[The evaluation of early and late results of using Codubix cranial prosthesis]

The filling of the cranial defect is an essential problem in neurosurgery on account of the necessity of brain protection as well as for cosmetic reasons. The aim of this study was to evaluate the direct and distant outcome after polypropylene-polyester Codubix prosthesis implantation. This research was based on the analysis of 41 patients treated surgically in the Department of Neurosurgery at the Jagiellonian University in Cracow between 1995-2004. All patients had the Codubix prosthesis implanted. The implantation was performed either synchronously or after the surgery which caused the cranial defect. Directly after the surgery proper healing of the prosthesis could be observed in all patients. The exception was one patient who died directly after the surgery but the cause of his death was not connected with the prosthesis implantation. Seven patients (17,1%) had the temperature temporarily elevated. Three had haematoma collection in the subgaleal space, one (2,4%) developed meningitis which was successfully treated with antibiotics, one (2,4%) suffered from temporary circulation disturbances of the scalp. The late evaluation was performed with help of a questionnaire to which 30 patients (73,2%) responded. The answer ranged 73,2% (30 patients). In this group 16 patients (53,4%) described the cosmetic effect as very good, 10 patients (33%) as good and 4 (13,3%) as unsatisfactory. The commonest reason for the critical note was the depression of the plate which happened to 3 patients. The other 3 patients complained about inappropriate profile of the plate causing the asymmetry of the cranial vault. Seven patients felt temporary pain in the postoperative scar, in one case the pain was took as the friction between the prosthesis and bone margin. Properly performed implantation of accurate bone prosthesis Codubix is safe and usually brings a good cosmetic effect. Direct complications are transitional and occur in the small percent of cases. Distant examinations show generally good therapeutic results but implanted Codubix requires suitable shape and careful fixation.