| Abstract: |
In this thesis, the anatomy of the scalp and skull, causes of skull d~fects, sequelae of cranial defects, indications for repair of cranial defects, timing of cranioplasty and methods of reconstruction of skull defects which are alloplastic and osteogenic were reviewed. In addition, ten patients with skull defects of different etiologies, sites, sizes were reconstructed using outer table calvarial bone grafts and fixation to the defects by titanium miniplates and screws. Ages of them ranged from (5-55years) of a mean about (26.2 years). The causes of the cranial defects were post traumatic in 8 patients; after excision of skull neoplasm in one case and post osteomylitis of skull bone in one case. The sizes of the defects included in this thesis ranged between 6 cm2 to 42 cm2 of a mean about (19.8cm\ The sites of the cranialdefects were seven at frontal region, two at parietal region and one at ~frontotemporal region. Pre-operative evaluation of these cranial defectswas done by history and clinical examination, preoperative plain X-rayskull, computerized tomography scanning with 3 dimensions views and preoperative photograph. Postoperative plain X-ray skull, computerised tomography scanning with 3 dimensions views and postoperative photograph was done.In all patients the cranial defects were reconstructed by the same technique using outer table calvarial bone graft and fixed to the cranial defects by titanium miniplates and screws.The results showed that the use of outer table calvarial bone grafts•can reconstruct cranial defects of different etiologies, sites, sizes, withsatisfactory cosmetic and functional outcome.No major complications occurred except minor complication: partial dural exposure in 2 cases during harvesting of outer table, one case of bone irregulatory and one case of subgaleal heamatoma.The results were discussed and concluded that reconstruction of cranial defects by outer table calvarial bone grafts and fixation by titanum mini plates and screws is a satisfactory and versatile method. It has many advantages compared to other techniques. These include: its being a biological material and its potential to be accepted completely at the graft site. The bone is also strong and has the potential for assimilation and growth. Split thickness graft has the advantages of short operative time, single surgical exposure with no need for additional incision or taking graft from another part of the body, and the resulting contour is smooth and natural.
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