Reconstruction of growing skull fracture with in situ galeal graft duraplasty and porous polyethylene sheet.
OBJECTIVE
In growing skull fractures with large calvarial defects, it is difficult to use autografts for reconstruction and it requires alternative materials for cranioplasty. In this report, the authors describe their experience and introduce reconstruction of the growing skull fractures' defects with a porous polyethylene sheet (Medpor) and with a novel technique of duraplasty with in situ galeal graft, which avoid the potentially risky dissection and exposure of brain tissue. The goal of this study was to clarify effective surgical methods and to provide the rationale for these techniques.


METHODS
We performed this technique on 8 patients with large calvarial defects resulting from growing skull fractures. The skin flap was retracted, leaving the galeal plane adherent to the underlying defect. After removing the bony edges and exposing the underlying retracted dural margins, duraplasty was performed by suturing the galeal tissue left in situ on the defect of the dural margins. Bone reconstruction was performed by placing porous polyethylene sheet (Medpor).


CONCLUSIONS
Duraplasty with in situ galeal tissue is a simple, safe, and effective technique to reconstruct dural defects in growing skull fracture, which avoids the risky dissection of the brain tissue. Also, by using Medpor, growing skull fractures can be effectively reconstructed with good cosmetic results.
Abuzayed
Bashar
B
Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. sylvius@live.com
Tuzgen
Saffet
S
Canbaz
Bulent
B
Yuksel
Odhan
O
Tutunculer
Banu
B
Sanus
Galip Zihni
GZ
D001672:Biocompatible Materials; D002648:Child; D002675:Child, Preschool; D004388:Dura Mater / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D011095:Polyethylenes; D016062:Porosity; D019651:Plastic Surgery Procedures / Q000379:methods*; D012887:Skull Fractures / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes