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Cranioplasty Outcomes in a Multidisciplinary Neuroplastic Surgery Program: A Single Center Experience
Jaeda Robinson, BS, Taborah Z. Zaramo BS, Hunter Stecko, BS, Kerry-Ann Mitchell MD PhD
The Ohio State University Department of Plastic and Reconstructive Surgery
2023-02-10
Presenter: Jaeda Robinson
Affidavit:
This work is original
Director Name: Gregory D. Pearson, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Although cranioplasty is a commonly performed procedure to repair skull defect after traumatic brain injury or surgical interventions, 20- 30% require reoperation due to surgery related complications. Studies suggest that a regimented, multidisciplinary approach may decrease risk of complications, particularly in high-risk patients. The objective of this study was to evaluate surgical outcomes of adult patients undergoing cranioplasty utilizing an algorithmic, multidisciplinary approach in a newly developed Neuroplastic Surgery Program.
Methods: We performed a retrospective chart review of adult patients who underwent cranioplasty in the Neuroplastic Surgery Program at The Ohio State University between 2020-2022. Patient demographics, medical comorbidities, cranioplasty indication, timing of cranioplasty, type of implant material, and surgical outcomes were curated from charts. Major complications were those requiring readmission or reoperation, while all others were considered minor.
Results: Thirteen consecutive cases met the inclusion criteria (three males, nine females). The average age was 59 years old, BMI 28.01, and post-surgical follow up time 5 months. All patients had significant risk factors for wound healing complications at baseline, with 6 patients having at least one previous cranioplasty failure, 3 patients with diabetes, and 4 with previous calvarial radiation. Two patients (16%) had a major complication, of which one was a hematoma requiring evacuation and one was a wound dehiscence requiring revision. There were no infections or hardware exposure.
Conclusions: These early outcomes from high-risk patients undergoing cranioplasty suggest that a multidisciplinary, algorithmic approach may decrease the risk of surgery related complications and improve patient outcomes.
