title: The therapeutic effect of patient-specific implants in cranioplasty.
abstract: OBJECTIVE
  Patient specific implants have been used for the reconstruction of large skull bone defects. Several therapeutic effects have been suggested in current literature but were never objectified. The aim of the current study was to evaluate the change in quality of life, pain, aesthetics, and the surgical and medical outcomes after reconstruction of large skull bone defects with titanium or polyetheretherketone (PEEK) implants.
  
  
  METHODS
  We retrospectively evaluated 29 consecutive patients receiving a patient specific skull implant between November 2004 and December 2015. Twenty-one patients received PEEK implants and eight received titanium implants. Data was acquired regarding quality of life, aesthetics, pain, demographics and complications. Quality of life was measured using the Glasgow Benefit Inventory (GBI). Additional questions were asked concerning pain, satisfaction and aesthetics.
  
  
  RESULTS
  The mean total GBI-score was +26.1 (95%CI 16.8-35.4, p < 0.001). Headache complaints or pain in the operation site improved in 75.0% and 77.8% of these patients, respectively. In 8.0% an increase was seen with regard to both variables.
  
  
  CONCLUSIONS
  Reconstruction of skull bone defects with PEEK and titanium patient specific implants gave a statistically significant improvement in quality of life. Furthermore, it decreased pain and headaches and gave aesthetically good results.
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, P. Debeyelaan 25, 6202AZ Maastricht, The Netherlands. Electronic address: thomaszegers@gmail.com.
authors.forename: Thomas
authors.initials: T
authors.lastname: Zegers
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, P. Debeyelaan 25, 6202AZ Maastricht, The Netherlands.
authors.forename: Mariel
authors.initials: M
authors.lastname: Ter Laak-Poort
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, P. Debeyelaan 25, 6202AZ Maastricht, The Netherlands.
authors.forename: David
authors.initials: D
authors.lastname: Koper
authors.affiliation: Department of Oral and Maxillofacial Surgery, RWTH Aachen University Hospital, Pauwelstraße 30, 52074 Aachen, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Lethaus
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, P. Debeyelaan 25, 6202AZ Maastricht, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001577:Benzophenones; D004954:Esthetics; D005260:Female; D006801:Humans; D007659:Ketones; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011092:Polyethylene Glycols; D011108:Polymers; D019736:Prostheses and Implants; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012886:Skull / Q000601:surgery*; D014025:Titanium; D055815:Young Adult
chemical_list: D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols; D014025:Titanium
keywords: Cranioplasty; Headache; Implants; Polyetheretherketone; Quality of life; Titanium