Repair of Chiari III malformation using cranioplasty and an occipital rotation flap: technical note and review of literature

BackgroundChiari III malformation (CM3) is rare among Chiari malformations (I-IV). Its definition has been expanded to include caudal medullary displacement and hindbrain herniation into encephaloceles in lower occipital and high cervical regions. Prognosis is recorded as dismal, with respect to survival and functional outcome.MethodsWe describe the presentation, radiologic evaluation, and repair of this malformation using methyl-methacrylate cranioplasty and an occipital scalp rotation flap for closure. Outcome after surgery is addressed.ResultsAdequate closure of the defect and protection of underlying structures was achieved without undue stress at incision site.ConclusionsThis method of closure can be considered in cases of large occipital and cervical encephaloceles with poor skin cover and added osseous anomalies around the foramen magnum.