A Less-Invasive Route for Skull Repair
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A number of patients who need urgent surgery for ruptured aneurysms, brain traumas, brain tumors, or other neurological injuries need to have a portion of their skull removed that’s later replaced, necessitating a second operation, a “cranioplasty.” That second procedure puts them at risk of adding insult to injury and may leave them looking significantly different in comparison to their presurgical appearance, says Johns Hopkins’ neurosurgeon Judy Huang. Replacing the portion of missing skull at a later date, which involves peeling back the scalp to expose the brain, may cause significant blood loss, can increase the risk of seizure, and sometimes leads patients to regress in their neurological recovery. In addition, the placement of bone or implant during cranioplasty reconstruction is often less than ideal, leaving an indentation in the temporal region that makes it obvious that a patient has undergone major brain surgery. “It’s hard for patients whose lives we saved to say that they’re unhappy with the side of their head,” Huang says.
Though she and other neurosurgeons have been performing the skull replacement procedure in much the same way for more than a century, she adds, it was clear that there was room for improvement. So Huang and a group of neurosurgeons teamed up with Johns Hopkins’ craniofacial plastic surgeon Chad Gordon. With Huang’s support and guidance, Gordon developed a novel repair technique that could prevent further brain trauma and risk for infection, while also preserving the skull’s original appearance.
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