骨缺损在生活质量方面有统计学意义的显著改善。此外,它减轻了疼痛和头痛,并取得了良好的美观效果。