Mb. Calobrace et Se. Downey, CALVARIAL DEFORMITY AND REMODELING FOLLOWING PROLONGED SCALP EXPANSION IN A CHILD, Annals of plastic surgery, 39(2), 1997, pp. 186-189
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.