Cranioplasty after 25 Years of Implant Rejection
DOI:
https://doi.org/10.35790/ecl.v14i1.63865Keywords:
cranioplasty; implant; rejectionAbstract
Abstract: Cranioplasty is a common neurosurgical procedure performed to reconstruct cranial defects. Failure of cranioplasty may be early or delayed and further can be attributed to the surgical procedure itself or to the reconstruction material used for the procedure. We reported a 54-year-old man came to the clinic with wound and defect in his scalp. He had previous craniectomy 25 years ago due to an accident that caused a head injury. The size of the wound was 10 x 10 cm with granulation tissue at the base of the wound. There was no discharge at the site of the wound. In physical examination, vital sign was normal, laboratory examination showed slight leukocytosis. Cranioplasty surgery was performed to reconstruct the scalp defect. Implant failure was found characterized by pain at the implant site, erythema, and fever. Therefore, cranioplasty implant rejection was diagnosed. Reconstructive cranioplasty with titanium mesh was done a week later. Thirty years ago, PMMA maybe the most available biomaterial, however, disadvantages may occur such as infections, extrusion, decomposition, fracture of implant in larger defect, and lack of integration to the bone. Spontaneous implementation of the biomaterials leads to CIR, and without proper resolution under two weeks it leads to a foreign body response (FBR) and chronic inflammation. Hence in this study, the use of titanium mesh can overcome those disadvantages, with lower risk of infection, non-corrosive, non-inflammatory, good cosmetic results and great potential of osseointegration. In conclusion, materials in cranioplasty should be considered and follow up regularly and well. Cranioplasty implant rejection was a known complication risk that can leads to chronic inflammation. Associated symptoms including pain, erythema and fever. Using synthetic implants with non-inflammatory and great osseointegration characteristics can lead to great results as shown in this case.
Keywords: cranioplasty; implant; rejection
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Copyright (c) 2025 Dennis M. Frederik, Mendy J. Hatibie, Stevy C. Suoth, Eko Prasetyo, Maximillian C. Oley , Ferdinan Tjungkagi, Yovanka N. Manuhutu
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