814 Bifrontal Craniectomy and Reconstruction with Synthes - a Surgical Approach for the Management of Symptomatic Hyperostosis Frontalis Interna

Abstract 57-year-old Caucasian female presented with depression, apathy, and personality changes a markedly “flaccid face”. A computerized tomography (CT scan) revealed remarkable bilateral hyperostosis frontalis interna significant frontal lobe compression. definitive operative procedure craniotomies was undertaken to relieve compression prevent further complications. During surgery, the bone flaps were found be very hard cut through craniotome or even drill. The complicated by dense adherence underlying dura. Craniotomy eventually completed multiple drilling efforts. Trimming down proved difficult, thus they not replaced back elected removed. Dura covered DuraGen galea closed without skull plates. Postsurgical imaging done synthetic plates made “Synthes” placed in second-stage procedure. patient recovered focal deficits remained stable at six months an improved mental state. Pathology showed benign hyperostosis. This case highlights difficulties of surgical management this rare discusses improvised techniques adopted for successful completion excellent outcomes.