Cranial bone grafting for alveolar clefts: a 25-year review of outcomes. Plast Reconstr Surg 2014 May;133(5):662e-668e
Date
04/30/2014Pubmed ID
24776568DOI
10.1097/PRS.0000000000000109Scopus ID
2-s2.0-84899734660 (requires institutional sign-in at Scopus site) 23 CitationsAbstract
BACKGROUND: Cranial bone grafting for an alveolar cleft obtains membranous bone from a low-morbidity donor site. Although iliac crest bone is the favored donor site, there are no objective analyses of three-dimensional radiologic outcomes with cranial bone grafting and no studies evaluating complications and long-term outcomes in a large series of patients undergoing cranial bone grafting.
METHODS: A retrospective chart review was conducted on patients who underwent alveolar bone grafting from the cranium over a 25-year period performed by a single surgeon. Data collected included patient characteristics, complications, and clinical outcomes. Radiologic analysis of graft outcomes was determined using Amira volume-rendering software on the most recent 10 consecutive patients.
RESULTS: The authors' study cohort included 308 patients, with an average age of 11.5 years. Complications involved harvesting the graft in 3.5 percent, the donor site in 1 percent, and the recipient site in 17.2 percent. Regrafting was required in 7.1 percent, with a clinical success rate of 92.9 percent. The average alveolar defect was 1.19 ml preoperatively and 0.19 ml postoperatively, with 85 percent fill of the cleft defect by radiologic analysis.
CONCLUSIONS: Cranial bone grafting for the alveolar cleft is a low-morbidity operation and has success similar to that of iliac crest bone grafting. It should be considered more often as a viable option for the alveolar cleft patient.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Author List
Hudak KA, Hettinger P, Denny ADAuthor
Kristen Ann Klement MD Associate Professor in the Plastic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Alveolar Bone Grafting
Alveolar Process
Child
Child, Preschool
Cleft Lip
Cleft Palate
Female
Follow-Up Studies
Humans
Ilium
Male
Middle Aged
Radiography
Retrospective Studies
Skull
Young Adult
