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Tantalum plate을 使用한 Cranioplasty에 關하여

Cranioplasty with Tantalum Plate

최신의학 1967년 10권 6호 p.101 ~ 108
서용원,
소속 상세정보
서용원 (  ) - 진해육군병원 신경외과

Abstract


Primitive man probably put in his "stopper" at the time of trepanation. Later it seems probable that the graft was inserted sometime after the occurrence of the skull defect. When cranioplasty become popular at the turn of 20th century, it was considered wise to wait until the wound is well healed before inserting the plate.
In World War I,the cranioplasty usually was deferred 12 to 18 months following compound injury of the head, for most of these wounds were infected. With the advent of antibiotics and chemotherapeutic agents, however, successful cranioplasty within a month or two was possible in clean wounds. If infection supervened most surgeons advised deferring the plating until the wound is healed for several months.
There were many reported historic achievements in regard to the cranioplasty in which various materials were used. To fill the skull defect gold, silver, lead, copper, aluminum, iron, tin, nickel and bronze plates were tried without satisfactory results.
The modern era of cranioplasty was initiated by Mersen and Walther at the turn of
´ this century. It is natural that the early grafts were derived from the same individual (auto-graft). The earliest autogenous graft was done by flap transposition technique (Muller-Koning method).
In 1941, Zunder first used methyl metacrylate (acrylic) for human cranioplasty to repair a large skull defect. Later, experiences with acrylic plates were reported by many authors.
Vitallium was tried by Geib in 1941. Vitallium plate, however, tends to oxydate within the -tissue forming chromium salt and failed to enjoy popularity.
Tantalum was introduced for cranioplasty by Hook in 1941. He reported a successful repair of a large cranial bone defect with tantalum plate. Since then tantalum cranioplasty became increasingly popular and today it is widely used in many neurosurgical institutes.
This report includes 15 cases of cranioplasty for traumatic skull defects seen at Chinhae Naval Hospital during the 2-year period from 1952 to 1953. The author used tantalum to 6 large cranial defects and autogenous bone chips to relatively small 9 skull defects. All 6 tantalum cases healed well with primary intention and the results were uniformly stisfactory, while among 9 cases of bone grafts there were two cases of infection and the end results were relatively poorcosmetically not to mention all the inconveniences entailed in subsequent management.
The author found that tantalum plate is quite satisfactory and suitable for cranioplastly in various cranial bone defects as compared with bone chip grafts.

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