阿曼的颅骨成形术:2012-2022 年国家颅面中心病例回顾性研究。

Cranioplasty in Oman: Retrospective review of cases from the National Craniofacial Center 2012-2022.

机构信息

Department of Plastic & Reconstructive Surgery, Khoula Hospital, Muscat, Oman.

Department of Plastic & Reconstructive Surgery, University of Toronto, Toronto, Canada.

出版信息

Sultan Qaboos Univ Med J. 2024 May;24(2):250-258. doi: 10.18295/squmj.3.2024.018. Epub 2024 May 27.

Abstract

OBJECTIVES

Cranioplasty is a complex craniofacial and neurosurgical procedure that aims to reinstate the architecture of the cranial vault and elevate both its aesthetic and neurological function. Several reconstructive materials have been thoroughly explored in the search for the optimal solution for cranioplasty. This study aimed to evaluate different material used for cranial reconstruction in Oman.

METHODS

This retrospective study included all patients who had had cranioplasty procedures performed at Khoula Hospital, Muscat, Oman, from 2012 to 2022. Demographic information, the characteristics of the cranial defect and any complications that occurred post-operatively were analysed.

RESULTS

A total of 47 patients were included in this study. The most common cause of cranial defects was craniectomy following traumatic head injury (70.2%) along with excision of fibrous dysplasia (10.6%). The most frequently utilised material for cranial repair was autologous bone grafts (n = 28), followed by polyetheretherketone (PEEK; n = 14). Interestingly, the replacement of bone grafts from previous craniectomy showed a notably high resorption rate (71.4%), in contrast to split calvarial grafts (0%) and other types of bone grafts (14.3%). Additionally, delayed graft infection was observed in 3.6% of the bone graft group and 7.1% of the PEEK group.

CONCLUSION

Patient-specific alloplastic implants such as PEEK have gained popularity for large and complex cranioplasty, as they provide excellent aesthetic outcomes and leave no donor site morbidity. In contrast, bone grafts remain the gold standard for small to medium-sized cranial defects.

摘要

目的

颅骨修复术是一种复杂的颅面和神经外科手术,旨在恢复颅穹窿的结构,并提高其美学和神经功能。为了寻找颅骨修复术的最佳解决方案,已经对几种重建材料进行了深入研究。本研究旨在评估阿曼使用的不同材料用于颅骨重建。

方法

本回顾性研究纳入了 2012 年至 2022 年在阿曼马斯喀特库拉医院行颅骨修复术的所有患者。分析了患者的人口统计学信息、颅骨缺损的特征以及术后发生的任何并发症。

结果

本研究共纳入 47 例患者。颅骨缺损最常见的原因是创伤性颅脑损伤后行颅骨切除术(70.2%),其次是纤维结构不良切除术(10.6%)。最常用于颅骨修复的材料是自体骨移植物(n=28),其次是聚醚醚酮(PEEK;n=14)。有趣的是,与劈开颅骨移植物(0%)和其他类型的骨移植物(14.3%)相比,先前颅骨切除术的骨移植物的吸收率明显更高(71.4%)。此外,骨移植物组中有 3.6%发生延迟移植物感染,PEEK 组中有 7.1%发生延迟移植物感染。

结论

对于大而复杂的颅骨修复术,患者特异性的假体植入物如 PEEK 已越来越受欢迎,因为它们可提供出色的美学效果,且不会造成供区并发症。相比之下,骨移植物仍然是小至中型颅骨缺损的金标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/338a/11139372/d4ea5d5f0c6a/squmj2405-250-258f1.jpg

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