How Far Down Into The Diploic Space Can Skull Reductions Go?

Q: Dr. Eppley,There are numerous places where I have seen you state that safe skull reduction cannot enter the diploic space, but in the case of this patient it appears you reduced his skull all the way down to the inner table – why is the diploic space the standard stopping point, and why was that rule able to be ignored in this instance?

A: What I always say is that skull reductions are taken down to the diploic space. You only find the diploic space by entering it. The diploic space is very thin so entering it usually means you are virtually through it. That is a good stopping point as the inner cranial table is now what is left…leaving some layer of bone over the underlying dura mater covering of the brain.

Dr. Barry Eppley

World-Renowned Plastic Surgeon