Cranial reconstruction after a post-craniotomy empyema

Autor: T. Bron, Y. Riah, C. Dellavolpe, D. Casanova, Y. Reynier, J.-F. Chabas, J.-M. Kaya
Přispěvatelé: Khrestchatisky, Michel, Département recherche et développements (R&D - SNCF), SNCF, Neurobiologie des interactions cellulaires et neurophysiopathologie - NICN (NICN), Centre National de la Recherche Scientifique (CNRS)-Université de la Méditerranée - Aix-Marseille 2, Institut de génétique humaine (IGH), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique (CNRS)
Rok vydání: 2009
Předmět:
Adult
medicine.medical_specialty
MESH: Empyema
Serratus anterior muscle
medicine.medical_treatment
MESH: Brain Diseases
MESH: Craniotomy
MESH: Bone Substitutes
Free flap
Surgical Flaps
03 medical and health sciences
0302 clinical medicine
Scapula
medicine
Humans
Surgical Wound Infection
[SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]
MESH: Surgical Wound Infection
Empyema
Craniotomy
Brain Diseases
MESH: Humans
business.industry
Skull
MESH: Adult
MESH: Surgical Flaps
Plastic Surgery Procedures
medicine.disease
Cranioplasty
3. Good health
Surgery
medicine.anatomical_structure
030220 oncology & carcinogenesis
Bone Substitutes
MESH: Reconstructive Surgical Procedures
MESH: Skull
[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]
Female
Osteitis
business
MESH: Female
030217 neurology & neurosurgery
Zdroj: Journal of Plastic, Reconstructive and Aesthetic Surgery
Journal of Plastic, Reconstructive and Aesthetic Surgery, Elsevier, 2009, 62 (6), pp.e131-5. ⟨10.1016/j.bjps.2008.10.001⟩
Journal of Plastic, Reconstructive and Aesthetic Surgery, 2008, in press
Journal of Plastic, Reconstructive and Aesthetic Surgery, 2009, 62 (6), pp.e131-5. ⟨10.1016/j.bjps.2008.10.001⟩
ISSN: 1748-6815
DOI: 10.1016/j.bjps.2008.10.001
Popis: International audience; 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.
Databáze: OpenAIRE
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