Cranioplasty for repair of a large bone defect with autologous and homologous bone in children

Cranioplasty is a well-established reconstructive procedure for restoring craniocerebral protection and improving cosmetic defects. Most allograft materials are not suitable in pediatric patients owing to skull growth; thus, autologous bone is often preferred in the reconstruction of the pediatric skull because of its capacity to osseointegrate and grow with the pediatric skeleton.A 33-month-old boy with Ewing sarcoma of the right frontal bone underwent surgical treatment with tumor excision. The resected bone was reconstructed with full-thickness calvaria harvested from the right parietal region. The residual parietal gap was filled with homologous bone taken from the iliac wing.This reconstructive technique was chosen to guarantee normal development of the frontal region and tissue integration, while considering possible radiotherapy after the primary surgery.