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Cranioplasty is a plastic surgery that is based on closing defects of the bones of the skull and the dura mater resulting from trauma and surgery.
The improvement in the treatment of severe traumatic brain injury with increased surgical activity has led to an increase in the incidence of defects in the skull bones, which lead not only to cosmetic defects but are also accompanied by various functional and organic brain dysfunctions.
Reasons for the formation of defects:
Decompressive trepanations of the skull – the formation of a trepanation hole toreduce intracranial pressure in various pathologies;
Infectious and inflammatory processes – osteomyelitis of the bones of the skull, when the only treatment is to remove the affected tissue within a healthy bone;
In what cases is it appointed?
Cranioplasty is performed with:
Elimination of the possibility of re-injury (cerebroprotection);
Elimination of a cosmetic defect.
To cover cranial defects, depending on the material used, the following types of cranioplasty are currently used by a neurosurgeon:
Autoplasty is a type of surgical intervention during which the patch is made from the bone tissue of the patient to cover the deformed area of the skull.
Alloplasty – the use of bone material taken from a donor with biological compatibility to diminish the deformation. In particular, cadaveric material is used. The use of plates made of bone tissue has several limitations, which is associated with the ability of bones to dissolve;
Xenoplasty – the use of artificial materials (alloys of metals and polymers), since they are the safest for the patient, root well, do not cause complications.
The shape of the flap, which will be used to overlap the damaged bones of the skull, is made in advance, according to individual casts using 3D modeling.
The technology of stereolithographic modeling (3D) allows you to close the bone defect almost exactly, recreating the bone flap as accurately as possible.
The price of cranioplasty depends on the type of material used and the technique of the operation. Cranioplasty of the primary type is based on the removal of broken bones and their indented fragments. The site of the injured area of the skull is overlapped with the patches immediately after the depressed bones have been
removed. The operation is carried out in 1 stage.
The more delayed type of cranioplasty is considered to be more complicated concerning the technique of execution. The term for applying the patch is up to 7 days after the initial operation when the broken, dented bones in the cranium are removed. This method, as a rule, is used if the patient with non-penetrating damage to the cranium or after surgeries fixing closed fractures.
In the case of cranioplasty of the early type, the duration of the procedure can stretch to several months. The late-type of this surgical intervention is performed in 2 months after the initial procedure. This delay is prescribed for traumatic brain injuries.
In young children, cranial deformities are corrected only after reaching 18 years of age. Cranioplasty, the duration of which is 6-12 weeks, is considered the most optimal in terms of time. Which surgical method to use to block cranial deformity is determined by the surgeon based on the results of medical tests.
The duration of the operation of laying a plate or stacks on the transformed area of the cranium is, on average, 2-3 hours. General anesthesia is used for the operation.
The recovery and rehabilitation period takes up to 7 days.