We herein describe the treatment of a patient who suffered temporal bone osteomyelitis after multiple craniotomies and gamma knife irradiation procedures. A 61-year-old woman exhibited an epidural abscess between the sequestrated autologous temporal bone graft and the artificial dura on computed tomography 3 years after three craniotomies including two sessions of gamma knife irradiation. For treatment, debridement of the bone graft and artificial dura, dural reconstruction with fascia lata, cranial hard tissue reconstruction with titanium mesh, and soft tissue and skin reconstruction with a free latissimus dorsi muscle flap were all performed in one procedure. We were able to successfully perform one-stage hard and soft tissue cranial reconstruction while controlling infection by the contribution of well-vascularized flap tissue and obtained good surgical results.
