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Analysis of Complications After Cranioplasty With a Customized Three-Dimensional Titanium Mesh Plate

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Analysis of Complications After Cranioplasty With a Customized Three-Dimensional Titanium Mesh Plate

Haewon Roh et al. World Neurosurg.

Abstract

Objective: To report outcomes of cranioplasty (CP) with a customized three-dimensional (3D) titanium mesh plate and identify the relationship between various clinical variables and complications after CP.

Methods: Twenty patients who underwent surgery with customized 3D titanium mesh plates and had follow-up for >6 months from January 2015 to December 2017 were enrolled. Complications related to CP were retrospectively reviewed. Patients were divided into 2 groups (no complication group and complication group), and clinical variables related to complications were compared between the 2 groups. Correlation analysis was performed to identify the clinical variable significantly correlated with complications after CP with a customized 3D titanium mesh plate.

Results: Of 20 patients, 11 developed complications, including extrusion, intracranial infection, severe operative site pain, and wound dehiscence. Among the clinical variables, only the presence of a ventriculoperitoneal shunt was significantly correlated with the overall complication rate (odds ratio = 18.66; 95% confidence interval, 1.56-222.92; P = 0.021).

Conclusions: A customized 3D titanium mesh plate is associated with a lower risk of intracranial infection, but the rate of postoperative complications, mainly cosmetic problems, such as forehead mesh extrusion and dehiscence, was high at 55%. A ventriculoperitoneal shunt was significantly correlated with the overall complication rate after CP with a customized 3D titanium mesh plate.

Keywords: Complication; Cranioplasty; Customized 3D titanium; Extrusion; Mesh; Titanium; Ventriculoperitoneal shunt.

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