Calvarial grafts for midface rehabilitation

Access, pain, prolonged hospitalization, or inadequacy of consistency and quantity of a graft are drawbacks to traditional donor sites of autologous bone for reconstruction of severe midface trauma with bone loss. The sectioning of human skulls resulted in selection of the parietal bone as a technically feasible donor site for obtaining adequate autologous bone for the rehabilitation of generous defects in the floor of the orbit or the anterior maxillary wall. The examination of various animal skulls resulted in the selection of the large canine as an adequate experimental model to evaluate the technique. The parietal bone served as a harvest site, without morbidity, for autologous bone used to fill in the defects in the orbit and anterior malar wall in the live canine model. Subsequently, human autografts of outer cranial table parietal bone provided adequate material to repair severe floor of orbit and maxillary defects with minimal patient discomfort and donor site morbidity.