Introduction: The timing of cranioplasty and method of bone flap storage are known risk factors of non-union and resorption of bone flaps. In this ani¬mal experimental study, we evaluated the efficacy of cranioplasty using frozen autologous bone flap, and examined whether the timing of cranio¬plasty after craniectomy affects bone fusion and new bone formation.
Method and materials: Total 8 rabbits (male, older than 16 weeks) were divided into two groups of early cranioplasty group (EG, 4 rabbits) and delayed cranioplasty group (DG, 4 rabbits). The rabbits of each group were performed cranioplasty via frozen autologous bone flaps 4 weeks (EG) and 8 weeks (DG) after craniectomy. In order to obtain control data, the cranioplasty immediate after craniectomy were made on the contralateral cranial bone of the rabbits (control group, CG).The bone fusion and new bone formation were evaluated by micro-CT scan and histological examination 8 weeks after cranioplasty on both groups.
Results: In the micro-CT scans, the mean values of the volume and the surface of new bone were 50.13±7.18 mm3 and 706.23±77.26 mm2 in EG, 53.78±10.86 mm3 and 726.60±170.99 mm2 in DG, and 31.51±12.84 mm3 and 436.65±132.24 mm2 in CG. In the statistical results, significant differences were shown between EG and CG and between DG and CG (volume: p=0.028 and surface: p=0.008). The histological results confirmed new bone formation in all rabbits.
Conclusion: We observed new bone formation on all the frozen autologous bone flaps that was stored within 8 weeks. The timing of cranioplasty showed no difference of degree of new bone formation. Not only the healing period after cranioplasty but the time interval from craniectomy to cranioplasty could affect the new bone formation.
This study was supported by a grant from the National Research Foundation of Korea (NRF-2014R1A1A1002630 and NRF-2016R1A2B4014600)