Posterior vault "free-floating" bone flap: indications, technique, advantages, and drawbacks

Childs Nerv Syst. 2021 Oct;37(10):3143-3147. doi: 10.1007/s00381-021-05281-x. Epub 2021 Jul 15.

Abstract

Background: The enlargement of the posterior cranial fossa volume is considered one of the main steps of the surgical management of children with multiple sutures craniosynostosis. Different management options have been proposed including fixed expansive craniotomy, free bone flap craniotomy, and distraction osteogenesis.

Objectives: To review indications to "free bone flap" craniotomy for the posterior fossa expansion, detailing advantages, disadvantages, and complications related to the technique.

Results and conclusions: A review of the literature shows that "free bone flap" posterior expansion cranioplasty still has a role, particularly in infants with thin and "honeycomb" structure of the bone, allowing to gain adequate intracranial volume increases and to postpone to a more adequate time surgery aimed at anterior cranial fossa expansion.

Keywords: Craniotomy; Free bone flap; Posterior vault; Syndromic craniosynostosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Child
  • Craniosynostoses* / diagnostic imaging
  • Craniosynostoses* / surgery
  • Craniotomy
  • Humans
  • Infant
  • Osteogenesis, Distraction*
  • Skull / surgery
  • Surgical Flaps