Reconstruction of cranial defects.

We have found that small defects, particularly those within the hairline, are easily reconstructed with methy methacrylate prepared at the operating table. Larger defects, especially in children and active adults, are benefited by autogenous bone grafts and we prefer split rib. When the fabrication facilities are available the preformed silicone implants offer much to the surgeon. They may be sculptured to correct difficult contour problems such as in the supraorbital or forehead region and are especially useful to fill in defects where the bone is present, but depressed. These three methods have many advantages over the metallic implants. There is little complaint of the implant being cold when the patient is exposed to cold weather and a very important fact is that these methods not only provide a radiolucent reconstruction, but also do not affect EEG examination.