• Jian Guo, Xu Hou, Junying Zeng, Xiaodong Chen, Shizhong Zheng, Bingchu Xu, Shoulian Zheng, Zhiliang Liu, and Gengqiang Ling.
• Department of Neurosurgery, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, china.
• World Neurosurg. 2024 Dec 4.

BackgroundCranioplasty is a common neurosurgical procedure aimed at providing structural protection to cerebral tissues and enhancing neurological function. The choice of implant material, particularly polyetheretherketone (PEEK) and titanium mesh, significantly influences postoperative outcomes, including the incidence of subgaleal fluid collections (SFC).ObjectiveThis study investigates the incidence of SFC associated with PEEK and titanium mesh in cranioplasty, identifying risk factors and implications for clinical practice.MethodsA retrospective analysis was conducted on 70 patients who underwent cranioplasty. The incidence of SFC, postoperative complications, and demographic data were collected and analyzed. Statistical comparisons were made between the two implant materials.ResultsThe incidence of SFC was significantly higher in the PEEK group (46.2%) compared to the titanium mesh group (20.5%) (p=0.023). PEEK was identified as an independent risk factor for SFC. Additionally, approximately 60% of postoperative epidural hematoma (PEH) cases presented with SFC, highlighting the importance of meticulous hemostasis during surgery. The overall reoperation rate was 5.7%, consistent with existing literature. Although diabetes mellitus did not show a statistically significant association with SFC (p=0.064), its potential impact on postoperative complications warrants further investigation.ConclusionThe selection of implant materials in cranioplasty significantly affects postoperative outcomes, with PEEK associated with a higher incidence of SFC. Careful material selection, particularly in patients with comorbidities, and meticulous surgical techniques are essential to improve patient outcomes. Future research should focus on the biological interactions between implant materials and cranial tissues to refine guidelines for clinical practice.Copyright © 2024. Published by Elsevier Inc.

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