Turkish Neurosurgery
Calvarial reconstruction of small-size skull defects performing “8 Cranioplasty” in children: Surgical experience, clinical results and treatment algorithm
İhsan Doğan1, Gökmen Kahiloğulları1, Haydar Sekmen2, Ümit Eroğlu1, Onur Özgüral1, Ağahan Ünlü1
1Ankara University School of Medicine, Neurosurgery, Ankara,
2Kocaeli Derince Education and Research Hospital, Neurosurgery, Kocaeli,
DOI: 10.5137/1019-5149.JTN.17229-16.0

Aim: The objective of this study was to report our clinical experience, surgical treatment algorithm and technique in reconstruction of uncomplicated and small-size calvarial defects by performing autolog split-bone grafting technique on anatomical findings and patients outcome. Material and Methods: In thirty-six patients (aged between 28 and 125 months; median age, 68.75 months, minimum follow-up 14 months), following the resection of pathological skull region, the defective calvarial zone without bone (area, 3.8 to 7.5 centimetersquare; median area 4.2 centimetersquare) was covered with inner table of horizontally splitted adjacent skull site. The donor site, the characteristics of skin incision such as length, shape, location and bone splitting technique were determined based on our treatment algorithm for eight cranioplasty. Pre and postoperative clinical outcomes and courses as well as radiological results are documented. Results: Mean follow-up for all children was 25 months. There was no mortality and 5,55% morbidity (n=2: 1 sterile wound dehiscence and 1 sterile wound discharge). No infected flaps was seen and none of the patients required a second surgery. No graft failure, tumour recurrence or residue occured. Conclusion: In our experience, autolog split bone grafting technique in small-size defects, with its proposed name “8 cranioplasty” is a safe and effective reconstructive procedure due to its short-term surgery, small-size surgical zone, low complication rate, good cosmetic results and cost effectiveness.

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