Reconstruction of Growing Skull Fracture With In Situ Galeal Graft Duraplasty and Porous Polyethylene Sheet

Abstract

Duraplasty with in situ galeal tissue is a simple, safe, and effective technique to reconstruct dural defects in growing skull fracture, which avoids the risky dissection of the brain tissue. Also, by using Medpor, growing skull fractures can be effectively reconstructed with good cosmetic results.

Early diagnosis and treatment of growing skull fracture

“…[1][2][3][4][5][6] GSFs primarily occur in the first few years of life and if the infancy and early childhood are taken into consideration, the incidence would be higher. [7,[9][10][11][12][13][14] Lende and Erickson reported 90% of GSFs occurring before 3 years of age and more than 50% occurred before 12 months.…”

“…Because the dura of young adheres more tightly to the bone than that of older group, it is more easily torn apart when the skull fractures. [1,13,21] In addition, the brain and skull grow rapidly within the first 2 years of life. [3][4][5][6][7] Thus, young children with skull fracture are more prone to develop GSFs.…”

“…[1,5,[7][8][9][10][11][12][13][14][15] Head injury in the younger children is distinctively different from that of older children and adults. Because the dura of young adheres more tightly to the bone than that of older group, it is more easily torn apart when the skull fractures.…”

“…Growing skull fracture (GSF) is a rare complication of infant head trauma [1][2][3][4] and accounts for 0.05-1.6% of all childhood fractures. [5,6] GSFs might cause progressive widening of the fracture, herniation of the leptomeninges, and ultimately, herniation of the underlying brain parenchyma.…”

Repair of the Venous Sinus Defect With Bovine Pericardium Dura Substitute in a Case of Aplasia Cutis Congenita

“…2 To ensure better healing of the dural reconstruction, autologous grafts are preferred due to their viability, vascularity, and absence of tissue reaction. 10,11 However, it may be difficult or even impossible to harvest sufficient tissue in newborns with large defects. For this reason, synthetic dural substitutes can be used in such critical cases.…”