Cranioplasty and Scar Revision

Video Type: CVideo
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Author: Ryan Strebeck
Published:
Specialties: Pediatric Surgery, Plastic Surgery
Schools:
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Basic Info

Contributors: Michael Golinko (MD) and Kumar Patel (PA)

A six-year-old male with history of skull trauma acquired in an ATV accident underwent emergency craniotomy three years ago. He now presents with bone resorption, frontal bossing, scalloped bone, and a widened scar in the middle of his forehead from the previous surgery.

DOI#:https://doi.org/10.17797/bysho32ez5

Advanced

Procedure

Cranioplasty with Scar Revision

Indications

- Cranioplasty: After compound fracture of the skull; After decompressive craniotomy/craniectomy for hemorrhages, stroke, edema, or trauma
- Scar Revision: To improve the aesthetic appearance of a scar and/or restore function of skin

Contraindications

Infection, Hydrocephalus, Brain Swelling

Instrumentation

Setup

General anesthesia, mark area of excision for scar and cranial repair, inject with local anesthetic with epinephrine before cleaning site with betadine. Place patient in the supine position.

Preoperative Workup

History and physical, CBC, Coagulation profile, CT, standardized photographs, Anesthesia ASA categorization

Anatomy and Landmarks

parietal bone, temporal bone, sphenoid bone, zygomatic bone, zygomatic process, temporalis muscle

Advantages/Disadvantages

Cranioplasty � improved skull aesthetic and balance, repair bone absorption
Scar Revision - aesthetic improvement

Complications/Risks

Bleeding, infection (osteomyelitis), CSF leak, seizure, transient neurological defect, epidural or subdural hematoma, hydrocephalus

Disclosure of Conflicts

Bleeding, infection (osteomyelitis), CSF leak, seizure, transient neurological defect, epidural or subdural hematoma, hydrocephalus

Acknowledgements

Michael Golinko, MD
Arkansas Children's Hospital
University of Arkansas for Medical Sciences College of Medicine

References

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