Page 17 - Clinical relevance of current materials for cranial implants

General introduction and outline of this thesis
History 1 Decompressive craniectomy and cranioplasty date back to the year 7000 BC and are
among the oldest neurosurgical procedures in history, with a long-term evolution
and a wide variety of materials15. Cranioplasties have been discovered in many ancient
civilizations including the Incas, the Britons, the Asians, the North Africans and the Polynesians15–17. Around 2000 BC, a Peruvian skull was found with a hemi-craniectomy on the left frontal side of the cranium with a cranioplasty of a 1 mm thick gold plate in situ. At that time shells, gourds, and silver were also used for cranial reconstructions. The choice of material for cranial reconstructions likely depended on the social rank of the Peruvian citizen15.
In 1505, the surgeon Ibrahim bin Abdullah was the first surgeon who wrote about the repair of cranial defects using goat and canine derivatives in his book ‘Wonders of Surgeons’ (Alâim-I Cerrâhin). This was followed by Fallopius (1523-1562) and Petronius (1565), who both used golden plates for the reconstruction of cranial defects18. In 1668, Job Janszoon van Meekeren, a surgeon from Amsterdam, The Netherlands, was the first who described a successful cranial reconstruction in a Russian nobleman who sustained a sword injury to his head. The cranial reconstruction was performed with the skull of a dead dog. The recovery went perfect, but the nobleman was excommunicated from the Russian church, because of religious reasons it could not accept animal bone in a human skull15,18. After this surgical intervention monkey, goose, rabbit, calf, and eagle bones were transplanted into the human skull, mostly after perforation and boiling the allograft in water16,17. The use of ox horns, buffalo horns, and ivory also gave satisfactory results. However, better results were observed in autologous bone grafts16. (Figure 2)
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