A cranial reshaping surgery, also called cranioplasty, is a surgery designed to correct skull / cranium deformities. Those deformities can be congenital, meaning the patient is born with the cranial deformity, or could be acquired, meaning the skull anomaly due to a trauma, a surgery, an infection or other causes.
Congenital cranial deformities can be caused by non-syndromic craniosynostosis, syndromic craniosynostosis, severe positional plagiocephaly, encephaloceles, cutis aplasia, among others.
Acquired cranial deformities can be secondary to a brain or cranial surgery (such as cancer resections), severe skull trauma and fractures, infections or others.
There are various ways to perform a skull reconstruction. The choice of the technique depends on multiple factors, including the patient’s needs and wants, size of defect, type of defect and location of defect. You can perform an “augmentation” cranioplasty (to fill a defect for contouring) or a “reduction” cranioplasty (to trim down a bony protuberance for contouring).
There are two main categories when it comes to skull reconstruction/augmentation:
- An autologous reconstruction: the surgeon will use the patient own bone to reconstruct the defect.
- An alloplastic reconstruction: the surgeon will use a synthetic material to reconstruct the defect. The most common alloplasts used include titanium mesh, calcium phosphate products, polymethylmetacrykate and PEEK implants.
The other type of cranioplasty is the “reduction cranioplasty”. Patients can present with abnormal bony growths or spurs that are most often congenital. Those bony growths can occur anywhere in the skull, including the forehead, vertex or occiput. The treatment involving a reduction cranioplasty is quite simple. Depending on the size of the area involved, through an incision hidden in the hairy scalp, the bony protuberances are shaved down using osteotomes or burrs. Scar are hidden in the scalp.