Evaluation of Cranioplasty in Pediatric Patients: A Single-Center Experience

Background: Cranioplasty is a well-known neurosurgical technique used for repairing cranial defects. It is performed to protect the brain, restore its appearance, and reverse the altered cerebral physiology. There is an ongoing debate on the best ma-terial and timing for cranioplasty in pediatric patients. Aim of Study: The present study aimed to evaluate the re-sults of cranioplasty with various materials in pediatric patients. Patients and Methods: A retrospective study was conduct-ed at a single center on pediatric patients who had undergone cranioplasty with any material from January 2020 to December 2021. A total of 54 consecutive cranioplasties in 46 patients were studied. Data on the patient’s gender, age, cause of skull defect, implant type, number of cranioplasties done per patient, cosmetic outcome, wound healing, complications, and compli-cations management were documented. The follow-up interval ranged from 24–36 months. Results: The cranioplasty procedure did not result in any mortality. Six (30%) out of 20 patients with autologous graft cranioplasty developed complications; Two cases experienced complications of subcutaneous surgical emphysema at the site where the rib graft was taken, while four cases had graft resorp-tion and required a second surgery using titanium mesh. Six (17.6%) out of 34 cases of synthetic graft cranioplasty devel-oped complications; Two cases of infection in acrylic cranio-plasty were successfully treated with antibiotics, and four cases of acrylic cranioplasty underwent cracking and fragmentation into pieces then reoperated using titanium mesh. Conclusion: Pediatric patients have a higher incidence of experiencing spontaneous resorption with autologous bone grafts. Patients above 5 years can safely undergo cranioplasty using synthetic material. Acrylic cranioplasty provides a safe and effective option for centers with limited facilities, but the long-term efficacy of acrylic material should be studied in a more comprehensive study.