Congenital scalp and calvarial deficiencies: principles for classification and surgical management.
Congenital defects of the scalp and skull present a challenge for care providers because of a combination of their rarity and the magnitude of potential morbidity. Recent advancements in autogenous and alloplastic cranioplasty and scalp reconstruction techniques argue for a comprehensive consideration of this problem. This article (1) reviews the causes of congenital scalp and calvarial defects; (2) proposes a classification system based on defect type, similar to the tumor-node-metastasis classification, in that defect location, defect size, and extent of neuromeningeal involvement are the critical variables; and (3) presents algorithms for care based on the defect classification. A set of management principles on which treatment plans can be based for these unique problems is provided.
Perlyn
Chad A
CA
Division of Plastic Surgery and the Cleft Palate and Craniofacial Deformities Institute, St. Louis Children's Hospital & Washington University School of Medicine, and St. John's Medical Center, Kids Plastic Surgery, St. Louis, Mo 63141 , USA.
Schmelzer
Rodney
R
Govier
Daniel
D
Marsh
Jeffrey L
JL
D000465:Algorithms; D000652:Amniotic Band Syndrome / Q000150:complications; D016025:Bone Transplantation; D002648:Child; D019465:Craniofacial Abnormalities / Q000145:classification* / Q000601:surgery*; D004476:Ectodermal Dysplasia / Q000601:surgery*; D005147:Facial Bones / Q000002:abnormalities*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019651:Plastic Surgery Procedures; D012535:Scalp / Q000002:abnormalities*; D012886:Skull / Q000002:abnormalities*