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Management of extensive and difficult cranial defects
B Guyuron1, M Shafron, B Columbi
1Division of Plastic Surgery, Mount Sinai Medical Center, Cleveland, Ohio.
Journal of Neurosurgery
|August 1, 1988
Summary
Split-skull cranioplasty effectively manages extensive cranial defects, even in patients with prior infection or radiation. This technique offers a natural contour and avoids donor site morbidity, with minimal complications.
Area of Science:
- Neurosurgery
- Plastic Surgery
Background:
- Split-skull cranioplasty was first investigated at the turn of the century.
- The authors first reported their technique in 1983.
Purpose of the Study:
- To describe experience with split-skull cranioplasty for extensive and difficult cranial defects.
- To evaluate the efficacy and safety of this procedure.
Main Methods:
- Review of 29 patients (11 female, 18 male) who underwent split-skull cranioplasty.
- Analysis of patient histories, including infection and radiation therapy.
- Postoperative follow-up ranging from 6 months to 4.5 years.
Main Results:
- No evidence of bone resorption observed during follow-up.
- Minor complications occurred in only two patients.
- Successful reconstruction with smooth, natural contour.
Conclusions:
- Split-skull cranioplasty is advantageous for previously infected areas and offers a natural contour with no donor site morbidity.
- The procedure is faster than split-rib cranioplasty, with minimal complications, despite decreased skull thickness at the donor site.