Reconstruction of Large Skull Defect Using Right-Angled Zigzag Osteotomy.

Lee, Kiyoung; Paik, Hye Won; Byeon, Jun Hee

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(5):667-670.
Published online September 1, 2007.

Reconstruction of Large Skull Defect Using Right-Angled Zigzag Osteotomy.

Kiyoung Lee, Hye Won Paik, Jun Hee Byeon

Department of Plastic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. byeon@ catholic.ac.kr

Abstract

PURPOSE
Among the materials for cranioplasty, autogenous bone is ideal because it is less susceptible to infection and has lower rates of subsequent exposure. However, the procedure is technically demanding to perform and requires a donor site. Disadvantages further exist when the defect is large and there are attendant limitations in donor site. The authors present their experience with reconstruction of large skull defect using right-angled zigzag osteotomized outer table of autogenous calvarial bone, overcoming the limitation in donor site. METHODS: From 2000 to 2006, 9 patients were retrospectively reviewed, who had undergone reconstruction with right angled zigzag osteotomized outer table of autogenous calvarial bone.
RESULTS
Aesthetically satisfactory skull shape was achieved. Major complications of infection, hematoma, plate exposure, and donor site complications of dural tear with bleeding, cerebrospinal fluid leak, and meningitis were not seen. One patient had delayed wound healing and was successfully managed conservatively.
CONCLUSION
Autogenous bone is the material of choice for cranioplasty, especially in complicated cases. Right angled zigzag osteotomy is a useful method in reconstruction of large skull defects with less donor site morbidity.

Keywords: Reconstruction of large skull defect; Split-thickness calvarial bone graft; Cranioplasty