title: The Efficacy of Titanium Burr Hole Cover for Reconstruction of Skull Defect after Burr Hole Trephination of Chronic Subdural Hematoma.
abstract: OBJECTIVE
  Although burr hole trephination is a safe and effective surgical option to treat patients with chronic subdural hematoma (CSDH), it often results in a small but undesirable scalp depression from burr hole defect. This study is to evaluate the efficacy of titanium burr hole cover (BHC) for reconstruction of skull defects in these patients.
  
  
  METHODS
  A hundred and ninety-six cases of burr hole trephinations for CSDHs between January 2009 and December 2013 were assigned into two groups; Gelfoam packing only (GPO) and reconstruction using titanium BHC group, according to the modalities of burr hole reconstructions. The incidences and depths of scalp depressions and incidences of postoperative complications such as infections or instrument failures were analyzed in both groups. We also conducted telephone surveys to evaluate the cosmetic and functional outcomes from patient's aspect.
  
  
  RESULTS
  Significantly lower incidence (p<0.0001) and smaller mean depth (p<0.0001) of scalp depressions were observed in BHC than GPO group. No statistical differences were seen in postoperative infection rates (p=0.498) between the two groups. There were no instrument failures in BHC group. According to the telephone surveys, 73.9% of respondents with scalp depressions had cosmetic inferiority complexes and 62.3% experienced functional handicaps during activities of daily life.
  
  
  CONCLUSIONS
  Titanium BHC is highly effective for reconstruction of skull defect after burr hole trephination of CSDH, and provides excellent cosmetic and functional outcomes without significant complications.
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Tae-Seop
authors.initials: TS
authors.lastname: Im
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Yoon-Soo
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Sang-Jun
authors.initials: SJ
authors.lastname: Suh
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Jeong-Ho
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Kee-Young
authors.initials: KY
authors.lastname: Ryu
authors.affiliation: Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Dong-Gee
authors.initials: DG
authors.lastname: Kang
keywords: Burr hole cover; Hematoma subdural chronic; Titanium; Treatment efficacy