Calvarial bone grafting of facial defects.

Bony defects of the face continue to challenge the reconstructive surgeon. Traditional sources of autologous bone from the rib or pelvis have been associated with the limitations of pain at the donor site, the need for a second operative field, variable "take" of the graft with poor eventual survival and, ultimately, less than optimal reconstruction. Calvarial bone grafting provides a readily accessible source of bone from an inconspicuous donor site, usually within the same operative field. The morbidity is minimal. The calvarial bone graft is especially useful in repair of the frontal sinus, orbital floor, nasal and malar regions, as well as in certain instances of cleft palate with alveolar involvement.