Silva Rafael Denadai Pigozzi DA, Raposo-Amaral Cesar Augusto, Guidi Marcelo Campos, Raposo-Amaral Cassio Eduardo, Buzzo Celso Luiz
- SOBRAPAR Hospital, Institute of Craniofacial Plastic Surgery, Campinas, Sao Paulo State, Brazil.
Rev Col Bras Cir. 2017 Mar-Apr;44(2):154-162. doi: 10.1590/0100-69912017002008.
to present our experience in the surgical treatment of extensive skullcap defects with customized acrylic implants.
we conducted a retrospective analysis of patients with extensive skull defects undergoing acrylic cranioplasties between 2004 and 2013. We carefully selected all patients and classified surgical results based on three scales (craniofacial esthetics, improvement of facial symmetry and need for additional surgery).
fifteen patients underwent cranioplasty with intraoperative acrylic implants, whether manually customized (46.67%) or made with prototyped three-dimensional biomodels (53.33%). There were two (13.33%) complications (one infection with implant withdrawal and one seroma). We considered the craniofacial aesthetics excellent (50%), the degree of improvement of craniofacial symmetry satisfactory (57.14%), and the overall mean of surgical results according to the need for new surgeries was 1.5±0.52.
cranioplasties of patients with extensive skullcap defects should obey careful and predetermined criteria, both for selection and for the acrylic implant customization method.
介绍我们使用定制丙烯酸植入物治疗大面积颅骨缺损的手术经验。
我们对2004年至2013年间接受丙烯酸颅骨成形术的大面积颅骨缺损患者进行了回顾性分析。我们仔细挑选了所有患者，并根据三个标准（颅面美学、面部对称性改善情况和是否需要额外手术）对手术结果进行分类。
15例患者接受了术中丙烯酸植入物颅骨成形术，其中手动定制的占46.67%，使用三维生物模型原型制作的占53.33%。出现了2例（13.33%）并发症（1例感染伴植入物取出，1例血清肿）。我们认为颅面美学效果极佳（50%），颅面对称性改善程度令人满意（57.14%），根据是否需要再次手术得出的手术结果总体平均值为1.5±0.52。
对于大面积颅骨缺损患者的颅骨成形术，无论是在患者选择还是丙烯酸植入物定制方法方面，都应遵循谨慎且预先确定的标准。
