Harvesting Split Calvarian Bone Graft

Calvarian bone graft is usually parietal and harvested above the end of the temporal muscle (see Fig. 10.93 ). It can be used for reconstruction of the facial structures (see Figs. 8.8 and 14.1 ). The incision is made above the temporal muscle ( Fig. 16.1a ) and the pericranium is elevated. The bone is outlined using a pattern made from aluminum foil (suture material wrapper) or glove paper as a guide ( Fig. 16.1b ). A trough groove several millimeters in size is drilled with a cutting bur ( Fig. 16.1c ), until the diploid space is reached. The bone is freed with an angled chisel or oscillating angled saw ( Fig. 16.1d ). The first graft should only be 1.0 to 1.5 cm wide. Subsequent grafts are easier to harvest because of the larger trough left by the removal of the first graft (Sherris and Larrabee 2009, p. 301).