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Comparative study between cortical bone graft versus bone dust for reconstruction of cranial burr holes

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Comparative study between cortical bone graft versus bone dust for reconstruction of cranial burr holes

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Título Comparative study between cortical bone graft versus bone dust for reconstruction of cranial burr holes
Autor Worm, Paulo Valdeci
Ferreira, Nelson Pires
Faria, Mário de Barros
Ferreira, Marcelo Paglioli
Kraemer, Jorge Luiz
Collares, Marcus Vinicius Martins
Abstract Background: As a consequence of the progressive evolution of neurosurgical techniques, there has been increasing concern with the esthetic aspects of burr holes. Therefore, the objective of this study was to compare the use of cortical bone graft and bone dust for correcting cranial deformities caused by neurosurgical trephines. Methods: Twenty-three patients were enrolled for cranial burr hole reconstruction with a 1-year follow-up. A total of 108 burr holes were treated; 36 burr holes were reconstructed with autogenous cortical bone discs (33.3%), and the remaining 72 with autogenous wet bone powder (66.6%). A trephine was specifically designed to produce this coin-shaped bone plug of 14 mm in diameter, which fit perfectly over the burr holes. The reconstructions were studied 12 months after the surgical procedure, using three-dimensional quantitative computed tomography. Additionally, general and plastic surgeons blinded for the study evaluated the cosmetic results of those areas, attributing scores from 0 to 10. Results: The mean bone densities were 987.95 ± 186.83 Hounsfield units (HU) for bone fragment and 473.55 ± 220.34 HU for bone dust (P < 0.001); the mean cosmetic scores were 9.5 for bone fragment and 5.7 for bone dust (P < 0.001). Conclusions: The use of autologous bone discs showed better results than bone dust for the reconstruction of cranial burr holes because of their lower degree of bone resorption and, consequently, better cosmetic results. The lack of donor site morbidity associated with procedural low cost qualifies the cortical autograft as the first choice for correcting cranial defects created by neurosurgical trephines.
Contido em Neurologia cirúrgica internacional. Mumbai. Vol. 1 (Dez. 2010), p. 91 [4 f.]
Assunto Cirurgia
Crânio
Transplante ósseo
[en] Autograft
[en] Bone dust
[en] Cranioplasty
[en] Surgery
Origem Estrangeiro
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/34208
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