• World Neurosurg · May 2016

    In situ cranioplasty technique for immediate calvarial reconstruction to optimize cosmesis.

    • Gary L Gallia.
    • Departments of Neurosurgery, Otolaryngology-Head and Neck Surgery, and Oncology, Johns Hopkins Hospital, Baltimore, Maryland, USA. Electronic address: ggallia1@jhmi.edu.
    • World Neurosurg. 2016 May 1; 89: 535-9.

    ObjectiveOne of the goals of calvarial reconstruction after craniectomy is optimization of cosmesis. A simple technique for intraoperative generation of an implant based on the patient's native skull contour for immediate skull reconstruction after craniectomy is described.MethodsIn this technique, a titanium mesh is molded to the contour of the skull in situ and temporarily secured to the calvarium before the craniectomy. After the definitive portion of the procedure, the implant is resecured using the predrilled holes in the skull.ResultsIn situ titanium cranioplasties are easily contoured to the patient's native skull before, and resecured after, craniectomy. Postoperative cosmesis is excellent.ConclusionsIn selected cases, this technique for in situ cranioplasty before craniectomy generates an implant that mimics the patient's calvarium and results in excellent cosmetic outcomes.Copyright © 2016 Elsevier Inc. All rights reserved.

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