Reconstruction of suboccipital craniectomy with autologous bone chips.
BACKGROUND
In patients submitted to suboccipital craniectomy in whom the bone is not repositioned, there may be a significant aesthetic defect due to lack of bone tissue, sometimes accompanied by paresthaesia and painful symptoms.


METHODS
In 15 patients submitted to suboccipital craniectomy, the bone chips were repositioned during wound closure.


RESULTS
At a mean follow up of 19 months (from 6 to 36 months), 2 patients (13%) complained of mild wound discomfort or occasional local pain. Twelve patients underwent control CT-scan. In three cases (25%) the bone fragments had been partly reabsorbed whereas in the other 9 (75%) they either formed a thin (4 patients) or consistent (5 patients) bony wall, with variable degree of adaptation to the contour of the contralateral occipital bone. The best cosmetic and functional results were obtained in young patients in whom the cerebellar parenchyma was well-preserved, as opposed to those in whom a CSF collection had replaced areas of cerebellar tissue.


CONCLUSIONS
In the majority of cases in whom an osteoplastic suboccipital craniotomy is not possible, repositioning of the bone chips from suboccipital craniectomy is able to restore a bone table, thus allowing morphological and functional recovery of the occipital region.
Missori
P
P
Department of Neurosciences, Neurosurgery and Neuroradiology II, University of Rome La Sapienza, Italy.
Rastelli
E
E
Polli
F Maria
FM
Tarantino
R
R
Rocchi
G
G
Delfini
R
R
D001139:Arnold-Chiari Malformation / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D001932:Brain Neoplasms / Q000601:surgery*; D002531:Cerebellum / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D004954:Esthetics; D005500:Follow-Up Studies; D006801:Humans; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014945:Wound Healing / Q000502:physiology