PMID- 31299743
OWN - NLM
STAT- MEDLINE
DCOM- 20191028
LR  - 20240329
IS  - 1536-3732 (Electronic)
IS  - 1049-2275 (Print)
IS  - 1049-2275 (Linking)
VI  - 30
IP  - 5
DP  - 2019 Jul
TI  - Sonolucent Cranial Implants: Cadaveric Study and Clinical Findings Supporting 
      Diagnostic and Therapeutic Transcranioplasty Ultrasound.
PG  - 1456-1461
LID - 10.1097/SCS.0000000000005454 [doi]
AB  - BACKGROUND: Previously, sonographic evaluation of the intracranial contents was 
      limited to intraoperative use following bone flap removal, with placement of the 
      probe directly on the cortical surface or through a transsulcal tubular 
      retractor. Cranioplasty with sonolucent implants may represent a postoperative 
      window into the brain by allowing ultrasound to serve as a novel bedside imaging 
      modality. The potential sonolucency of various commonly used cranial implant 
      types was examined in this study. METHODS: A 3-phase study was comprised of 
      cadaveric evaluation of transcranioplasty ultrasound (TCU) with cranioplasty 
      implants of varying materials, intraoperative TCU during right-sided cranioplasty 
      with clear implant made of poly-methyl-methacrylate (PMMA), and bedside TCU on 
      postoperative day 5 after cranioplasty. RESULTS: The TCU through clear PMMA, 
      polyether-ether-ketone, and opaque PMMA cranial implants revealed implant 
      sonoluceny, in contrast to autologous bone and porous-polyethylene. 
      Intraoperative ultrasound via the clear PMMA implant in a single patient revealed 
      recognizable ventricular anatomy. Furthermore, postoperative bedside ultrasound 
      in the same patient revealed comparable ventricular anatomy and a small epidural 
      fluid collection corresponding to that visualized on an axial computed tomography 
      scan. CONCLUSION: Sonolucent cranial implants, such as those made of clear PMMA, 
      hold great promise for enhanced diagnostic and therapeutic applications 
      previously limited by cranial bone. Furthermore, as functional cranial implants 
      are manufactured with implantable devices housed within clear PMMA, the 
      possibility of utilizing ultrasound for real-time surveillance of intracranial 
      pathology becomes much more feasible.
FAU - Belzberg, Micah
AU  - Belzberg M
AD  - Department of Plastic and Reconstructive Surgery, Johns Hopkins University School 
      of Medicine, Baltimore, MD.
FAU - Shalom, Netanel Ben
AU  - Shalom NB
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore, MD.
FAU - Yuhanna, Edward
AU  - Yuhanna E
AD  - Department of Radiology, Johns Hopkins Hospital, Baltimore, MD.
FAU - Manbachi, Amir
AU  - Manbachi A
AD  - Department of Radiology, Johns Hopkins Hospital, Baltimore, MD.
AD  - Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD.
FAU - Tekes, Aylin
AU  - Tekes A
AD  - Division of Pediatric Radiology and Pediatric Neuroradiology, The Russell H. 
      Morgan Department of Radiology and Radiological Science, Johns Hopkins University 
      School of Medicine, Baltimore, MD.
FAU - Huang, Judy
AU  - Huang J
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore, MD.
FAU - Brem, Henry
AU  - Brem H
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore, MD.
FAU - Gordon, Chad R
AU  - Gordon CR
AD  - Department of Plastic and Reconstructive Surgery, Johns Hopkins University School 
      of Medicine, Baltimore, MD.
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore, MD.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Craniofac Surg
JT  - The Journal of craniofacial surgery
JID - 9010410
RN  - 9011-14-7 (Polymethyl Methacrylate)
MH  - Adult
MH  - Cadaver
MH  - Humans
MH  - Male
MH  - Polymethyl Methacrylate/therapeutic use
MH  - Porosity
MH  - Postoperative Period
MH  - *Prostheses and Implants
MH  - Skull/surgery
MH  - Tomography, X-Ray Computed
MH  - Ultrasonic Therapy
PMC - PMC7329202
COIS- CG is a consultant for Stryker and Longeviti Neuro Solutions. JH and CG are 
      stockholders of Longeviti Neuro Solutions. The remaining authors report no 
      conflicts of interest.
EDAT- 2019/07/14 06:00
MHDA- 2019/10/29 06:00
PMCR- 2020/07/01
CRDT- 2019/07/14 06:00
PHST- 2019/07/14 06:00 [entrez]
PHST- 2019/07/14 06:00 [pubmed]
PHST- 2019/10/29 06:00 [medline]
PHST- 2020/07/01 00:00 [pmc-release]
AID - 00001665-201907000-00035 [pii]
AID - SCS-18-01857 [pii]
AID - 10.1097/SCS.0000000000005454 [doi]
PST - ppublish
SO  - J Craniofac Surg. 2019 Jul;30(5):1456-1461. doi: 10.1097/SCS.0000000000005454.