EFFECT OF CRANIAL SUTURE AUTOTRANSPLANTATION FROM METOPIC TO CORONAL SUTURE

The aim of this study was to determine the outcome of autotransplantin g part of the metopic suture to a defect in the coronal suture in a pi g model and to explore further the concept of functioning and nonfunct ioning recipient sites. The authors harvested 15-mm x 10-mm bone graft s, incorporating a part of the metopic suture, in 10 Yorkshire pigs un der general anesthesia. The authors immediately autotransplanted the g rafts to a surgically created defect along the line of the coronal sut ure. Both donor and graft were either covered with pericranium or left bare. Radiopaque titanium markers were inserted to assess growth 1) o f the transplanted suture; 2) across both coronal sutures; and 3) acro ss the metopic suture. Serial radiographs were taken immediately after surgery and at 3-week intervals. The pigs were then killed at 21 week s. The cranium was harvested, and blocks of donor site and graft were taken, incorporating the embedded titanium markers. Histologic analysi s confirmed graft take in all pigs. All grafts continued to function a s active cranial sutures with no growth disturbance compared with the contralateral coronal suture (P = 0.953). There Tvas also regeneration of the donor defect, as confirmed by histologic analysis, with no gro wth disturbance across the metopic suture (P = 0.972). Pericranium did not alter graft take or subsequent growth (P = 0.964). However, peric ranium resulted in a much smaller defect (P = 0.045). These results sh ow that after autotransplanting a cranial suture to replace another cr anial suture, the graft continues to grow and function as a cranial su ture to meet the functional demands of the new recipient site. Pericra nium has a significant effect on calvarial regeneration but does not a ffect cranial suture autotransplantation.