Cranioplasty

A cranioplasty (from ancient Greek κρανίον krānion , German 'skull' and πλαστική (τέχνη) plastikē (tekhnē) , German ' plastic ' (as surgical restoration)) is an operation in which a defect or deformity of the skull is repaired or restored.

The procedure is classified as 5-020 cranioplasty according to OPS-301 .

indication

The main indications are the removal of a disfiguring deformity of the skull and the mechanical vulnerability of the skull and brain .

methodology

Earlier procedures used a gold plate or bone transplants , currently plastics such as polymethyl methacrylate (PMMA), metals such as titanium , various ceramics or, preferably, the body's own bones , often the removed bone cover during a relief operation ( craniectomy ), are used.

An implant that is individually adapted to the contour of the skull is often required. This can be generated by laser sintering or other 3D printing processes .

Complications

As with any surgical procedure, complications such as infection, bleeding, and necrosis of the transplant can occur.

history

After trephination , cranioplasty is also a very old procedure that began around 2000 BC. Was carried out by the Incas .

Probably the first surviving report of a skull plastic comes from Gabriele Falloppio , who recommended reattaching one's own bone in the case of skull fractures if the dura was not injured. Otherwise a gold plate should be used.

In 1668, the Dutch doctor Job Janszoon van Meekeren (1593-1674) described a cranioplasty using a bone transplant from a dog's skull in a gunshot wound in a soldier for the first time.

literature

• E. Archavlis, MC Nievas: Cranioplasty after supratentorial decompressive craniectomy. When is the best time? In: The neurologist . Vol. 83, No. 6, June 2012, pp. 751-758, doi: 10.1007 / s00115-011-3424-2 , PMID 22215218 .
• EK Park, JY Lim, IS Yun, JS Kim, SH Woo, DS Kim, KW Shim: Cranioplasty Enhanced by Three-Dimensional Printing: Custom-Made Three-Dimensional-Printed Titanium Implants for Skull Defects. In: The Journal of craniofacial surgery. Vol. 27, No. 4, June 2016, pp. 943-949, doi: 10.1097 / SCS.0000000000002656 , PMID 27192643 .
• L. Williams, K. Fan, R. Bentley: Titanium cranioplasty in children and adolescents. In: Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery. [electronic publication before printing] April 2016, doi: 10.1016 / j.jcms.2016.03.010 , PMID 27174495 .

Individual evidence

1. ↑ ^{a b} http://hss.ulb.uni-bonn.de/2006/0901/0901.pdf RJ Kriegel: Dome plastic for large skull defects with PMMA (polymethyl methacrylate) or Tutoplast (R) processed autogenous bone grafts. Diss. Bonn, 2006
2. ↑ M. Bullemer: Medical technology: Individual implant production In: Deutsches Ärzteblatt Vol. 109, No. 16, 2012, p. 24
3. ↑ S. Honeybul, KM Ho: Cranioplasty: morbidity and failure. In: British journal of neurosurgery. [Electronic publication before printing] May 2016, doi: 10.1080 / 02688697.2016.1187259 , PMID 27215939 .
4. ↑ CB COURVILLE: Cranioplasty in prehistoric times. In: Bulletin of the Los Angeles Neurological Society. Vol. 24, No. 1, March 1959, pp. 1-8, PMID 13629188 .
5. ^ A. Sanan, SJ Haines: Repairing holes in the head: a history of cranioplasty. In: Neurosurgery. Vol. 40, No. 3, March 1997, pp. 588-603, PMID 9055300 .
6. ↑ B. Häseker: Mr. Job van Meekeren (1611-1666) and surgery of the hand. In: Plastic and reconstructive surgery. Volume 82, Number 3, September 1988, pp. 539-546, PMID 3043489 .

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