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Posterior vault "free-floating" bone flap: indications, technique, advantages, and drawbacks
Gianpiero Tamburrini1, Martina Offi1, Luca Massimi1
1Pediatric Neurosurgery, Institute of Neurosurgery, Fondazione Policlinico Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Summary
Free bone flap craniotomy is a valuable surgical technique for expanding posterior cranial fossa volume in infants with multiple sutures craniosynostosis, offering adequate intracranial volume increases.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Surgery
Background:
- Posterior cranial fossa volume enlargement is crucial in managing multiple sutures craniosynostosis in children.
- Surgical options include fixed expansive craniotomy, free bone flap craniotomy, and distraction osteogenesis.
Purpose of the Study:
- To review the indications for free bone flap craniotomy in posterior fossa expansion.
- To detail the advantages, disadvantages, and complications of this surgical technique.
Main Methods:
- Literature review of studies on free bone flap craniotomy for posterior fossa expansion.
Main Results:
- Free bone flap posterior expansion cranioplasty remains a viable option.
- Particularly beneficial in infants with thin, "honeycomb" bone structure.
- Allows for adequate intracranial volume increase and delayed anterior cranial fossa surgery.
Conclusions:
- Free bone flap craniotomy is an effective method for posterior cranial fossa expansion in select pediatric patients.
- It facilitates achieving necessary intracranial volume and strategic timing of subsequent surgeries.
