New reconstructive technologies after decompressive craniectomy in traumatic brain injury: The role of three-dimensional titanium mesh

Woon Man Kung, Feng Huei Lin, Sheng Huang Hsiao, Wen Ta Chiu, Charng Cherng Chyau, Shing Hwa Lu, Betau Hwang, Jia Hua Lee, Muh Shi Lin

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Functional and aesthetic reconstruction after wide decompressive craniectomy directly correlates with subsequent quality of life. Advancements in the development of biomaterials have now made three-dimensional (3-D) titanium mesh a new option for the repair of skull defects after craniectomy. The purpose of this study was to review aesthetic and surgical outcomes and complications of patients who had skull defects repaired with 3-D titanium mesh. The records of 40 adult patients (31 unilateral craniectomies and 9 bilateral craniectomies) who underwent a computer-assisted designed titanium mesh implant at a university hospital from January 2008 to January 2010 were retrospectively reviewed. Aesthetic outcomes, cranial nerve V and VII function, and complications (hardware extrusions, meningitis, osteomyelitis, brain abscess, and pneumocephalus) were evaluated. The craniofacial symmetry, implant stability, and functional outcomes were excellent for all patients. No patients had trigeminal or facial dysfunction. All had excellent cosmetic results as measured by post-reduction radiographs and personal and family perceptions of the forehead contour. Two patients had delayed wound healing and subsequent subclinical wound infections, which resolved after treatment with antibiotics for 2 weeks. Craniofacial skeletal reconstruction with 3-D titanium mesh results in excellent forehead contour and cosmesis, and subsequently a better quality of life with few complications. Titanium mesh reconstruction offers a favorable alternative to other graft materials in the repair of large skull defects.

Original languageEnglish
Pages (from-to)2030-2037
Number of pages8
JournalJournal of Neurotrauma
Volume29
Issue number11
DOIs
Publication statusPublished - Jul 20 2012

Keywords

  • cosmesis
  • decompressive craniectomy
  • head injury
  • quality of life
  • reconstruction
  • three-dimensional titanium mesh

ASJC Scopus subject areas

  • Clinical Neurology

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