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Cranioplasty - operation for correction of skull defects
Cranioplasty is an operation to correct deformities of the skull or defects of its bones.
As a result of the surgery, intracranial pressure is restored, the circulation of the cerebrospinal fluid is normalized and the blood circulation of the brain improves.
The implementation of cranioplasty prevents the appearance of the syndrome of the Trepanized Skull.
- When is the intervention necessary?
- Preparation for operation
- Modern approach to surgical intervention
- Autotransplantation - use of patient's tissues
- Alloplastics - from the dead alive
- Xenotransplantation - use of foreign materials
- Is the opinion
- Rehabilitation period
- Price issue
When is the intervention necessary?
Indications for operation:
- presence of skull defects;
- sealing of the cranial cavity;
- Elimination of symptoms arising from the defects of the cranial vault, such as amnesia, impaired concentrating ability, impaired consci
- presence of posttraumatic epilepsy;
- manifestation of the syndrome of the Trepanized Skull.
The operation for the correction of cranial defects can not be carried out with infections of the soft tissues of the head, persistent intracranial hypertension and in the severe condition of the patient.
Preparation for operation
Do not drink or eat food 12 hours before surgery. Also, the patient must undergo a complete examination to exclude contraindications to the operation.
In the presence of penetrating wounds to the head, it is necessary to make pneumography and computed tomography. Thus, the presence of cysts and tumors is determined, and the condition of the ventricular system of the brain is specified. In case of involvement of paranasal sinuses, doctors wait at least six months before performing cranioplasty to prevent the risk of wound suppuration.
Modern Approach to Operative Intervention
To date, neurosurgeons conduct three types of cranioplasty.
Autotransplantation - use of the patient's tissues
The tissues of the patient are used for autoplasty. Autografts are the most preferred for cranioplasty.
In this case, an implant is used on the stalk, which connects it to the maternal tissue. This method of operation promotes a good blood supply to the implant and its rapid engraftment.
The drawback of this technique lies in the inability to repair large defects. In addition, there is a need for additional surgical interventions.
Alloplasty - from the dead alive
It is carried out using hard meninges and bone grafts taken from the corpse. These materials are pretreated in the form of decalcification, digestion, canning and freezing.
Xenotransplantation - use of foreign materials
Xenoplasty is performed using non-biological materials and tissues taken from animals. The most popular are methyl methacrylates.
This material makes it easy to simulate implants of any size and shape. In addition, the price of the material is quite low.
It should be noted that methyl methacrylates can cause the risk of complications in the postoperative period. The most common xenografts also include hydroxyapatite( hydroxyapatite cement).
Its use is possible with defect sizes not exceeding 30 cm2.If it is necessary to correct larger defects, the material is reinforced with a titanium mesh.
The main advantage of the transplant is its full biocompatibility. It does not contribute to the appearance of long toxic and inflammatory reactions, which can cause methyl methacrylates. With minor skull defects, hydroxyapatite is completely replaced with bone tissue for eighteen months.
When xenotransplantation is also used titanium implants. They have high resistance to fracture, plasticity, minimal interference with CT and MRI.When using such a material, the risk of local inflammatory reactions is minimal.
There is an opinion of
From the practice of a neurosurgeon and patient of a neurological department.
Recently, I often carry out similar operations. Of all the possible transplants, I prefer titanium. When it is used, it is possible to perform a second operation within two to three months( of course, if the patient's condition allows it).
The only negative is the ability to get a disability after the operation. As for rehabilitation, the duration of this period depends on the individual characteristics of the organism.
Nikolai Sergeyevich, doctor of neurosurgeon
I had a craniocerebral injury, after which I had to carry out cranioplasty. As an implant, I was installed protakryl( which I was unhappy, since most clinics have long replaced it on a simulated plate).
Six months have passed since the operation, the appearance is simply terrible, due to the fact that the frontal bone is simply collapsed. After consulting with the doctors, they said that everything could be rectified by replacing the existing implant with a pala-cola plate. Now I am preparing for a second operation.
The purpose of rehabilitation is to gain independence and self-reliance. Rehabilitation activities consist in the preservation and renewal of such skills:
- speech communication skills;
- self-service skills( feeding, dressing, grooming, etc.);
- mobile skills( walking, fragile movements and stuff);
- cognitive skills( memory or the possibility of logical mental thinking);
- social skills( the ability to interact with other people).
The rehabilitation period takes place individually. In the post-operation period, it is recommended to undergo a course of dehydration therapy. Perhaps the appointment of a course of antibiotics.
The cost of cranioplasty depends on the complexity of the operation. Below is the average price for the operation without taking into account the cost of the implant, depending on the complexity category:
- first - 85500 rubles;
- the second - 100 000 rubles;
- the third - 126 000 rubles;
- the fourth - 150 000 rubles;
- the fifth - 175 000 rubles.