Technical considerations and morbidity in outer table calvarial bone graft harvesting

Introduction: Calvarium is valued for craniomaxillofacial reconstruction because of the proximity of the donor site to the recipient site, reasonable resistance to resorbtion, suitable geometry, and ability to be rigidly fixated. Although intracranial injury is a possibility, careful harvesting techniques minimize donor site morbidity. They can be used as onlay or interpositional grafts and for continuity defects due to their distinctive properties. The aim of this paper is to compare different surgical approaches and their implications on postoperative outcomes/morbidity for calvarial graft harvesting used for pre-prosthetic, articular eminence and nasal augmentation. 8 patients were evaluated in this study.

Patients and methods: Calvarial grafts were used for alveolar augmentation ( n = 1), nasal bone reconstruction ( n = 1) and augmentation of articular eminence ( n = 6). Four approaches were used; the bicoronal, the hemicoronal flap, the short parietal incision (8 cm) or the parietal extension of a preauricular incision. Dural exposure/tear, infection and graft healing were assessed parameters.

Conclusion: The bicoronal approach provides excellent view however duration of surgery and violation of hair follicles are the main withdrawals. The smaller sized grafts are harvested quickly through small parietal approach. Preoperative evaluation of calvarial thickness is the most important aspect to prevent major dural complications.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Technical considerations and morbidity in outer table calvarial bone graft harvesting
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