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Calvarial and Dural Reconstruction
  1. ROBERT MACFARLANE

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    Calvarial and Dural Reconstruction. Edited by setti r rengacharyand edward c benzel. (Pp 200). Published by AANS, Illinois 1998. ISBN 1-879284-63-4.

    This monograph is the latest to be produced by the American Association of Neurological Surgeons as part of itsNeurosurgical Topics series. It begins by tracing the history of calvarial reconstruction from ancient times. There follows a discussion of the different autologous donor sites and synthetic materials currently available for repair of calvarial and facial defects. The merits, disadvantages, and contraindications of each are considered. Dural substitutes are then dealt with in similar fashion. Specific problems, such as scalp reconstruction, the management of comminuted frontal sinus fractures, and reconstruction of the anterior skull base are the subject of separate chapters. The final part of the book is devoted to craniosynostosis. A review of current knowledge on pathogenesis is followed by a good account of some of the more common techniques used to treat single suture synostosis. Understandably, in a book of this type there is space only for an overview of the treatment and complications of multisuture involvement, but the chapter provides well chosen references for further reading.

    The reconstruction of traumatic and postsurgical calvarial defects occupies the bulk of this volume, and is dealt with very effectively. Operative techniques and the relative merits of various materials are covered in a clear and consise manner. By contrast, the section on aural substitutes is a little disappointing because it does not provide the reader with reasoned argument on how to select the most appropriate graft from the sometimes bewildering variety of autologous, synthetic, and xenograft materials which are available when vascularised pericranial tissue is not an option.

    Craniosynostosis is a topic which is covered very well in standard paediatric neurosurgical texts and it is not worth buying this book for that section alone. However, the account of techniques for repair of calvarial defects is excellent and merits the inclusion of this text in a departmental library.

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