In 1938 I reported on the operative repair of deep depressions in the frontal region of the skull in 15 patients. The depressions were filled with segments of autogenous rib cartilage, inserted one above the other, as illustrated in figure 1. These patients presented normally rounded skull contours until about two months after the operation, but from this time on irregularities developed which outlined the separate rib cartilage segments. The irregularities were most noticeable when an extensive depression had been repaired.
Secondary operations in which projecting portions of cartilage were removed served to improve the line of the forehead, but did not completely correct the irregularities. Some immediate improvement was also obtained by introduction of sheets of dermal graft between the cartilage and the overlying skin of the scalp, but the late results were disappointing. Depressions in the skull repaired by insertion of bone grafts likewise present postoperative irregularities, similar
PEER LA. DICED CARTILAGE GRAFTS: NEW METHOD FOR REPAIR OF SKULL DEFECTS, MASTOID FISTULA AND OTHER DEFORMITIES. Arch Otolaryngol. 1943;38(2):156–165. doi:10.1001/archotol.1943.00670040167008
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