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Prognosis of Performing Split-Rib Bone Graft for Cranial Bone Defects
Hyun Ki Hong1, Jeong Yeop Ryu1, Joon Seok Lee1
1From the Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University.
Plastic and Reconstructive Surgery
|April 10, 2023
Summary
Split-rib bone grafts show stable results for frontal sinus anterior wall defects, especially when graft size is under 27 cm² and volume under 6 cm³. Younger patients experience better graft take, but age-related resorption necessitates considering overcorrection.
Area of Science:
- Plastic Surgery
- Craniofacial Reconstruction
- Bone Grafting
Background:
- Frontal sinus anterior wall defects cause aesthetic issues and neurological pressure.
- Reconstruction is necessary to address forehead bulging, ptosis, and potential brain or optic nerve compression.
Purpose of the Study:
- To evaluate the long-term prognosis of using split-rib bone grafts for frontal sinus anterior wall defects.
Main Methods:
- 30 patients with frontal sinus anterior wall defects received split-rib bone grafts.
- Three-dimensional computed tomography (3D CT) measured defect and graft sizes/volumes pre- and post-surgery (2-year follow-up).
Main Results:
- Average graft size decreased from 27.29 cm² to 23.76 cm² and volume from 5.88 cm³ to 4.80 cm³ over 24 months.
- Graft take exceeded 80% for defects <27 cm² and <6 cm³.
- Younger age correlated with higher graft take; absorption occurred up to 18 months.
Conclusions:
- Split-rib bone grafting provides stable frontal bone defect reconstruction for grafts <27 cm² and <6 cm³.
- Bone resorption occurred in 20-30% of patients, increasing with age.
- Overcorrection and alternative reconstruction methods should be considered due to age-related resorption.
