• Jonathan R Garst, Jacques Lara-Reyna, Willie Elliott, and Andrew J Tsung.
• Department of Neurosurgery, University of Illinois College of Medicine at Peoria, OSF HealthCare Illinois Neurological Institute, Peoria, Illinois, USA. Electronic address: Jonathan.r.garst@osfhealthcare.org.
• World Neurosurg. 2023 May 1; 173: e62e65e62-e65.

BackgroundHistorically, depressed skull fractures that warranted surgery were treated in 2 stages: the first stage involved debridement and craniectomy, followed by the second stage of delayed cranioplasty. More recently, single-stage autologous cranioplasty has been proven to be safe. However, there is a paucity of literature regarding single-stage titanium mesh cranioplasty when autologous repair is not possible.MethodsA retrospective review identified 22 patients who underwent single-stage titanium mesh cranioplasty for the acute treatment of comminuted depressed skull fractures. Fracture location, fracture etiology, timing of surgery, neurologic complications, infection, and cosmetic deformity were recorded. Average follow-up was 9 months.ResultsThe mean age of the patients was 34 years (range: 3-77); 83% were male. Seventeen (77%) involved the frontal bone, with 7 (32%) involving the frontal sinus. Eighteen (82%) had open defects at presentation. Sixteen (73%) were neurologically normal. Average time from presentation to repair was 11 hours (range: 1-28 hours). There were no neurologic worsening, seizures, or infections postoperatively. Antibiotic prophylaxis was prescribed in 13 cases (57%). One patient required revision surgery for persistent cosmetic deformity.ConclusionsAutologous cranioplasty for depressed skull fractures is not always possible especially in cases of significant comminution. From our case series, single-stage titanium mesh cranioplasty appears to be a safe option.Copyright © 2023 Elsevier Inc. All rights reserved.

23 keywords...

hide…