Split Calvarial Bone Graft for the Reconstruction of SkullDefects

Cranioplasty is a common, but formidable surgical procedurefor neurosurgeons, in patients with scalp and / or calvarialdefects. this procedure can be simple or complex. the mainobjectives of cranioplasty are: to achieve primary woundhealing, obliterate dead space, and seal off sterile cranialareas from contaminated oronasal cavities, to restore thenormal barriers protecting the intracranial structures (togetherwith a satisfactory cosmetic result) and obtain a permanent orvery durable reconstruction, using biologically inert materials,and also to restore the aesthetics. the greatest problem isselecting the optimum material for repair of the cranial defect.many synthetic substitutions of the dura and bone are oftenused for reconstruction of the skull base; unfortunately, thesemethods bear significant disadvantages and can induce chronicinflammation, carry a high risk of infection, and are inferior tobiological sources in terms of strength and sealing quality [withthe exception of some materials, such as titanium mashes andcortosstm (orthovita®, malvern, usa), which are seen to havemore strength than the thin split thickness calvarial bone]. theprimary aim of this article is to review the basic principles to usethe split calvarial graft for the reconstruction of the skull defect.