Scar remained from a<unk>  Before the operation, CT scans and MRIs are taken to study the cranial defect. The patient is given antibiotics to prevent bacterial infection. The patient is situated on a foam donut or a horseshoe head holder for the operation. The patient is then anaesthetised and an incision is made following the incision of the previous operation. The scalp and the temporalis muscle is reflected to completely reveal the cranial defect. Significant blood loss is observed as new blood vessels formed in scar tissues are damaged by incision. Any soft tissues at the edge of the defect are removed and the defect is cleaned. The<unk>  material is placed on the defect and is fixed to the surrounding skull with standard titanium plate and screws. CSF may be drained from the brain to reduce herniation. Small holes may be drilled on the bone graft or the prosthesis to prevent the accumulation of fluid under the repaired defect. Soft tissues, temporalis, and the scalp are then fixed back in place. Subgaleal drain and dressing are applied to control facial swelling. After the operation, a CT scan is taken and patients may stay in intensive care for at least a night for better neurological status observation, or be placed in a regular care unit. The subgaleal drain and dressing are removed before the patient is dispatched. Children Special considerations to children undergoing<unk>  are made to accommodate for their growing cranium. Certain materials are more favoured when compared to adult<unk> . Autologous bone grafts are the most preferred materials for paediatric<unk> , as they are accepted by the host and the bone flap can be integrated into the body of the host. However, autologous bone pieces may be unavailable or unsuitable in certain occasions. The body size of children may be not enough to have bone flaps to be stored in their subcutaneous spaces, while cryopreservation facilities for bone grafts are not widely available. The use of autograft is also associated with a high rate of bone resorption. Synthetic materials are used for paediatric<unk>  when the use of autografts is not available or not recommended. Hydroxyapatite is another option for children<unk>  as it allows the expansion of cranium for children and its ability to be moulded smoothly. It is less commonly used than autografts due to its brittle nature, high infection rate, and poor ability to integrate with the human cranium. Bilateral<unk> es are more prone to complications compared to unilateral<unk> es in children. This may be explained by its larger scalp wound area, a higher volume of blood loss, and the higher complexity and duration of the operation.
Cranioplasty
Astragalectomy
Craniotomy
Cerebrospinal fluid diversion
Decompressive craniectomy
Minimal-access cranial suspension
Head transplant
Lumbar–peritoneal shunt