A Case of Intractable Cranial Infection After Multiple Craniotomies and Radiotherapy That was Cured by a One-stage Cranioplasty Using a Free Muscle Valve Graft

  • KOBAYASHI Miharu
    Division of Plastic and Aesthetic Surgery, Ina Central Hospital Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine
  • YUZURIHA Shunsuke
    Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine
  • NAKAMURA Toshitsugu
    Division of Pathology, Ina Central Hospital
  • SATO Atsushi
    Division of Neurosurgery, Ina Central Hospital
  • KONDOH Shoji
    Division of Plastic and Aesthetic Surgery, Ina Central Hospital

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Other Title
  • 複数回の開頭手術と放射線治療後の頭蓋難治感染創に対して遊離筋弁移植を用いた1期的頭蓋形成手術により治癒し得た1例
  • フクスウカイ ノ カイトウ シュジュツ ト ホウシャセン チリョウ ゴ ノ ズガイ ナンチ カンセンソウ ニ タイシテ ユウリキンベン イショク オ モチイタ 1キテキ ズガイ ケイセイ シュジュツ ニ ヨリ チユ シエタ 1レイ

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Abstract

We herein describe the treatment of a patient who suffered temporal bone osteomyelitis after multiple craniotomies and gamma knife irradiation procedures. A 61-year-old woman exhibited an epidural abscess between the sequestrated autologous temporal bone graft and the artificial dura on computed tomography 3 years after three craniotomies including two sessions of gamma knife irradiation. For treatment, debridement of the bone graft and artificial dura, dural reconstruction with fascia lata, cranial hard tissue reconstruction with titanium mesh, and soft tissue and skin reconstruction with a free latissimus dorsi muscle flap were all performed in one procedure. We were able to successfully perform one-stage hard and soft tissue cranial reconstruction while controlling infection by the contribution of well-vascularized flap tissue and obtained good surgical results.

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