Comparative Characteristics of Methods of Reconstructive Treatment of Skull Bone Defects

Background. Cranial defect repair by autograft is considered to be the optimal method of cranioplasty. However, if it is impossible to preserve the bone flap, it becomes necessary to use artificial materials. The most important indicator of a successful cranioplasty operation is the low level of postoperative complications that would require repeated surgical interventions. Aim of the research. To evaluate and compare the results of cranioplasty operations using different materials. Material and methods. A single-center retrospective study of the medical records of inpatients operated on in the neurosurgical department of the Grodno City Clinical Emergency Hospital for skull bone defects within 16 years (from January 2009 to December 2024) was conducted. All patients were divided into 4 groups. The first group consisted of patients who underwent cranioplasty with autogenous bone (249 individuals), the second group included patients who underwent plastic surgery with protacryl (70 individuals). The third group (49 individuals) consisted of patients with titanium plate plastic surgery and the fourth group included 62 patients with combined plastic surgery (autogenous bone and titanium plate). Results. Complications after cranioplasty were observed in 16 (3.7%) operated patients and occurred in all four study groups. The highest percentage was with the combined method (4.8%) but without statistical significance (p>0.05) in relation to other methods of skull defect plastic surgery. Complications included epidural hematoma in 10 (2.3%) patients, osteomyelitis of the bone flap in 4 (1.0%) patients, intracerebral hematoma in 1 (0.2%) patient and epidural empyema in 1 (0.2%) patient. Conclusions. The use of artificial grafts to close defects in the bones of the skull significantly (p<0.05) reduces the time required to perform surgery compared with the use of an autogenous bone, due to the reduction in time spent on bone graft harvesting. This helps to reduce the number of complications and, in addition, eliminates the occurrence of osteomyelitis of the transplanted bone flap.