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  • Beynon, Christopher  (4)
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  • 1
    Online Resource
    Online Resource
    Long-term complications and implant survival rates after cranioplastic surgery: a single-center study of 392 patients
    Springer Science and Business Media LLC ; 2021
    In:  Neurosurgical Review Vol. 44, No. 3 ( 2021-06), p. 1755-1763
    Details
    In: Neurosurgical Review, Springer Science and Business Media LLC, Vol. 44, No. 3 ( 2021-06), p. 1755-1763
    Abstract: Cranioplasty (CP) is a standard procedure in neurosurgical practice for patients after (decompressive) craniectomy. However, CP surgery is not standardized, is carried out in different ways, and is associated with considerable complication rates. Here, we report our experiences with the use of different CP materials and analyze long-term complications and implant survival rates. We retrospectively studied patients who underwent CP surgery at our institution between 2004 and 2014. Binary logistic regression analysis was performed in order to identify risk factors for the development of complications. Kaplan-Meier analysis was used to estimate implant survival rates. A total of 392 patients (182 females, 210 males) with a mean age of 48 years were included. These patients underwent a total of 508 CP surgeries. The overall complication rate of primary CP was 33.2%, due to bone resorption/loosening (14.6%) and graft infection (7.9%) with a mean implant survival of 120 ± 5 months. Binary logistic regression analysis showed that young age ( 〈  30 years) ( p  = 0.026, OR 3.150), the presence of multidrug-resistant bacteria ( p  = 0.045, OR 2.273), and cerebrospinal fluid (CSF) shunt ( p  = 0.001, OR 3.137) were risk factors for postoperative complications. The use of titanium miniplates for CP fixation was associated with reduced complication rates and bone flap osteolysis as well as longer implant survival rates. The present study highlights the risk profile of CP surgery. Young age ( 〈  30 years) and shunt-dependent hydrocephalus are associated with postoperative complications especially due to bone flap autolysis. Furthermore, a rigid CP fixation seems to play a crucial role in reducing complication rates.
    Type of Medium: Online Resource
    ISSN: 0344-5607 , 1437-2320
    URL: Article
    DOI: 10.1007/s10143-020-01374-4
    RVK:
    XA 10000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1474861-7
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Preoperative lumbar drainage placement for surgical cranioplasty
    Elsevier BV ; 2018
    In:  Journal of Clinical Neuroscience Vol. 52 ( 2018-06), p. 88-91
    Details
    In: Journal of Clinical Neuroscience, Elsevier BV, Vol. 52 ( 2018-06), p. 88-91
    Type of Medium: Online Resource
    ISSN: 0967-5868
    URL: Article
    DOI: 10.1016/j.jocn.2018.03.008
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 2009190-4
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Long-Term Results of Neurological Outcome, Quality of Life, and Cosmetic Outcome After Cranioplastic Surgery: A Single Center Study of 202 Patients
    Frontiers Media SA ; 2021
    In:  Frontiers in Neurology Vol. 12 ( 2021-7-20)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 12 ( 2021-7-20)
    Abstract: Objective: An increased interest in the surgical procedures of decompressive craniectomy (DC) and subsequent cranioplasty (CP) has emerged during the last decades with specific focus on mortality and complication rates. The aim of the present study was to evaluate long-term neurological and cosmetic outcomes as well as Quality of Life (QoL) after CP surgery. Methods: We retrospectively reviewed the medical records of CP patients treated at our institution between 2004 and 2014 and performed a follow-up examination, with evaluation of neurological outcome using the modified Rankin Scale (mRS) and the Glasgow outcome scale (GOS), QoL (SF-36 and EQ-5D-3L). Furthermore, the cosmetic results after CP were analyzed. Results: A total of 202 CP-patients were included in the present study. The main indications for DC and subsequent CP were space-occupying cerebral ischemia (32%), traumatic brain injury (TBI, 26%), intracerebral or subarachnoid hemorrhage (32%) and infection (10%). During a mean follow-up period of 91.9 months 46/42.6% of patients had a favorable neurological outcome (mRS ≤ 3/GOS ≥ 4). Patients with ischemia had a significant worse outcome (mRS 4.3 ± 1.5) compared with patients after TBI (3.1 ± 2.3) and infectious diseases requiring CP (2.4 ± 2.3). The QoL analysis showed that & lt;1/3rd of patients (31.2%) had a good QoL (SF-36) with a mean EQ-5D-VAS of 59 ± 26. Statistical analysis confirmed a significant worse QoL of ischemia patients compared to other groups whereas multivariate regression analysis showed no other factors which may had an impact on the QoL. The majority (86.5%) of patients were satisfied with the cosmetic result after CP and regression analysis showed no significant factors associated with unfavorable outcomes. Conclusion: Long-term outcome and QoL after CP were significantly influenced by the medical condition requiring DC. Early detection and evaluation of QoL after CP may improve the patient's outcome due to an immediate initiation of targeted therapies (e.g., occupational- or physiotherapy).
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    DOI: 10.3389/fneur.2021.702339
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2564214-5
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  • 4
    Online Resource
    Online Resource
    Polymethylmethacrylate patient-matched implants (PMMA-PMI) for complex and revision cranioplasty: analysis of long-term complication rates and patient outcomes
    Informa UK Limited ; 2020
    In:  Brain Injury Vol. 34, No. 2 ( 2020-01-28), p. 269-275
    Details
    In: Brain Injury, Informa UK Limited, Vol. 34, No. 2 ( 2020-01-28), p. 269-275
    Type of Medium: Online Resource
    ISSN: 0269-9052 , 1362-301X
    URL: Article
    DOI: 10.1080/02699052.2019.1683895
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2020
    detail.hit.zdb_id: 2004054-4
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