ABSTRACT
Objective: The aim of this study is to describe our experience with cranioplasty plus using implantable biomaterials in repairing calvarial defect, and to highlight its necessity in treating this serious condition
Methods: The authors retrospectively reviewed and analysed 107 patients who were operated at King Hussein Medical Centre, during the period between Jan. 2004 and Jan 2015, the final study included 84 patients with acquired skull defects of variable size from [3x4cm to 10x13 cm] and location
Results: cranioplasty using titanium plate or bone cement procedure was technically successful and feasible. Defects were attributable to different pathologies: post depressed fracture 34 cases [40.5%], trauma with decompressive surgery 21 cases [25%], bone tumour 13 [15.5%], infected flap 7 [8.3%], growing skull fracture 9 [10.7%]. The procedure achieved successfully the targets of providing protection for the regions of the brain in 85.7% of cases, by reconstructing the harmonic contours of the damaged cranium and give it anaesthetic appearance. However, the observed complication rate was 14.3% overall in our study [n=12], which included three cases of flap infection, sterile wound dehiscence one case, subgalial collection 4 cases, exteriozation of repair material 2 cases, and loosening of repair material 2 cases
Conclusion: Cranioplasty using Titanium mesh and bone cement was found to be adequate in achieving the wanted goals by re-establishing the integrity of cranium defect, restoring the anatomic and aesthetic deformity, eliminating the risk of traumatic insult to the brain, and relieving the psychological stress of patients and families with a high success rate 85.7%.Cranioplasty is considered simple and safe surgery, however, associated with some complications. Titanium mesh graft repair seems to be easier surgical procedure
ABSTRACT
The purpose of the present study is to describe our experience with endoscopic third ventriculostomy in children with obstructive hydrocephalus secondary to posterior fossa tumours. Between January 2000 and January 2006, 42 children with posterior fossa tumour were treated. Thirty patients had symptomatic hydrocephalus. Third ventriculostomy was performed to relieve intracranial pressure in all cases as an urgent procedure after admission. The other 12 cases had no hydrocephalus or non symptomatic mild dilatation of ventricles. They were excluded from the study. Pre craniectomy endoscopic third ventriculostomy procedures were technically successful. One case was complicated with infection. The procedure resolved the increased intracranial pressure before posterior fossa surgery in all cases. One case developed post operative hydrocephalus and was treated by ventriculo-peritoneal shunt insertion. Endoscopic third ventriculostomy is a plausible choice for the emergency control of severe hydrocephalus caused by posterior fossa tumours. It can quickly eliminate symptoms. In addition, it eliminates the risks of cerebrospinal fluid infection related to external drainage, minimizes the risk of over drainage because it provides more physiological cerebrospinal fluid drainage than the other procedures and avoids the complications of shunting procedures