Significance of cranial repair.
The skull, as the protective shield of the human brain, assumes the most important duties of life activities. According to statistics, there are more than 3 million patients with cranial defects due to traffic accidents and accidents every year, and cranial defects are the more common sequelae of post-injury and post-operative patients with craniosynostosis. As the brain tissue loses the shielding role of normal skull and is easily injured twice, and the skull defect can cause various symptoms and affect the appearance, it is often necessary to perform skull repair and shaping to restore the normal stable state of intracranial pressure as soon as possible and reduce the continuous severe damage and functional effects on the brain due to the daily drastic changes of brain pressure caused by the skull defect. How to make the patient’s defective skull get the maximum repair is the focus of many years of clinical translational medicine research in Medical Center and Department of Materials.
Based on the practice of a large number of clinical cases, we have summarized the “Tsinghua University Cranial Repair Surgery Plan”, which allows patients and families to make the best choice according to age, defect size, defect site, overall condition and family economic status.
Cranial repair for children III (one year after surgery)
Cranial Repair for Children IV (one year post-operative)
Cranial repair for children XIX (four years old)
Dr. Lin Jiuluan explains the above case
Cranial repair for children XVIII (seventeen years old)
Cranial repair for children seventeen (eleven years old)
Cranial repair for children sixteen (three years old)
Cranial repair for children fifteen (three years old)
Cranial repair for children fourteen (eight years old)
Cranial Repair for Children XIII
Cranial Repair for Children XII
Cranial repair for children xi
Cranial Repair for Children X
Cranial Repair for Children IX
Cranial Repair for Children VIII
Cranial Repair for Children VII
Children’s skull repair case one
Children’s skull repair case two
Children’s skull repair case five
Skull Repair Case Six
Frequently Asked Questions
1.Q: Children’s skull defect, the people say “the child’s head bone is missing a piece”, what is the common cause?
A: There are many reasons for this, the common ones are traumatic brain injury and post-surgery, post-brain hemorrhage, inflammation and tumor of skull, meningitis and so on. In the past two years, our statistics show that the incidence of traumatic brain injury in children has climbed, which is related to the decrease of children’s activity places and the increase of private cars. This has planted a bomb for cranial defects in children.
2.Q: So children’s skull can grow with growth and development, so the skull defect does not need to be treated, and it will grow slowly, right?
A: This is not the actual situation. This is an abnormal deformed growth, which often causes fracture, we call it “child growth fracture”, this is very harmful to children, and individual cases can be seen to damage brain tissue, so children with skull defect cannot heal normally. In addition, when a child has a prolonged skull defect, the lower part of the brain tissue can collapse, causing abnormal development of the cerebral cortex or a potential risk of epilepsy. More importantly, the child is still in the psychological development period, and needs to go to school and communicate normally. Due to the skull defect, children around the same age will discriminate or bully the affected child, which is very unfavorable to the child’s physical and mental development.
3.Q: Is it necessary to repair the skull defect? Is there any size requirement?
A: This question is about the basic condition of cranial repair, or the indication of surgery. In the past, medical experts generally thought that skull defect more than 3 cm in diameter is meaningful to repair, but it is too general to say so. From the perspective of international evidence-based medicine, cranial defects can be repaired if they are greater than 2 cm in the area of cosmetic concern or greater than 3 cm in other areas. In addition, patients with very negative psychology about skull defects should be aggressively repaired without limiting the size limit. All cranial defects in children should be actively repaired.
4.Q: How long should the repair of skull defect be carried out?
A: In the past, experts believed that the skull should be repaired from three months to six months after the injury, but now it is believed that the timing of skull repair should not be too late, and as long as the condition is stable, it should be repaired early to prevent the negative effects of various skull defects.
5.Q: What is the material used for repairing skull defects in children? Is it the same as adults? What are the advantages of new material technology?
