Avanços e desafios atuais sobre o uso de cimentos ósseos de polimetilmetacrilato (PMMA) na neurocirurgia
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Introdução: A cranioplastia é essencial para reconstrução craniana após craniectomia, utilizando enxertos autólogos (padrão-ouro) ou sintéticos. PMMA destaca-se pela viabilidade econômica e flexibilidade intraoperatória, apesar da alta taxa de complicações.
Objetivo: Oferecer análise abrangente da evolução do PMMA e suas variantes, destacando seus avanços desafios e necessidade contínua de inovações.
Método: Foi realizada revisão integrativa de 32 estudos recentes sobre PMMA em cranioplastias, selecionados nas bases PubMed, MedLine e ScienceDirect. Foram incluídos artigos originais, revisões e estudos computacionais dos últimos 10 anos. A busca utilizou descritores como "Polymethyl Methacrylate" AND "Cranioplasty".
Resultado: PMMA, amplamente usado, pode ser moldado intraoperatoriamente, mas apresenta risco elevado de complicações. Alternativas incluem PMMA impregnado com antibióticos, reduzindo infecções, e implantes personalizados em 3D, otimizando estética e tempo cirúrgico, apesar de custos elevados.
Conclusão: A cranioplastia com PMMA é acessível e versátil, mas apresenta alta taxa de complicações. Estratégias como impregnação antibiótica e técnicas aprimoradas ajudam a mitigar riscos. Biomateriais 3D surgem como alternativa promissora, embora mais caros. A escolha deve equilibrar custo, segurança e necessidades do paciente.
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Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
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