Division of Neurosurgery, Connecticut Children's, Hartford, Connecticut.
Department of Surgery, UConn School of Medicine, Farmington, Connecticut.
Oper Neurosurg (Hagerstown). 2021 Apr 15;20(5):436-443. doi: 10.1093/ons/opaa452.
Following a decompressive craniectomy, the autologous bone flap is generally considered the reconstructive material of choice in pediatric patients. Replacement of the original bone flap takes advantage of its natural biocompatibility and the associated low risk of rejection, as well as the potential to reintegrate with the adjacent bone and subsequently grow with the patient. However, despite these advantages and unlike adult patients, the replaced calvarial bone is more likely to undergo delayed bone resorption in pediatric patients, ultimately requiring revision surgery. In this review, we describe the materials that are currently available for pediatric cranioplasty, the advantages and disadvantages of autologous calvarial replacement, the incidence and classification of bone resorption, and the clinical risk factors for bone flap resorption that have been identified to date.
去骨瓣减压术后,自体骨瓣通常被认为是小儿患者首选的重建材料。替换原始骨瓣利用了其天然的生物相容性和低排斥风险,以及与相邻骨重新整合并随患者生长的潜力。然而,尽管有这些优势,但与成年患者不同,小儿患者的替换颅骨更有可能发生延迟性骨吸收,最终需要进行翻修手术。在这篇综述中,我们描述了目前可用于小儿颅骨成形术的材料、自体颅骨替换的优缺点、骨吸收的发生率和分类,以及迄今为止确定的与骨瓣吸收相关的临床危险因素。