Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, Japan.
J Neurol Surg A Cent Eur Neurosurg. 2024 Nov;85(6):615-617. doi: 10.1055/a-2053-8491. Epub 2023 Mar 14.
Cranioplasty can be a challenging procedure in certain patients, such as those with scalp necrosis, or when performed after multiple surgical procedures. Herein, we present a patient in whom a part of the skull was placed inside out in a setting where the scalp wound could not be simply sutured because of multiple previous operations.
A 66-year-old patient with a history of multiple craniotomies to resect an intracranial tumor suffered significant skin flap necrosis after harvesting the superficial temporal artery for a bypass intending to ligate the internal carotid artery. He subsequently underwent a one-stage reconstruction surgery, in which the central part of the bone was excised, turned over, and fixed at the inner plate of the bone flap on the outside, and the outer plate on the inside.
This technique reduced the skin tension and reduced the epidural dead space, allowing skin flap healing with acceptable cosmetic results.
"Inside out cranioplasty" is a valid option for one-stage reconstruction in the cases with scalp necrosis.
在某些患者中，颅骨修复术可能是一项具有挑战性的手术，例如头皮坏死的患者，或在多次手术后进行手术的患者。在此，我们介绍了一位患者，由于多次手术，头皮伤口无法简单缝合，部分颅骨被里外翻。
一位 66 岁的患者，因颅内肿瘤多次开颅切除，在为打算结扎颈内动脉的旁路手术采集颞浅动脉后，出现明显的皮瓣坏死。随后，他接受了一期重建手术，其中切除了骨的中央部分，将其翻转并固定在骨瓣的内板外侧和外板内侧。
该技术减少了皮肤张力，减少了硬脑膜死腔，使皮瓣愈合，外观美观。
“内外翻颅骨修复术”是头皮坏死的一期重建的有效选择。
