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Congenital scalp and calvarial deficiencies: principles for classification and surgical management
Chad A Perlyn1, Rodney Schmelzer, Daniel Govier
1Division of Plastic Surgery and the Cleft Palate and Craniofacial Deformities Institute, St. Louis Children's Hospital & Washington University School of Medicine, and St. John's Medical Center, Kids Plastic Surgery, St. Louis, Mo 63141 , USA.
Abstract:
Congenital defects of the scalp and skull present a challenge for care providers because of a combination of their rarity and the magnitude of potential morbidity. Recent advancements in autogenous and alloplastic cranioplasty and scalp reconstruction techniques argue for a comprehensive consideration of this problem. This article (1) reviews the causes of congenital scalp and calvarial defects; (2) proposes a classification system based on defect type, similar to the tumor-node-metastasis classification, in that defect location, defect size, and extent of neuromeningeal involvement are the critical variables; and (3) presents algorithms for care based on the defect classification. A set of management principles on which treatment plans can be based for these unique problems is provided.
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