Simple and safe method of cranial reconstruction after posterior fossa craniectomy

Reconstructing the posterior fossa after surgical intervention in this region is important both for prevention of postoperative complication such as headache and for cosmetic purposes. Several methods have been reported that use either synthetic or natural graft, the latter being either autograft or allograft. The previously described methods require either surgical intervention on a second setting or an additional procedure that prolongs the time of the surgery and may contribute to morbidity. The present report describes a simple modified method of reconstructing the postcraniectomy defect by using the patients' own bone dust, tissue glue, and gel foam sheets.

The method of reconstruction requires collection of as much as possible of the produced bone dust at the time of craniectomy, adding tissue glue, placing in between 2 sheets of gel foam, and shaping it to match the surgical defect.

Ten cases of various posterior fossa pathologies managed at King Faisal hospital of the university between January 2000 and September 2004 had reconstruction of the posterior fossa after craniectomy during the same operative setting using the described method of cranial reconstruction. No complication was noted. Patients did not have any delayed postcraniectomy pain at reconstruction site. Postoperative plane x-ray of the skull and computed tomography showed good healing and shaping of the suboccipital bone at the surgical defect.

Reconstructive cranioplasty is an important part of any posterior fossa exposure. The present report describes a safe and simple method that gives acceptable results both clinically and radiologically.