ArticleNeurosurgery2014
Multidisciplinary approach for improved outcomes in secondary cranial reconstruction: introducing the pericranial-onlay cranioplasty technique.
Article in Neurosurgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Can we do better at measuring patient-reported outcomes after cranioplasty? A systematic review.Neurosurgical review · 2023Pooled it
- The Importance of Plastic Surgery in Multidisciplinary Teams: A Systematic Review and Meta-analysis of Comparative Studies.Plastic and reconstructive surgery. Global open · 2026Article
- Algorithmic Approach to Management of Complex Scalp and Calvarial Burn Injuries.Annals of plastic surgery · 2026Review
- Comparative Analysis of Bite Force after Cranioplasty with and without Temporalis Dissection in Large Skull Defects Caused by Decompressive Craniectomy.Asian journal of neurosurgery · 2025Article
- Neuroplastic Surgery Principles of Computerized Surgical Planning in Complex Cranioplasty Reconstruction.Seminars in plastic surgery · 2024Review
- Flap Design for Cranial Reconstruction: An Analysis of Craniectomy and Cranioplasty Incisions.Journal of maxillofacial and oral surgery · 2024Article
- Breaking Barriers in Cranioplasty: 3D Printing in Low and Middle-Income Settings-Insights from Zenica, Bosnia and Herzegovina.Medicina (Kaunas, Lithuania) · 2023Observational
- Clinical and patient-reported outcome after patient-specific 3D printer-assisted cranioplasty.Neurosurgical review · 2023Article
- Single-stage cranioplasty with customized polyetheretherketone implant after tumor resection using virtual reality and augmented reality for precise implant customization and placement: illustrative case.Journal of neurosurgery. Case lessons · 2022Article
- First-In-Human Experience With Integration of Wireless Intracranial Pressure Monitoring Device Within a Customized Cranial Implant.Operative neurosurgery (Hagerstown, Md.) · 2020Article
- Neuroplastic Surgery Aboard USNS Comfort During the COVID-19 Pandemic in New York City.The Journal of craniofacial surgery · 2020Article
- Letter to the editor: response to article "management and prevention of cranioplasty infections".Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2019Article
- Sonolucent Cranial Implants: Cadaveric Study and Clinical Findings Supporting Diagnostic and Therapeutic Transcranioplasty Ultrasound.The Journal of craniofacial surgery · 2019Article
- A Standard Algorithm for Reconstruction of Scalp Defects With Simultaneous Free Flaps in an Interdisciplinary Two-Team Approach.Frontiers in oncology · 2019Article
- Bone flap salvage in acute surgical site infection after craniotomy for tumor resection.Neurosurgical review · 2018Article
- Pedicle Galeo-pericranial Flap Augmentation in Salvage Frontotemporal Cranioplasty: Additional 'Neurosurgeon-friendly' Reconstruction Technique of Aesthetic Neurosurgery in Superficial Temporal Artery Branch Compromised Host.Neurologia medico-chirurgica · 2018Article
- Review of Cranioplasty after Decompressive Craniectomy.Korean journal of neurotrauma · 2017Review
- Interactive reconstructions of cranial 3D implants under MeVisLab as an alternative to commercial planning software.PloS one · 2017Article
- Bone formation in subcutaneous pocket after bone flap preservation.Clinical case reports · 2016Article
- Cranioplasty for large-sized calvarial defects in the pediatric population: a review.Craniomaxillofacial trauma & reconstruction · 2015Article
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Authors and funding
13 authors.
Funding
Abstract
backgroundAlthough materials for secondary cranial reconstruction have evolved with time, the overall approach in terms of bone flap/implant reconstruction after necessary delay has remained constant.
objectiveTo present our cases series of 50 consecutive secondary cranial reconstruction patients and to describe a multidisciplinary cranioplasty approach developed to reduce morbidity, to minimize infection, and to improve aesthetic appearance.
methodsStandard technique teaches us to place the bone flap and/or alloplastic implant directly over the dura or dural protectant after scalp flap re-elevation. However, this procedure is fraught with high complication rates, including infection. While raising the previously incised scalp flap overlying the full-thickness calvarial defect, the dissection is performed within the loose areolar tissue plane beneath the galea aponeurosis, thus leaving vascularized pericranium intact over the dura.
resultsA total of 50 consecutive patients were treated by the senior author encompassing 46 cranioplasties using the pericranial-onlay approach, along with 4 isolated temporal soft tissue reconstructions with liquid poly-methyl-methacrylate. Of the 46 cranioplasties (> 5 cm), only 1 autologous bone flap developed deep infection necessitating bone flap removal (1 of 46, 2.17%; 95% confidence interval, 0.003-11.3). None of the alloplastic custom implants placed have developed any infection requiring removal.
conclusionThis multidisciplinary approach illustrated in our case series, including our "pericranial-onlay" technique described here for the first time, has the potential to improve patient outcomes, to decrease perioperative morbidity, and to minimize costs associated with postoperative infections after secondary cranial reconstruction.
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