Moellmann Henriette L, Mehr Vanessa N, Karnatz Nadia, Wilkat Max, Riedel Erik, Rana Majeed
Department of Oral and Maxillofacial Surgery, University Hospital Duesseldorf, 40225 Duesseldorf, Germany.
J Clin Med. 2022 Apr 6;11(7):2045. doi: 10.3390/jcm11072045.
Cranioplasties show overall high complication rates of up to 45.3%. Risk factors potentially associated with the occurrence of postoperative complications are frequently discussed in existing research. The present study examines the positioning of 39 patient-specific implants (PSI) made from polyetheretherketone (PEEK) and retrospectively investigates the relationship between the fitting accuracy and incidence of postoperative complications. To analyze the fitting accuracy of the implants pre- and post-operatively, STL files were created and superimposed in a 3D coordinate system, and the deviations were graphically displayed and evaluated along with the postoperative complications. On average, 95.17% (SD = 9.42) of the measurements between planned and surgically achieved implant position were within the defined tolerance range. In cases with lower accordance, an increased occurrence of complications could not be demonstrated. The overall postoperative complication rate was 64.1%. The fitting of the PEEK-PSI was highly satisfactory. There were predominantly minor deviations of the achieved compared to the planned implant positions; however, estimations were within the defined tolerance range. Despite the overall high accuracy of fitting, a considerable complication rate was found. To optimize the surgical outcome, the focus should instead be directed towards the investigation of other risk factors.
颅骨成形术显示总体并发症发生率高达45.3%。现有研究中经常讨论可能与术后并发症发生相关的风险因素。本研究检查了39个聚醚醚酮（PEEK）材质的患者特异性植入物（PSI）的定位情况，并回顾性研究了贴合精度与术后并发症发生率之间的关系。为了分析植入物术前和术后贴合精度，创建了STL文件并在三维坐标系中进行叠加，偏差以图形方式显示，并与术后并发症一起进行评估。平均而言，计划植入位置与手术实际植入位置之间的测量值有95.17%（标准差=9.42）在规定的公差范围内。在符合度较低的情况下，未发现并发症发生率增加。总体术后并发症发生率为64.1%。PEEK-PSI的贴合度非常令人满意。与计划植入位置相比，实际位置主要存在微小偏差；然而，估计值在规定的公差范围内。尽管贴合精度总体较高，但仍发现了相当高的并发症发生率。为了优化手术结果，应转而关注其他风险因素的研究。
