Reconstruction of cranial vault defect with polyetheretherketone (PEEK) implants

• Published in: World neurosurgery 2017-09, Vol.105, p.783-789
• Main Authors: Brandicourt, Pierre, Delanoé, Franck, Roux, Franck-Emmanuel, Jalbert, Florian, Brauge, David, Lauwers, Frédéric
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biocompatible Materials - therapeutic use; Bioengineering; Child; Cranioplasty; Female; Humans; Ketones - adverse effects; Life Sciences; Male; Middle Aged; Neurosurgery; Polyetheretherketone; Polyethylene Glycols - adverse effects; Postoperative Complications; Prostheses and Implants - adverse effects; Prosthesis; Prosthesis Implantation - adverse effects; Reconstruction of the cranial vault; Reconstructive Surgical Procedures - methods; Reoperation - adverse effects; Retrospective Studies; Skull - surgery; Surgical Flaps - surgery; Young Adult
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2017.04.049

Summary Object Reconstruction of a cranial vault defect is a frequent challenge in neurosurgery. Polyetheretherketone (PEEK) is used in many types of prostheses and has been employed for 10 years in our institution (University Hospital of Toulouse - France). The objectives of this study are to describe the benefits and drawbacks of reconstructing the cranial vault defect with a PEEK prosthesis. Methods Clinical data of the 37 patients who received a reconstruction with a custom-made PEEK prosthesis from 2007 to 2015 were retrospectively analysed. Operative technique, post-operative complications and patient’s satisfaction with the aesthetic result – on a scale ranging from 1 (very dissatisfied) to 5 (very satisfied) – were studied. Results Average follow-up was 4.3 years (from 2 months to 9 years). The placement of the prosthesis was performed 195 days on average (from 0 to 1051 days – sd 258 days) after the initial bone flap removal. One infection (2.7%) was described, which required the removal of the prosthesis. Six patients (16%) were re-operated by the maxillo-facial surgery team to treat a lack of temporal projection related to muscle atrophy, using a fat cell autograft taken from the abdominal region. Overall, 30 (81%) answered the question about their aesthetic satisfaction, with good results on the satisfaction scale (average 4.5; from 3 to 5). Conclusion The use of a PEEK prosthesis in cranial vault defect reconstruction is a reliable technique with a high patient satisfaction rate and with few complications. Corrections of the temporal muscle atrophy by fat grafting may be performed in addition, without increasing the rate of complications.