Pediatric cranioplasty using particulate calvarial bone graft

Area of Science:

• Pediatric Neurosurgery
• Craniofacial Surgery
• Bone Grafting Techniques

Background:

• Autologous bone supply is limited for pediatric calvarial defect closure.
• Alloplastic materials are generally not recommended for pediatric skull reconstruction.
• Previous studies showed particulate bone graft efficacy in primary fronto-orbital advancement.

Purpose of the Study:

• To evaluate the effectiveness of particulate bone graft for treating existing calvarial defects in children.
• To assess the outcomes of inlay particulate bone grafting for established cranial defects.

Main Methods:

• Retrospective analysis of 38 children undergoing cranioplasty with inlay particulate bone grafting (1989-2007).
• Particulate bone harvested from parietal calvaria or cranial endocortex.
• Data collected on patient demographics, defect characteristics, and surgical outcomes.

Main Results:

• Average patient age was 8.0 years; average defect size was 66.5 cm².
• Indications included revision surgery, primary remodeling gaps, congenital defects, trauma, and tumors.
• A low rate of persistent defects (7.9%) and reoperation (2.6%) was observed after a mean follow-up of 6.1 years.

Conclusions:

• Inlay autologous cranial particulate bone graft is an effective method for healing established pediatric cranial defects.
• The technique is feasible in infants and young children.
• Bone harvesting has minimal morbidity and does not require neurosurgical assistance.