title: Outcome in patient-specific PEEK cranioplasty: A two-center cohort study of 40 implants.
abstract: OBJECTIVE
  The best material choice for cranioplasty following craniectomy remains a subject to discussion. Complication rates after cranioplasty tend to be high. Computer-assisted 3-dimensional modelling of polyetheretherketone (PEEK) was recently introduced for cranial reconstruction. The aim of this study was to evaluate patient- and surgery-related characteristics and risk factors that predispose patients to cranioplasty complications.
  
  
  METHODS
  This retrospective study included a total of 40 cranial PEEK implants in 38 patients, performed at two reference centers in the Netherlands from 2011 to 2014. Complications were registered and patient- and surgery-related data were carefully analysed.
  
  
  RESULTS
  The overall complication rate of PEEK cranioplasty was 28%. Complications included infection (13 %), postoperative haematoma (10 %), cerebrospinal fluid leak (2.5 %) and wound-related problems (2.5 %). All postoperative infections required removal of the implant. Nonetheless removed implants could be successfully re-used after re-sterilization.
  
  
  CONCLUSIONS
  Although overall complication rates after PEEK cranioplasty remain high, outcomes are satisfactory, as our results compare favourably to recent literature reports on cranial vault reconstruction.
authors.affiliation: Department of Oral and Maxillofacial Surgery Tilburg, Hilvarenbeekseweg 60, 5022 GC, Tilburg, The Netherlands; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Jonkergouw
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; Academic Centre of Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands. Electronic address: s.e.vandevijfeijken@amc.uva.nl.
authors.forename: S E C M
authors.initials: SE
authors.lastname: van de Vijfeijken
authors.affiliation: Department of Oral and Maxillofacial Surgery Tilburg, Hilvarenbeekseweg 60, 5022 GC, Tilburg, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Nout
authors.affiliation: Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: T
authors.initials: T
authors.lastname: Theys
authors.affiliation: iMinds-Vision Lab, Department of Physics, University of Antwerp, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Van de Casteele
authors.affiliation: Neurosurgical Center Amsterdam, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Folkersma
authors.affiliation: Department of Neurosurgery Tilburg, Hilvarenbeekseweg 60, 5022 GC, Tilburg, The Netherlands.
authors.forename: P R A M
authors.initials: PR
authors.lastname: Depauw
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; Academic Centre of Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
authors.forename: A G
authors.initials: AG
authors.lastname: Becking
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001577:Benzophenones; D001672:Biocompatible Materials / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D007659:Ketones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011108:Polymers; D011183:Postoperative Complications / Q000453:epidemiology; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D012886:Skull / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001577:Benzophenones; D001672:Biocompatible Materials; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols
keywords: Computer aided-design and modelling; Cranial vault reconstruction; Craniectomy; Cranioplasty; PEEK; Patient specific implant