1. Introduction

    Cranioplasty can be performed for a bony tumor resulting from traumatic injury (e.g., depressed skull fracture) or, more rarely, from a condition resulting from a congenital malformation (e.g., fused suture lines). These defects may occur anywhere on the head, so the surgical procedure may take place with the patient in varying positions such as supine, sitting, prone, or supine with the head turned. Patients range widely in age from newborn to elderly.

2. Preoperative assessment

    These are individualized according to the patient’s need.

3. Patient preparation

    Complete blood count (CBC), electrolytes, blood urea nitrogen, creatinine, glucose, prothrombin time, and partial thromboplastin time (D-dimer or fibrin split products if disseminated intravascular coagulation needs to be ruled out) are used. Type and crossmatch (for at least 2 units). Arterial blood gases are measured if the patient is being ventilated.

4. Room preparation