A Study of Reconstruction of Calvarial Defect in Varied Etiology and Its Surgical Outcome

Cranioplasty is a relatively simple procedure which has its own morbidity associated with it. The current study was done to study the outcome of cranioplasty in terms of complication rate and the need for reoperation.

A total of 23 patients who had undergone decompressive craniectomy were included in the study. All patients underwent cranioplasty with either autologous bone graft or titanium mesh with screws as secondary procedure. Among the selected patients the clinical profile, operative details and the surgical interventions were undertaken and the outcome were noted. Outcome variables included early and late postoperative complications and need for reoperation.

Mean age of the patients was 31 ± 12.3 years, Mean duration between decompressive craniectomy/Ablative surgery and cranioplasty was 203.7 ± 32.0 days. 11 patients underwent autologous bone graft with screws and 12 patients with Titanium mesh with screws. The overall rate of any complication was 39.1%. Wound seroma (13%), wound infection (8.7%) and transient hemiparesis (8.7%) were the common early complications. Wound infection was the common cause of reoperation. The late complication (63%) and reoperation rate (54%) was significantly higher among patients with autologous bone graft compared to Titanium mesh.

Cranioplasty even though considered simple surgery, is associated with very high complication rates. There was significant higher incidence of complication and reoperation rates in patients undergoing cranioplasty with autologous bone graft.