Anterior skull defect reconstruction with methyl methacrylate

A case of squamous cell carcinoma of the fronto-ethmoid complex in an 18-year-old man is presented. At the time of resection both the anterior and posterior tables of the frontal sinus had to be removed. The resulting surgical defect left a marked cosmetic deformity. CT scan five months after the resection suggested calcification with possible ossification of the dura. Exploration of the area confirmed these findings. Because of the firmness of the dura it was possible to contour a methyl methacrylate template to fill the defect. This was wired to the surrounding bone and provided an excellent cosmetic result. The principle of dural osteogenesis is described, and cranioplasty methods are reviewed.