Outcome in patient-specific PEEK cranioplasty: A two-center cohort study of 40 implants

• Published in: Journal of cranio-maxillo-facial surgery Vol. 44; no. 9; pp. 1266 - 1272
• Main Authors: Jonkergouw, J., van de Vijfeijken, S.E.C.M., Nout, E., Theys, T., Van de Casteele, E., Folkersma, H., Depauw, P.R.A.M., Becking, A.G.
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.09.2016
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biocompatible Materials - therapeutic use; Child; Computer aided-design and modelling; Cranial vault reconstruction; Craniectomy; Cranioplasty; Female; Humans; Ketones - therapeutic use; Male; Middle Aged; Netherlands - epidemiology; Neurosurgical Procedures - instrumentation; Neurosurgical Procedures - methods; Patient specific implant; PEEK; Polyethylene Glycols - therapeutic use; Postoperative Complications - epidemiology; Prostheses and Implants; Reconstructive Surgical Procedures - instrumentation; Reconstructive Surgical Procedures - methods; Retrospective Studies; Skull - surgery; Surgery; Treatment Outcome; Cranioplasty; Computer aided-design and modelling; Patient specific implant; Cranial vault reconstruction; Craniectomy; PEEK
• ISSN: 1010-5182; 1878-4119; 1878-4119
• DOI: 10.1016/j.jcms.2016.07.005

The best material choice for cranioplasty following craniectomy remains a subject to discussion. Complication rates after cranioplasty tend to be high. Computer-assisted 3-dimensional modelling of polyetheretherketone (PEEK) was recently introduced for cranial reconstruction. The aim of this study was to evaluate patient- and surgery-related characteristics and risk factors that predispose patients to cranioplasty complications. This retrospective study included a total of 40 cranial PEEK implants in 38 patients, performed at two reference centers in the Netherlands from 2011 to 2014. Complications were registered and patient- and surgery-related data were carefully analysed. The overall complication rate of PEEK cranioplasty was 28%. Complications included infection (13 %), postoperative haematoma (10 %), cerebrospinal fluid leak (2.5 %) and wound-related problems (2.5 %). All postoperative infections required removal of the implant. Nonetheless removed implants could be successfully re-used after re-sterilization. Although overall complication rates after PEEK cranioplasty remain high, outcomes are satisfactory, as our results compare favourably to recent literature reports on cranial vault reconstruction.