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Related Experiment Video

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Intravital Imaging of Fluorescent Protein Expression in Mice with a Closed-Skull Traumatic Brain Injury and Cranial Window Using a Two-Photon Microscope

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Cranial reconstruction after a post-craniotomy empyema.

J-F Chabas¹, C Dellavolpe, Y Riah

¹Department of plastic and reconstructive surgery, Hôpital Nord, chemin des Bourrelly 13915 Marseille Cedex 20, France. jeff.chabas@neuf.fr

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS

|November 28, 2008

Summary

This study reports a successful cranioplasty using a bioceramic implant and free flap for skull reconstruction after infection. The procedure restored neurological function and social life, demonstrating effective treatment for large skull defects.

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Area of Science:

Neurosurgery
Plastic and Reconstructive Surgery

Background:

Post-craniotomy empyema with osteitis can lead to extensive skull defects requiring complex reconstruction.
Reconstruction of large cranial defects, especially in infected fields, presents significant surgical challenges.

Observation:

A case report details cranioplasty for a large (120 cm²) skull defect following post-craniotomy empyema and osteitis.
The reconstruction utilized a bioceramic implant combined with a latissimus dorsi and serratus anterior muscular free flap.

Findings:

The combined approach successfully covered the wide skull defect and filled intracranial dead space.
Post-operatively, the patient showed significant neurological improvement, including correction of hemiparesis andphasic disorders.
Eight-month follow-up revealed no infection recurrence, no skull distortion, and a return to normal social life, with CT scans showing cerebral hemisphere re-expansion.

Implications:

This single-stage procedure effectively reconstructs extensive skull defects in previously infected areas.
The use of customized biomaterials and muscular free flaps offers a viable solution for complex cranial reconstruction.
The technique shows potential for restoring both functional and aesthetic outcomes in patients with severe cranial defects.