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Split calvarial bone graft in cranio-orbital sphenoid wing reconstruction
F A Papay1, J E Zins, J F Hahn
1Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Ohio 44195, USA.
The Journal of Craniofacial Surgery
|March 1, 1996
Summary
Autogenous split calvarial bone grafts effectively reconstruct sphenoid wing defects after tumor ablation. This method restored cranial and orbital integrity, resolving proptosis and showing no graft loss or instability.
Area of Science:
- Neurosurgery
- Craniofacial Reconstruction
- Oncology
Background:
- Sphenoid wing defects pose challenges in orbital and cranial base reconstruction following tumor ablation.
- Tumor resection, particularly for meningioma and fibrous dysplasia, often necessitates extensive cranial bone removal.
Purpose of the Study:
- To evaluate the efficacy of autogenous split calvarial bone grafts in reconstructing sphenoid wing defects.
- To assess the functional and structural outcomes of this reconstructive technique.
Main Methods:
- Nine patients with sphenoid wing defects underwent reconstruction using autogenous split calvarial bone grafts between 1983 and 1993.
- Grafts were harvested during neurosurgical tumor ablation procedures.
- Outcomes were assessed through clinical examination, exophthalmometry, and imaging (CT scans).
Main Results:
- Calvarial bone grafting successfully restored the continuity of the frontal bone, supraorbital ridge, orbital roof, and lateral orbital wall/floor.
- Significant improvement or complete resolution of proptosis was observed in all affected patients.
- No instances of graft loss, osteomyelitis, or structural instability were reported.
- Transient pulsatile exophthalmos and diplopia resolved spontaneously or within six weeks.
Conclusions:
- Autogenous split calvarial bone grafting is a reliable method for reconstructing sphenoid wing defects.
- This technique provides structural stability and functional improvement in the orbit and cranial base.
- The use of autogenous grafts minimizes complications and ensures long-term structural integrity.