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J Neurol Surg A Cent Eur Neurosurg 2018; 79(05): 386-390
DOI: 10.1055/s-0038-1641567
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Hybrid Technique for Cranial Defect Reconstruction: Surgical Results over a 10-Year Period in a Single Institution

Pablo David Guerrero-Suarez
1   Department of Surgical Neurology, Toluca Medical Center of Social Security Institute of the State of Mexico and Provinces, Metepec, State of Mexico, Mexico
,
Paola Guerrero-López
1   Department of Surgical Neurology, Toluca Medical Center of Social Security Institute of the State of Mexico and Provinces, Metepec, State of Mexico, Mexico
,
Abarin Ortiz-Leon
1   Department of Surgical Neurology, Toluca Medical Center of Social Security Institute of the State of Mexico and Provinces, Metepec, State of Mexico, Mexico
,
Haydee Samantha Sosa-Castillo
2   Amphitheater, Universidad Nacional Autonoma de Mexico Facultad de Medicina, Mexico, Mexico City, Mexico
,
Lenny Marlene Velazquez-Gonzalez
3   Anatomy, Universidad Nacional Autonoma de Mexico Facultad de Medicina, Mexico, Mexico City, Mexico
,
Jaime Jesus Martinez-Anda
4   ABC Medical Center - Neurological Center, Mexico City, Mexico City, Mexico
› Author Affiliations
Further Information

Publication History

01 July 2017

29 November 2017

Publication Date:
11 June 2018 (online)

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Abstract

Decompressive craniectomy is an urgent procedure that is increasingly used for treatment of intracranial hypertension. After recovery, reconstruction of the cranial defect is necessary. Cranioplasty is an elective procedure with a high potential for morbidity if care is not taken on different surgical factors such as the material used as the cranial flap. In Latin America, high costs in some materials used in cranioplasty make its use prohibitive for some patients and institutions, and looking for alternatives has become a priority in neurosurgical centers. An autologous bone flap is an excellent option possessing the characteristics of an ideal material for cranioplasty. Nevertheless, its use is associated with high morbidity and flap failure. We report our mono-institutional experience in a 10-year period of a hybrid technique for cranioplasty using an autologous bone flap with titanium plates. Sixty-five patients underwent the technique, with good cosmetic results in 89.2% and success in functional result in 90.8% of patients . No significant statistical differences were found on the timing of the surgery or the location of the cranial defect. We had a 1.5% rate of surgical site infection, less than that reported on previous series. We propose that the hybrid technique of cranioplasty is a safety and effective option for cranial defect reconstruction.

Keywords

decompressive craniectomy - cranioplasty - autologous bone flap
 

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