Skip Navigation LinksHome > May 2014 - Volume 133 - Issue 5 > Cranial Bone Grafting for Alveolar Clefts: A 25-Year Review...
Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0000000000000109
Pediatric/Craniofacial: Original Articles

Cranial Bone Grafting for Alveolar Clefts: A 25-Year Review of Outcomes

Hudak, Kristen A. M.D.; Hettinger, Patrick M.D.; Denny, Arlen D. M.D.

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Abstract

Background: Cranial bone grafting for an alveolar cleft obtains membranous bone from a low-morbidity donor site. Although iliac crest bone is the favored donor site, there are no objective analyses of three-dimensional radiologic outcomes with cranial bone grafting and no studies evaluating complications and long-term outcomes in a large series of patients undergoing cranial bone grafting.

Methods: A retrospective chart review was conducted on patients who underwent alveolar bone grafting from the cranium over a 25-year period performed by a single surgeon. Data collected included patient characteristics, complications, and clinical outcomes. Radiologic analysis of graft outcomes was determined using Amira volume-rendering software on the most recent 10 consecutive patients.

Results: The authors’ study cohort included 308 patients, with an average age of 11.5 years. Complications involved harvesting the graft in 3.5 percent, the donor site in 1 percent, and the recipient site in 17.2 percent. Regrafting was required in 7.1 percent, with a clinical success rate of 92.9 percent. The average alveolar defect was 1.19 ml preoperatively and 0.19 ml postoperatively, with 85 percent fill of the cleft defect by radiologic analysis.

Conclusions: Cranial bone grafting for the alveolar cleft is a low-morbidity operation and has success similar to that of iliac crest bone grafting. It should be considered more often as a viable option for the alveolar cleft patient.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

©2014American Society of Plastic Surgeons

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