A: The repair of children’s skull defect is very demanding, not only for aesthetic needs, but also for the future development and growth of children. In adults, metal titanium plates are commonly used and fixed to the skull with titanium nails, but this technique may not work well in pediatric patients. The skull density varies among children of different ages and titanium nail fixation can be potentially dangerous. In addition, the growth of the child’s skull after the metal object is fixed to the skull can cause deformation or hinder the growth of the metal plate due to changes in force. There is also a psychological burden associated with metal retention in the child’s brain. We now recommend and use the artificial bone repair material – “Skeleton Gold” developed by Tsinghua University, which is a bionic bone material without any metal, this material is metal free, the bone density and hardness is in accordance with the age of the child, it does not inhibit the growth of the skull, and It is formed by computerized three-dimensional positioning, and the engineer analyzes the data according to the child’s bone age, so that the formed cranial bone is seamlessly matched with the defective cranial bone. From the children who have been followed up so far, the cranial bone repair after surgery is satisfactory without skull deformation and fluid accumulation. And it can effectively improve the mental abnormality of children and adolescents after cranial defects, and the efficacy is indeed. After the operation, the child can move as normal children, participate in study and spare time activities, and normal airplane travel is not affected (the original metal plate security check reacts), and the MRI examination in the future is not affected (no metal).
Introduction of bionic bone material.
The bionic bone material developed by the Department of Materials is a type Ι collagen + nanoscale hydroxyapatite prepared by in vitro mineralization technology, which has a very high similarity to the human body’s own bone composition and structure, and can participate in human bone remodeling and growth due to its excellent bone growth and very close to human calcium/phosphorus values, and the bionic material is eventually completely transformed into its own bone. Our new bionic bone material has excellent biocompatibility, no rejection reaction, no thermal and electrical conductivity, no influence on nuclear magnetic examination, and the bionic bone can fuse and grow with the cranial bone at the edge of the defect without affecting the growth and development of children’s skull and brain, which is the most ideal material for children’s skull repair and fills the gap in this field in China!
The technology not only won several domestic 863 projects, the project won the second prize of national technical invention in 2008, the second prize of national natural science in 2011 (the first prize is vacant), four Chinese invention patents and one US invention patent. 2002 international famous journals “Nature” and “Science” also gave high praise to the product. in July 2015, it won U.S. Food and Drug Administration (FDA) market access permission. This is the only product among China’s Class III implants to receive such a distinction, and it has become a key product project supported by the state because of its completely independent intellectual property rights technology!
6.Q: So what process do you usually take to examine the child with skull defect after he comes to the hospital and how to count this cycle?
A: After the child is admitted to the hospital, a 64-row CT three-dimensional imaging engraving is performed first, and then the child can go home first. The engraved disk will be handed over to the engineer for skull shaping, and we will communicate with the child at any time to make a “private order” according to the child’s specific age, location and shape of the skull defect, and the shaped skull will be sterilized and vacuum packed directly to the operating table. Therefore, if the child comes to the hospital for examination on the first day, the repair surgery can be performed in the third week and the hospitalization takes about 10 days.
7.Q: What is the approximate cost of this bionic bone skull repair material without metal?
A: It depends on the size and area of the skull defect, and the corresponding cost will increase if the defect area is large.
8.Q: Last question, can adults take this skull repair technique? Besides cranial defects, what other diseases can be treated with this repair material?
A: Adults can take this artificial bone for repair, we will individualize cranial bone forming according to different ages of adults, and can adjust cranial shape according to patients’ needs, so that patients with cranial defects can enjoy the highest level of cranial cosmetic services, which is also a reflection of medical technology into service. Patients can come to us for this artificial bone repair treatment as long as they are resistant to metal retention or are concerned about future MRI or airplane travel restrictions. In addition to the skull defect itself, some patients who have suffered a skull depression fracture due to childhood head trauma and have not undergone skull depression repair treatment and have a deformed healing condition can also adopt this technique, during which we will remove the old bone of the deformed depression and fix the new bone with a good shape to restore the skull to its original shape.