Abstract

Objective To compare the clinical outcomes and complications of alloplastic cranioplasty performed with custom-designed polyetheretherketone (PEEK) and titanium mesh after decompressive craniectomy. Methods Eighty-six patients admitted to our hospital from June 2014 to December 2017 were chosen; and 28 patients underwent cranioplasty with PEEK and 58 with titanium mesh by the same surgical team. The general clinical data and postoperative complications were compared between the two groups. Multivariable Logistic regression analysis was performed to analyze the influencing factors of postoperative complications. The surgical time, molding quality and cost were compared between the two groups. Results Patients in PEEK group trended to be younger and had higher GOS scores as compared with patients in the titanium group, with significant differences (P<0.05). Overall complication rates of 10.7% and 32.8% for PEEK and titanium cranioplasty were identified respectively; as compared with that in titanium group, the incidence of overall complication in PEEK group was significant lower (P<0.05). Logistic regression analysis identified material was the independent influencing factor for cranioplasty complications (OR=4.486, P=0.047, 95%CI: 1.021-19.703). Overall satisfaction rate with cranioplasty and aesthetic result in PEEK group was significantly higher than that in titanium group (96.4% vs. 79.3%, P<0.05); however, the treatment cost for cranioplasty with PEEK was considerably higher than skull bone reconstruction based on titanium mesh. Conclusion Despite of high treatment cost, custom-designed PEEK implants seem to be good choice for patients with large cranial defects after decompressive craniectomy, enjoying few complications and high satisfaction of cranioplasty and aesthetic result. Key words: Cranioplasty; Decompressive craniectomy; Polyetheretherketone; Titanium; Complication

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