CALVARIAL DEFORMITY AND REMODELING FOLLOWING PROLONGED SCALP EXPANSION IN A CHILD

A main concern in the use of scalp tissue expansion in the pediatric p opulation has been the risk of skull deformation. Little is known abou t the long-term effects of tissue expansion on the skull and the abili ty of the skull to remodel following removal of the tissue expander. W e report a recent case in which a 5-year-old boy had a fully inflated tissue expander retained under the scalp for a 15-month period. At sur gery for removal of the implant the patient was noted to have a profou nd skull deformity characterized by severe calvarial depression and ri dging. The patient underwent scalp reconstruction. Follow-up at 6 mont hs revealed nearly complete remodeling of the skull with minimal visua l deformity. This case demonstrates not only the profound bony deformi ty that can result from tissue expansion, but also the striking abilit y of the pediatric skull to remodel.