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Article Dans Une Revue Journal of Plastic, Reconstructive and Aesthetic Surgery Année : 2009

Cranial reconstruction after a post-craniotomy empyema.

Résumé

This article presents a case report of a cranioplasty performed after a post-craniotomy empyema with osteitis. The skull reconstruction was performed using a bioceramic implant and a combined muscular free flap of latissimus dorsi and serratus anterior. This procedure not only provided coverage of a wide skull defect but also allowed the filling of the intracranial dead space. Clinically, we observed an improvement of the patient's preoperative neurological status with a near-complete correction of her right hemiparaesis and phasic disorders. Eight months after the cranioplasty, (1) no recurrence of infection was noticed; (2) no distortion of the skull was noticeable and (3) the patient again experienced a normal social life. Using computed tomography (CT) scan images, we observed a re-expansion of the left cerebral hemisphere without any dead space or extradural collection. The only observable sequelae were a temporoparietal alopecia (10 cm x 4 cm) and a winging of the scapula, induced by the skin graft and the removal of the lower-third of the serratus anterior muscle, respectively. The use of a muscular free flap associated with a customised biomaterial allows a single-stage reconstruction of extensive skull defect (120 cm(2)) in a previously infected area.

Dates et versions

hal-00417377 , version 1 (15-09-2009)

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J.-F. Chabas, C. Dellavolpe, Y. Riah, T. Bron, Y. Reynier, et al.. Cranial reconstruction after a post-craniotomy empyema.. Journal of Plastic, Reconstructive and Aesthetic Surgery, 2009, 62 (6), pp.e131-5. ⟨10.1016/j.bjps.2008.10.001⟩. ⟨hal-00417377⟩
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