Cranioplasty is a neurosurgical procedure designed to repair or reshape irregularities or imperfections in the skull. A bone graft from elsewhere in the body or a synthetic material may be used to repair defects or gaps in the cranial (skull) bones. Some factors that may be treated by a cranioplasty include:
- Premature closing of cranial sutures, or craniosynostosis
- Lack of skull expansion
- Hereditary factors resulting in birth defects
- Trauma damage
- Other skull defects that result in a hole or sensitive section of the skull
- A misshapen skull of unknown cause that affects appearance
Who should undergo a cranioplasty?
Both patients with medical conditions and aesthetic concerns may be treated by a cranioplasty. Though the procedure is typically performed at infancy for birth defects such as craniosynostosis, older patients may also require a cranioplasty for other reasons, such as trauma or a condition that has only recently been detected.
Patients of any age may wish to have their skull shaped for cosmetic reasons. Those undergoing a cranioplasty should be in good overall mental and physical health, understand the steps of the procedure and stop smoking as soon as possible to prevent a slow or irregular healing process.
What happens during surgery?
The patient is first administered a general anesthetic, and the incision area is cleaned and shaved if necessary. The surrounding area is covered with surgical drape, and the incision site is numbed with local anesthetic. The incision or incisions are made to expose the bone, and the bone is removed surgically, if necessary, to allow for reshaping and reattachment. The surrounding bone edges are cleaned and treated to improve grafting attachment.
Depending on the specific situation, the removed bone may be reshaped and reattached, or another piece of bone from another place in the body may be used to fill any holes. This bone is typically taken from elsewhere on the skull, such as from the ribs or the iliac bone of the pelvis.
Synthetic materials may also be utilized, including silastic, titanium plates, tantalum, acrylic or synthetic bone substitute. The bone or bone substitute is attached to the skull using special discs, plates and screws. The skin is then closed around the skull using fine sutures.
What should I expect after surgery?
Immediately following cranioplasty, the patient will typically recover from the anesthetic in under an hour, but will need to stay in the hospital for 5-7 days. The area will be bandaged, and drains may be used to release the build-up of any fluids the body cannot naturally absorb. In some cases, external fixators are needed to help position the skull as it heals.
The sutures may usually be removed in about a week, though bandages are often removed before then. Specific instructions regarding recovery times and physical activity will be given for the particular situation. Typically, normal activities may be resumed in 2-3 weeks, providing the head is protected from accidental impacts.
Very rare complications of this procedure include infection, nerve damage, brain damage, seizures and blood clots. These will be discussed thoroughly with the patient prior to the procedure.
Learn more about cranioplasty
If you are interested in cranioplasty, schedule a consultation with Brian Andrews, MD, so he can discuss the operation with you and address your questions and concerns. Contact us to learn more about cranioplasty.