Background: Cranioplasty is a well-known neurosurgical
technique used for repairing cranial defects. It is performed to
protect the brain, restore its appearance, and reverse the altered
cerebral physiology. There is an ongoing debate on the best material and timing for cranioplasty in pediatric patients.
Aim of Study: The present study aimed to evaluate the results of cranioplasty with various materials in pediatric patients.
Patients and Methods: A retrospective study was conducted at a single center on pediatric patients who had undergone
cranioplasty with any material from January 2020 to December
2021. A total of 54 consecutive cranioplasties in 46 patients
were studied. Data on the patient’s gender, age, cause of skull
defect, implant type, number of cranioplasties done per patient,
cosmetic outcome, wound healing, complications, and complications management were documented. The follow-up interval
ranged from 24–36 months.
Results: The cranioplasty procedure did not result in any
mortality. Six (30%) out of 20 patients with autologous graft
cranioplasty developed complications; Two cases experienced
complications of subcutaneous surgical emphysema at the site
where the rib graft was taken, while four cases had graft resorption and required a second surgery using titanium mesh. Six
(17.6%) out of 34 cases of synthetic graft cranioplasty developed complications; Two cases of infection in acrylic cranioplasty were successfully treated with antibiotics, and four cases
of acrylic cranioplasty underwent cracking and fragmentation
into pieces then reoperated using titanium mesh.
Conclusion: Pediatric patients have a higher incidence of
experiencing spontaneous resorption with autologous bone
grafts. Patients above 5 years can safely undergo cranioplasty using synthetic material. Acrylic cranioplasty provides a safe
and effective option for centers with limited facilities, but the
long-term efficacy of acrylic material should be studied in a
more comprehensive study. |
