• World Neurosurg · Sep 2017

    Reconstruction of cranial vault defect with polyetheretherketone (PEEK) implants.

    • Pierre Brandicourt, Franck Delanoé, Franck-Emmanuel Roux, Florian Jalbert, David Brauge, and Frédéric Lauwers.
    • Department of Neurosurgery, Hospital Center University of Toulouse, Paul Sabatier University, Toulouse, France. Electronic address: pierre.brandicourt@gmail.com.
    • World Neurosurg. 2017 Sep 1; 105: 783-789.

    ObjectReconstruction 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.MethodsClinical data of the 37 patients who received a reconstruction with a custom-made PEEK prosthesis from 2007-2015 were retrospectively analysed. Operative technique, postoperative complications, and patient's satisfaction with the aesthetic result-on a scale ranging from 1 (very dissatisfied) to 5 (very satisfied)-were studied.ResultsAverage follow-up was 4.3 years (from 2 months-9 years). The placement of the prosthesis was performed 195 days on average (from 0-1051 days, standard deviation 258 days) after the initial bone flap removal. One infection (2.7%), which required the removal of the prosthesis, was described. Six patients (16%) were reoperated by the maxillofacial 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 patients (81%) answered the question about their aesthetic satisfaction, with good results on the satisfaction scale (average 4.5; from 3-5).ConclusionThe use of a PEEK prosthesis in cranial vault defect reconstruction is a reliable technique with a high patient satisfaction rate and few complications. Corrections of the temporal muscle atrophy by fat grafting may be performed in addition, without increasing the rate of complications.Copyright © 2017 Elsevier Inc. All rights reserved.

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