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Updated: Sep 14, 2025
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
German cranial reconstruction registry - a prospective multicenter cohort study: 883-day follow-up on the outcome and
Maximilian Bschorer1, Henrik Giese2,3, Julius Höhne4
1Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Introduction:
This international prospective multicenter cohort study investigates the long-term surgical complication rate and neurological outcomes in patients who underwent autologous or allogeneic cranioplasty (CP) after decompressive craniectomy (DC) for traumatic brain injury, stroke, aneurysmatic subarachnoid hemorrhage, and intracranial hemorrhage.
Research Question:
This study investigated the predictors of long-term outcomes and surgical revision after cranioplasty.
Materials And Methods:
Patients who underwent CP with a minimum follow-up of at least 12 months were included. Favorable long-term outcome (FLTO) was defined as a Glasgow Outcome Score (GOS) of 4 or 5 and a modified Rankin scale (mRS) score of <4. Univariate and multivariate analyses were performed.
Results:
A total of 200 patients with a median follow-up of 883.1 520.5 days were included. Ninety-nine patients (50.0 %) had a FLTO, and the surgical revision rate was 25.0 % (n = 50). Thirty-eight percent (37.7 %) and 27.5 % of patients showed improvement in the mRS and GOS scores, respectively. Simultaneous implantation of a ventriculoperitoneal shunt (OR 6.114) and a time interval of <90 days between DC and CP (OR 2.189) predicted an increase in reoperation rates. The use of subcutaneous drains with suction predicted a lower rate of reoperation (OR .410). Diabetes mellitus (OR .221) and reoperations during the initial stay (OR .347) were negative predictors of FLTO. Implants imbued with antibiotics predicted a positive FLTO (OR 2.973).
Discussion And Conclusion:
Suction drains were predicted to reduce reoperation rates. Simultaneous implantation of VPS and CP within 3 months of DC predicted an increased likelihood of surgical revision.
