BACKGROUND: Cranial bone deformities are most often the result of trauma or extirpation for tumors, and the principal cause of the cranial deformities after cranial trauma is related to the craniectomy realized in neurosurgical approach for the treatment of brain damage. The reconstructive goals in cranioplasty are to provide protection of the brain, restore preinjury appearance and to lead clinical improvement like soft tissue pulsation and the unsafe feeling. Large full thickness skull defects can be quite challenging for the surgeon because of its complexity course which includes previous surgery, local infection and osteonecrosis. These factors lead to the difficult choice of the best reconstructive material. METHODS: A prospective study of the patients treated, from January 2008 to April 2010, for the calvaria reconstruction at Centro de Cirurgia Crânio-maxilofacial - Instituto Nacional de Traumatologia e Ortopedia (MS). RESULTS: Eleven patients with large full thickness skull defects submitted to cranioplasty were analysed. Nine of them were treated with parietal outer table without craniectomy and two were treated with customized prosthesis. CONCLUSIONS: In large full thickness skull defects the first method of reconstruction is the parietal outer table without craniectomy. In selected cases, when this reconstructive method can not be used, the option for the cranioplasty is the customized prosthesis.
Skull; Craniocerebral Trauma; Parietal Bone; Prosthesis and Implants; Plastic Surgery
