Split Calvarial Grafting for Closure of Large Cranial Defects: The Ideal Option?
Among the various cranioplasty options for reconstruction of large post-craniectomy defects, split calvarial grafting offers numerous significant advantages such as the provision of viable autogenous bone graft material comprising of living, immunocompatible bony cells that integrate fully with the skull bone bordering the cranial defect. Its potential for revascularization and subsequent integration and consolidation allows its successful use even in previously infected or otherwise compromised recipient sites. Its excellent contour match at the recipient site and low cost as compared to various alloplastic implant materials often makes it preferable to the latter. Surgeon’s skill, dexterity, expertise and experience are important factors to be considered in this highly technique-sensitive procedure.
KeywordsCranioplasty Split calvarial grafting Corticocancellous calvarial bone strips Decompressive craniectomy (DC)
This study was not funded by any organization/society.
Compliance with Ethical Standards
Conflict of interest
The author of this article has not received any research grant, remuneration, or speaker honorarium from any company or committee whatsoever, and neither owns any stock in any company. The author declares that she does not have any conflict of interest.
This article does not contain any new studies with human participants or animals performed by the author.
Informed consent was obtained from all the individual participants in this study.
Research involving human participants and/or animals
All procedures performed on the patients (human participants) involved were in accordance with the ethical standards of the institution and/or national research committee, as well as with the 1964 Helsinki declaration and its later amendments and comparable ethical standards.
- 5.Tabaddor K, LaMorgese J (1976) Complication of a large cranial defect. Case report. J Neurosurg 44:506–508Google Scholar
- 13.Prolo DJ, Oklund SA (1991) The use of bone grafts and alloplastic materials in cranioplasty. Clin Orthop Relat Res 268:270–278Google Scholar
- 15.Tessier P (1982) Autogenous bone grafts taken from the calvarium for facial and cranial applications. Clin Plast Surg 9:531–538Google Scholar
- 20.Sanan A, Haines SJ (1997) Repairing holes in the head: a history of cranioplasty. Neurosurgery 40:588–603Google Scholar
- 22.Lee C, Antonyshyn OM, Forrest CR (1995) Cranioplasty: indications, technique, and early results of autogenous split skull crartial vault reconstruction. J Crartio Maxfac Surg 23:133–142Google Scholar
- 24.Frodel JL (2002) Calvarial bone graft harvesting techniques: considerations for their use with rigid fixation techniques in the craniomaxillofacial region. In: Greenberg A, Prein J (eds) Craniomaxillofacial reconstructive and corrective bone surgery. Springer, New York, pp 700–712CrossRefGoogle Scholar
- 33.Grant GA, Jolley M, Ellenbogen RG, Roberts TS, Gruss JR, Loeser JD (2004) Failure of autologous bone-assisted cranioplasty following decompressive craniectomy in children and adolescents. J Neurosurg 100:163–168Google Scholar
- 42.Sahoo NK, Rangan M (2012) Role of split calvarial graft in reconstruction of craniofacial defects. J Craniofac Surg 23: e1–4Google Scholar