title: Three-layered osteodural plasty for severe anterior skull base and facial injuries. Report of eleven cases.
abstract: OBJECTIVE
  The upper cranial trauma of high force and wide area of application leads to fractures of calvaria, the skull base, and the viscerocranium. The aim of the study was to present eleven patients treated for severe anterior skull base and facial defects by means of three-layered osteodural plasty.
  
  
  METHODS
  The operative tactics consisted of bicoronal incision, bifrontal craniotomy, closure of the dura mater damage with a pericranium, reconstruction of bone defects with autologous bone grafts and plasty with anteriorly pedicled pericranial flap on the supratrochlear and supraorbital vessels.
  
  
  RESULTS
  During follow-up, which lasted 2-7 years, none of the patients developed any early or late postoperative complications.
  
  
  CONCLUSIONS
  The three-layer osteodural plasty of severe anterior skull base injuries with the use of autologous bone grafts for the reconstruction of craniofacial skeleton resulted in a good final functional, morphological and aesthetic outcome in all patients.
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Medical University of Warsaw, Poland. Electronic address: kcst@kcs.amwaw.edu.pl.
authors.forename: Hubert
authors.initials: H
authors.lastname: Wanyura
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Medical University of Warsaw, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Kamiński
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Medical University of Warsaw, Poland.
authors.forename: Zygmunt
authors.initials: Z
authors.lastname: Stopa
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods; D001924:Brain Concussion / Q000150:complications; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000150:complications; D004388:Dura Mater / Q000601:surgery*; D005151:Facial Injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005626:Frontal Sinus / Q000601:surgery; D006407:Hematoma, Epidural, Cranial / Q000150:complications; D006408:Hematoma, Subdural / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D019291:Skull Base / Q000293:injuries*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anteriorly pedicled pericranial flap; Autogenic bone graft; Cranioplasty; Osteo-dural plasty; Skull base fracture