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Published on: November 19, 2017
Temperature elevation during simulated polymethylmethacrylate (PMMA) cranioplasty in a cadaver model.
T Golz1, C R Graham, L C Busch
1Institute of Anatomy, University of Lübeck, Ratzeburger-Allee 160, 23538 Lübeck, Germany.
Summary
This study measured heat during polymethylmethacrylate (PMMA) cranioplasty. High temperatures exceeding 50°C were observed, suggesting pre-fabricated prostheses are safer for patients.
Area of Science:
- Biomaterials Science
- Neurosurgery
- Medical Device Engineering
Background:
- Polymethylmethacrylate (PMMA) is used in cranioplasty.
- Concerns exist regarding heat generated during PMMA polymerization and its effect on surrounding tissues.
- Literature on tissue thermal sensitivity is conflicting.
Purpose of the Study:
- To measure temperatures during in vitro PMMA polymerization of varying thicknesses.
- To measure tissue temperatures in a cadaver skull defect during simulated PMMA cranioplasty.
- To inform the clinical practice of PMMA cranioplasty.
Main Methods:
- In vitro polymerization of PMMA disks with controlled thickness.
- Simulated cranioplasty on a cadaver specimen with temperature monitoring at multiple tissue locations.
- Exothermic reaction analysis of PMMA.
Main Results:
- In vitro: Higher temperatures correlated with increased PMMA disk thickness.
- Simulated cranioplasty: Peak temperatures occurred within the PMMA, with adjacent tissues exposed to >50°C for extended durations.
- Significant thermal exposure to neural and bony tissues was documented.
Conclusions:
- The exothermic polymerization of PMMA can generate temperatures harmful to adjacent tissues during cranioplasty.
- Preoperatively fabricated PMMA prostheses minimize intraoperative thermal risks.
- Further research into tissue thermal tolerance is warranted but clinical caution is advised.
