Cranial defects repair by replacing bone flaps

The Authors, after few historical remarks, discuss the indications and the contra-indications for cranioplasty. Although, in the last 30 years, various materials and techniques have been investigated and proposed, the Authors suggest, as method of choice, the reimplantation to each patient of his own volet, when possible, to repair skulls defects. This technique in fact permits to restore an almost normal physiological condition of the cranial vault functions. In the light of the recent researches on the "bone induction principle" and on the possibility of storing at a temperature of -30 degrees C in a freezer the bone flap in ideal condition before the reimplantation, this method is proposed again. The Authors report their experience on 15 patients, 13 of whom have been successful; a perfect aseptic storage, a rational choice of the patients who should be treated and a correct surgical approach are underlined as mandatory for the successful use of the technique. The mean follow up for the 13 successful patients is 15 months. In the paper the 2 unfavourable cases are discussed too: the hypothetical causes which lead to reject of the reimplants are suggested and debated.