title: Calvarial Reconstruction of Small-Size Skull Defects Performing "8 Cranioplasty" in Children: Surgical Experience, Clinical Results and Treatment Algorithm.
abstract: OBJECTIVE
  To report our clinical experience, surgical treatment algorithm and technique in the reconstruction of uncomplicated and small-size calvarial defects by performing autologous split-bone grafting technique on anatomical findings and patients" outcome.
  
  
  METHODS
  We covered the defective calvarial zone without bone (area, 3.8 to 7.5 centimetersquare; median area 4.2 centimetersquare) following the resection of pathological skull region with an inner table of horizontally split adjacent skull site in thirty-six patients (aged between 28 and 125 months; median age, 68.75 months, minimum follow-up 14 months). The donor site, the characteristics of skin incision such as length, shape, location and bone splitting technique were determined based on our treatment algorithm for "8 cranioplasty". Pre- and postoperative clinical outcomes and courses as well as radiological results are documented.
  
  
  RESULTS
  Mean follow-up period for all children was 25 months. There was no mortality and 5.55% morbidity (n=2: 1 sterile wound dehiscence and 1 sterile wound discharge). No infected flap was seen and none of the patients required a second surgery. No graft failure, tumor recurrence or residue occurred.
  
  
  CONCLUSIONS
  Almost all of our patients reported good surgical and clinical outcomes with this presented management and surgical algorithm. Autologous split bone grafting technique in small-size skull defects, with its proposed name "8 cranioplasty" is a safe and effective reconstructive procedure due to its short-term surgery, small-size surgical zone, low complication rate, good cosmetic results and cost effectiveness. In addition, our algorithm specified for this procedure is purposive and also saves the surgeon time in the surgical planning stage.
authors: Ankara University, School of Medicine, Department of Neurosurgery, Ankara, Turkey.
authors: Ihsan
authors: I
authors: Dogan
authors: Gokmen
authors: G
authors: Kahilogullari
authors: Haydar
authors: H
authors: Sekmen
authors: Umit
authors: U
authors: Eroglu
authors: Onur
authors: O
authors: Ozgural
authors: Mustafa Agahan
authors: MA
authors: Unlu
mesh_terms: D000465:Algorithms; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012886:Skull / Q000601:surgery*; D013524:Surgical Flaps / Q000601:surgery; D014182:Transplantation, Autologous