극저온 냉동 보관된 자가골편을 이용한 두개골 성형술
Autogenous Cranioplasty Using Deep-Freezing Bone Flap
소홍섭, 김복량, 한유정,
소속 상세정보
소홍섭 ( )
원광대학교 의과대학 신경외과학교실
김복량 ( )
원광대학교 의과대학 신경외과학교실
한유정 ( )
원광대학교 의과대학 신경외과학교실
KMID : 0359819980270020159
Abstract
결론
골은행으로 이용되고 있는 영하 70℃의 극저온 냉동고에 개두술시 제거한 자가골편을 보
관하여 이를 이용한 두개골 성형술을 시행함으로써 만족할만한 결과를 얻을 수 있었다.
염증성 합병증과 지연성 골 흡수가 각각 10%에서 발생하였으나. 미용학적으로 우수하고.
수술시간이 매우 짧고, 환자의 전신상태가 허용하는 한 조기 두개골 성형술이 가능하였으며,
비용이 저렴하다는 장점이 있었다.
#초록#
Every craniotomy requires immediate replacement of a fresh autograft of skull or, in
the presence of cerebral swelling, delayed cranioplasty. The use of artificial implant
materials for cranioplasty has been reported by many authors. Among them, acrylic
resin and titanium are most commonly used in neurosurgical practice ; however,
untoward complications such as infection and fluid collection appear at times.
In cases with a large bone defect we have been using autogenous bone flaps, which
was removed during the initial surgery, then preserved at -70℃. Twenty cases of
cranioplasty with autogenous bone grafts stored in a deep-freezer are reviewed. Skull
sections removed aspectically at initial craniotomy were frozen and stored for 18 to 320
days(average 102 days) at -70℃. At cranioplasty the pericranium was completely
removed, and the skull plate was immersed in antibiotic solution for one hour in room
temperature and fixed in skull defect site. The changes of replaced bone flaps were
studied by follow-up skull roentgenograms and radionuclide scintigraphy.
The results of follow-up for an average period of 14 months were satisfactory from
the standpoint of brain protection and cosmetic reconstruction. Delayed resorption of
grafted bone was observed in two cases. No serious complications were seen except in
two cases, whose bone flaps had to be removed due to and epidural abscess.
These results suggest that autogenous skull cranioplasty using deep freezing skull
plate offers several advantages : 1) the reconstruction contour is nearly same as
preoperative feature ; 2) operation time is much shorter than other methods ; 3) early
cranioplasty is possible as soon as patient's condition allows general anesthesia ; 4) cost
effective
키워드
Deep freezing; Autogenous cranioplasty;
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