Rasse Michael, Dodier Phillipe, Sacher Christoph
Medical University of Innsbruck, Christoph Probst-Platz 1, 6020, Innsbruck, Austria.
Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Wien Klin Wochenschr. 2025 Sep 19. doi: 10.1007/s00508-025-02614-7.
Preformed implants based on computed tomography (CT) data have widened the spectrum of calvaria reconstruction. Different materials have been used. Carbon fiber-reinforced resin implants were first introduced into calvaria reconstruction in 1996.
A long-term study of such implants including subjective comfort data as well as a radiological control of adjacent tissues and a thorough clinical investigation seemed of value to see whether or not the implants were integrated and whether there were long-term complications. From a collective of 27 patients with calvarial defects surgically treated at least 20 years ago with insertion of such an implant, 9 patients could be followed up. A neurological and maxillofacial status was performed, The CT scans were obtained to assess the implant fit, changes in surrounding tissues and the brain. A health-related quality of life evaluation was performed.
There was no implant loss or operative revision. No infection was experienced. Patient satisfaction was maximum in all cases. The stated restrictions in quality of life in the case histories, impaired esthetics, pain and dysesthesia, were completely cured after implantation and were permanent over more than 20 years. There were no neurological pathologies evoked by the reconstruction, except a slight dysesthesia along the coronal scar and a minor muscular atrophy of the temporal muscle in one case each. No other functional deficits were detected. The implant fit was undisturbed without any implant loosening or resorption of bone.
Carbon fiber-reinforced resin implants seem a valuable option for calvarial reconstruction. The material proved to be biologically inert.
基于计算机断层扫描（CT）数据的预制植入物拓宽了颅骨重建的范围。已使用了不同的材料。碳纤维增强树脂植入物于1996年首次引入颅骨重建。
对这类植入物进行长期研究，包括主观舒适度数据、对相邻组织的放射学对照以及全面的临床调查，似乎有价值来观察植入物是否整合以及是否存在长期并发症。在至少20年前接受此类植入物插入手术治疗的27例颅骨缺损患者群体中，有9例患者能够得到随访。进行了神经和颌面状况检查，获取CT扫描以评估植入物的适配情况、周围组织和大脑的变化。进行了与健康相关的生活质量评估。
没有植入物丢失或进行手术翻修。没有发生感染。所有病例中患者满意度最高。病史中所述的生活质量受限、美学受损、疼痛和感觉异常，在植入后完全治愈且在20多年来一直保持。除了一例沿冠状瘢痕有轻微感觉异常和一例颞肌有轻微肌肉萎缩外，重建未引发其他神经病变。未检测到其他功能缺陷。植入物适配良好，没有任何植入物松动或骨质吸收。
碳纤维增强树脂植入物似乎是颅骨重建的一个有价值的选择。该材料被证明具有生物惰性。
