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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2021; 10(02): 103-107
DOI: 10.1055/s-0040-1716933
Original Article

Material of Choice in Pediatric Cranioplasty

Anooja Abdul Salam 
1   Department of Neurosurgery, Royal Hobart Hospital, Affiliated to University of Tasmania, Hobart, Tasmania, Australia
,
Imogen Ibbett
2   Department of Spine, Mater Hospital, Brisbane, Australia
,
Nova Thani
1   Department of Neurosurgery, Royal Hobart Hospital, Affiliated to University of Tasmania, Hobart, Tasmania, Australia
› Author Affiliations Funding None.
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Abstract

Background Current evidence is lacking regarding the optimum material required for cranioplasty in the pediatric population when native bone cannot be replaced. The aim of our survey was to examine current practice in Australia and New Zealand regarding pediatric cranioplasty material.

Methods The online tool SurveyMonkey was used to survey 244 neurosurgeons in Australasia. The survey consisted of five questions concerning preference of material and donor origin for pediatric cranioplasty.

Results Twenty-two neurosurgeons (9%) participated. The results indicate that with small skull defects (< 3 cm) in patients aged 0 to 2years, conservative management with observation alone is the preferred option (65%). In patients aged 3 to 10 years, autologous donor bone was the most popular option, whereas for 11+ years, hydroxyapatite (HA) was the material of choice, followed by titanium. For defects of more than 3 cm, autologous donor bone was preferred in under 11 years. In patients older than 11 years, titanium was the preferred choice (46.67%). The preferred donor origin for autologous cranioplasty in small skull defects (< 3 cm) was split calvarial grafts for all age groups. However, 68.42% of respondents managed those under 2 years conservatively. In large skull defects (> 3 cm), the preferred donor origin was split calvarial grafts for patients older than 3 years (48.3%). In patients aged 0 to 2 years, exchange cranioplasty was the preferred option when cranioplasty was performed.

Conclusion The current practice in Australia and New Zealand is to use autologous donor bone in preference to synthetic materials for cranioplasty in children under 11 years. In children older than 11 years, hydroxyapatite and titanium are the materials of choice.

Keywords

pediatric cranioplasty - autologous - donor graft origin - synthetic cranioplasty material - survey


Publication History

Article published online:
19 April 2021

© 2021. Neurological Surgeons’ Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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