Okumura T, Oda Y, Mori K, Uchida Y, Morimoto M, Kamimura Y, Seike M, Murata T, Arisawa M
No Shinkei Geka. 1984 Mar;12(3 Suppl):246-52.
External decompression is an effective treatment for acute intracranial hypertension, but the repair of cranial defect by cranioplasty is necessary sooner or later. Various materials have been used for cranioplasty, such as bone, metallic materials and methyl methacrylate. Alumina ceramic (Bioceram), which is known to be extremely compatible with tissues, has already been used in the operations of not only orthopedic and oral surgery but also neurosurgery such as transsphenoidal surgery and anterior cervical fusion. At first, we implanted pieces of ceramic and small titan shield in the parietal bone of mongrel dogs. In this experimental study, tissue compatibility and osteogenesis are investigated in each case. The new bone formation was observed macroscopically and histologically around the ceramic pieces, but there were no osteogenic changes around the titan shields. Then ceramic plates, which were designed just as patients' own bone flaps, and titan shields were used for cranioplasties after decompression surgery, and compared clinically and histologically. The ceramic plate is superior than the titan shield in its strength, tissue-compatibility and excellent fit for cranial defect compared with the titan shield. There was no tissue reaction such as subgaleal fluid collection just as seen in the application of acryl resin. We believe that Alumina ceramic (Bioceram) is a good material for cranioplasty.
外减压术是治疗急性颅内高压的一种有效方法,但迟早需要通过颅骨成形术修复颅骨缺损。多种材料已被用于颅骨成形术,如骨、金属材料和甲基丙烯酸甲酯。氧化铝陶瓷(生物陶瓷)已知与组织具有极高的相容性,不仅已用于整形外科和口腔外科手术,还用于神经外科手术,如经蝶窦手术和颈椎前路融合术。起初,我们将陶瓷片和小钛片植入杂种犬的顶骨。在本实验研究中,对每种情况的组织相容性和成骨情况进行了研究。在陶瓷片周围宏观和组织学上均观察到新骨形成,但钛片周围未出现成骨变化。然后,将设计成患者自身骨瓣形状的陶瓷板和钛片用于减压手术后的颅骨成形术,并进行临床和组织学比较。与钛片相比,陶瓷板在强度、组织相容性以及与颅骨缺损的良好贴合度方面均优于钛片。与应用丙烯酸树脂时所见情况不同,未出现如帽状腱膜下积液等组织反应。我们认为氧化铝陶瓷(生物陶瓷)是颅骨成形术的一种良好材料。