A technique for cranial bone expansion

There are several techniques for cranial bone remodeling available to the craniofacial surgeon. We present a method for expanding the cranial bone to reconstruct large cranial defects or contour large abnormalities using a progressive series of tongue-and-groove extensions of local cranial bone plates. This technique has been used by the senior author in more than 95 cases with a 6-month to 15-year follow-up. This technique offers several advantages over traditional cranial remodeling techniques, including three-dimensional stabilization of the remodeled calvaria, use of local tissue obviating the need for distant donor tissue or nonautologous biomaterials, greater flexibility in the modeling of the cranial bone, and a controlled decrease in the size of the remaining craniectomy defects, thus improving potential for cranial bone regeneration and closure. Although cranial bone expansion is not applicable or even necessary in all craniofacial procedures, it nevertheless is a valuable tool of the craniofacial surgeon.