What Is The Best Material For A Custom Occipital Implant?
Q: Dr. Eppley, my son of 10 years of age has occipital plagiocephaly and a big flat spot in the back of his head. I recently sent in his old CT scan and updated photos to a doctor in our area. The surgeon recommended waiting for the completion of puberty and then to evaluate for an implant in the back.
This doctor did not not recommend a silicone implant. If I recall correctly, he said they were found to deteriorate with time. Do you know anything about this? Do you still think a silicone implant is okay for the skull? Things seems to change with time and between surgeons.
The thing I like about silicone implants is the reduced incision length. The doctor thought imaging could be used to determine the optimal location and length for an implant made of some material other than silicone. What are your thoughts on this?
A: I do agree that waiting until after puberty to have the occipital implant surgery is reasonable. However, it is absolutely not true that silicone skull implants degrade with time. They can never breakdown or degrade. Silicone is a fundamental element (#14 on the Periodic Table) and there are no human enzymes that can degrade the material. A thousand years from now the implant will look the same as the day it was put in.
There are a variety of materials that can be used for a custom occipital implant including silicone, HTR and PEEK materials. While these materials are chemically and structurally different, how the body reacts to them and treats them is not fundamentally different. The biggest difference to a patient is going to be the length of the incision to place them. Stiff rigid materials like HTR and PEEK are going to require a full coronal incision to place. Conversely, silicone can be placed through a much smaller incision because the material is flexible.
Dr. Barry Eppley