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Cranioplasty refers to a reconstructive procedure performed to repair cranial defects (holes in the skull). These procedures are performed to repair and reconstruct defects caused by previous surgeries or traumas.
Cranioplasties may vary depending on the type of material used to reconstruct the skull defect. The first cranioplasty was thought to have been performed more than 4000 years ago, using precious metals and shells. Fortunately today, advancements have been made in the type of materials used. Titanium implants are both non-reactive and moldable that serves as a temporary or permanent reconstruction. Other materials include synthetic bone substitutes, as well as acrylic implants.
The goal of the surgery is to restore the natural contour and shape of the skull, in addition to providing a rigid protective structure around the brain. In essence, the cranioplasty is performed to replace the rigid bony structure that is missing in the skull. The cranioplasty can be prepared prior to the surgery. These are known as “prefabricated” implants. These implants can be designed and 3D printed to provide excellent results. Once completed, they are sterilized and utilized during the operation. Other times, cranioplasties can be prepared at the time of surgery. These non-prefabricated implants are hand contoured by the surgeon during the surgery. Sometimes, temporary, non-prefabricated implants are used, allowing for time to develop and print a 3D printed cranioplasty that can be placed at a secondary operation.
Defects of the skull may occur after surgery or related to cancer resections or prior craniotomies. Other times, patients may have defects secondary to prior traumas. Cranioplasties are performed to fill these defects, restore the shape and contour of the skull, while providing a protective encasement around the brain.
Depending on the reason for your cranioplasty, the recovery may be different. Generally speaking, cranioplasties are typically performed under anesthesia either as a stand-alone procedure or in combination with other surgeries. After the cranioplasty, you should expect to spend at least 2 days in the hospital to monitor your post-operative healing, in addition to managing pain. More extensive surgery may require longer hospital stays. Cranioplasties are performed through incisions in the scalp. It is not uncommon to experience numbness around the incision. Additionally, patients may experience mild and temporary hair loss around the incision.
Recovery after a cranioplasty may vary depending on the indication for the surgery. The immediate recovery period is typically spent in the hospital where you will be cared for around the clock by trained providers including nurses and doctors. They will manage pain while ensuring that you are healing well from the surgery. During this time, it is normal to experience mild pain and discomfort around the incisions. Patients can typically resume their normal diet. During the immediate postoperative period, it is normal to have drains in the scalp to remove any fluids that may collect. These are usually removed prior to discharge, but it is not uncommon to go home with them. Upon discharge from the hospital, you will return home with restricted activities. Your first week, you will need to minimize any heavy lifting or strenuous activities. Your doctor may prescribe stool softeners to prevent any bearing down. Other medications typically include pain medications and antibiotics. You will likely follow up with your physician within 1 to 2 weeks of discharge.
Cranioplasty costs are typically covered by insurance, as these are deemed necessary procedures.
Cranioplasty may be performed in addition to other types of surgery. Other related surgeries include neurosurgical procedures such as tumor removal, clot evacuation, cranial decompression, or trauma-related repairs. Other surgeries may involve surgery on the nose and sinuses. Sometimes, patients may have associated flap procedures.