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KMID : 1148420200030020048
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Journal of Neurointensive Care
2020 Volume.3 No. 2 p.48 ~ p.57
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Optimal Timing and Complications of Cranioplasty: A Single-Center Retrospective Review of 109 Cases
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Kim Young-Mook
Park Tae-Joon
Lee Sang-Pyung
Baek Jin-Wook
Ryou Kyoung-Soo
Kim Seong-Hwan
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Abstract
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Objective: Cranioplasty is the surgical reparation of decompressive craniectomy. Although cranioplasty is performed for cosmetic and functional benefits, and is a simple surgical procedure, it is usually associated with a relatively high complication rate, ranging from 10% to 50%.
Methods: This was a retrospective review of 109 patients who had undergone a cranioplasty over a period of 10 years. At our institution, the time period were classified into very early (<30 days), early (between 30-60 days), late (between 60-90 days), and more late (>90 days) interventions based on the time period before cranioplasty. We evaluated postoperative complications and the relationship between their occurrence and the timing of the cranioplasty.
Results: The overall complication rate in this study was 44%. Hydrocephalus was the most common complication (34.9%), followed by infections (6.4%), hematoma (4.6%), and others such as seizure (0.9%) and headache (0.9%). Infections were the only complications whose incidence increased with the early timing of the cranioplasty. The incidence of hematoma increased with the late timing of cranioplasty and was probably a result of its prolonged operation time (p=0.007). The incidence of hydrocephalus was not associated with cranioplasty timing but the indication of craniectomy and the number of revision surgeries performed before cranioplasty. (p=0.046)
Conclusion: Cranioplasty is associated with high rate of complication and the incidence of the complications vary with the timing of the operation. There are many advantages of early cranioplasty that can be redeemed if strict measures are taken, while performing the surgery, to prevent postoperative infections.
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KEYWORD
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Cranioplasty, Complication, Optimal Timing, Infection, Hydrocephalus
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