Abstract
Osteoradionecrosis of the skull remains a common and life-threatening complication of radiation therapy in cancer patients. This necrotic process may develop in the skull after high-dose radiation therapy, is slowly progressing and is challenging to manage.
A 30-year-old woman, who had undergone brain surgery for temporal astrocytoma followed by radiation therapy, presented 4 years later with extrusion of the cranioplasty fixation clamp discs and signs of soft tissue inflammation around them.
Thorough debridement of the necrotic bone was followed by soft tissue reconstruction of the temporoparietal area with a free radial forearm fasciocutaneous flap.
The postoperative course was uneventful and the calvarial bone reconstruction was performed at a second stage with the use of methyl-methacrylate plate, which was successfully covered by the previously reconstructed soft tissue.
Skull osteoradionecrosis management requires meticulous debridement of the necrotic tissue and cover with durable soft tissue. Free radial forearm flap is a reconstructive option providing abundant and reliable coverage for the cranioplasty.
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Gravvanis, A., Kakagia, D. (2022). Reconstruction of Calvarial Bone Radionecrosis and Osteomyelitis. In: Clinical Scenarios in Reconstructive Microsurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-94191-2_3-1
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DOI: https://doi.org/10.1007/978-3-319-94191-2_3-1
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