Bone autografting of the calvaria and craniofacial skeleton: Historical background, surgical results in a series of 15 patients, and review of the literature

BACKGROUND Although the use of autologous bone for reconstruction of the cranial and facial skeleton underwent a partial reappraisal following the introduction of a vast range of alloplastic materials for this purpose, it has demonstrated definite advantages over the last century and, particularly, during the last decade. METHODS Fifteen patients underwent cranial and/or cranio-facial reconstruction using autologous bone grafting in the Department of Neurologic Sciences-Neurosurgery and the Division of Maxillo-Facial Surgery of the Rome "La Sapienza" University between 1987 and 1995. This group of patients consisted of 8 females and 7 males whose average age was 29.5 years (range 7.5 to 59 years, mean age 30). In all these patients cranioplasty and/or cranio-facial reconstruction had been performed to repair bone defects secondary to benign tumors or tumor-like lesions (12 cases), trauma (2 cases), or, in the remaining case, to wound infection after craniotomy for a neurosurgical operation. RESULTS The results obtained in a series of 15 patients treated using this method are described with reference to the abundant data published on this topic. CONCLUSION The mechanical, immunologic, and technical-grafting properties of autologous bone, together with its superior esthetic and psychological effects, probably make it the best material for cranioplasty

Tunneled modified lotus petal flap for surgical reconstruction of severe introital stenosis after radical vulvectomy

AbstractINTRODUCTIONWe presented the anatomical, functional and aesthetic results achieved with lotus petal flap in case of introital stenosis as a results of inadequate primary plastic reconstruction. We discussed the potential advantages of lotus petal flap compared to others vulvar reconstructive techniques.PRESENTATION OF CASEWe report a case of a 44-years old woman presenting a severe introital stenosis following radical surgery for vulvar cancer. She could not have a normal sexual activity life because the narrow scarred introitus resulting after primary closure of a large vulvar defect. The patient comes to our attention after three years from primary surgery. Once the scar was removed we performed a vulvoperineal reconstruction with bilateral tunneled lotus petal flaps.DISCUSSIONLotus petal flap is a safe, easy and quick technique, has a good functional and cosmetic results in this young woman, and represents an optimal alternative solution for plastic reconstruction in case of severe introital stenosis after primary closure of large vulvoperineal defect.CONCLUSIONTunneled lotus petal flaps represents a feasible, attractive and versatile surgical reconstructive technique that can be easily performed after surgical treatment of vulvoperineal neoplasms