Author Topic: Cranioplasty  (Read 10703 times)

Melissa778

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Cranioplasty
« on: November 06, 2009, 10:19:06 am »
I have been having severe pain in my head/neck, and in general right around the surgical scar area for months now.  I've had numerous steroid injections to calm the nerves, but this only seems to provide miinimal relief.  My doc has done a few scans and it seems that my body has somewhat reabsorbed the fat packing.  I'm a small petite person and apparently this can happen?  They are hesitant to do another fat packing since they feel my body may reabsorb it again.  The doc is now pushing for me to consider a cranioplasty.....anyone had this done?  or know anyone who has??

On a positive note....My BAHA implant healed impecably!  at 3 1/2 weeks post op doc said he's almost ready to give me the go ahead for the processor because it looks terrific!  Still going to wait about 3 more weeks just to make sure, but 3 weeks should fly by!  My BAHA gotcha day will be here before I know it!

Melissa
1.6cm X 1.6cm diagnosed Jan 30 2008
Translab Surgery scheduled for May 15th with Surgery went well, got ALMOST all of it.
GK to zap the rest on 10/22/08
2010 MRI showed no new growth tumor measuring at that time at 1.1 x .4
2011 Holding steady
2012 new growth 1.7 x .7 :( :(

Kaybo

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Re: Cranioplasty
« Reply #1 on: November 06, 2009, 11:19:44 am »
Sorry you are still having trouble - I don't know anything about a cranioplasty...however, I guess that explains why little people are so little - your body just keeps sucking up any fat.  Obviously, I don't have that problem!   :o

Hopefully someone will come along with a much better answer for you!

;D

PS - GREAT news about the BAHA!
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

Debbi

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Re: Cranioplasty
« Reply #2 on: November 06, 2009, 11:27:16 am »
Hi Melissa-

So sorry to hear you are still having pain. I am afraid I can't shed any light on cranioplasty either - hopefully someone else will know about it.  Good luck - and sending you a hug.

Debbi
Debbi - diagnosed March 4, 2008 
2.4 cm Right Side AN
Translab April 30, 2008 at NYU with Drs. Golfinos and Roland
SSD Right ear, Mild synkinesis and facial nerve damage
BAHA "installed" Feb 2011 by Dr. Cosetti @ NYU

http://debsanadventure.blogspot.com

epc1970

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Re: Cranioplasty
« Reply #3 on: November 06, 2009, 11:44:14 am »
Hi Melissa
I had a crainoplasty as part of my closing up process.  Basically, they put some sort of material to space the muscles/nerves etc from the dura. In you case they used fat which is being absorbed. From what I have read, it may or may not help headaches or neck pain if you go back for one. I know for me, I have head and neck pain even with one. I guess it just depends on what they feel is the exact cause of your head and neck pain. Mine is probably not realted to anything a crainoplasty will help. Good luck!
Erin

CHD63

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Re: Cranioplasty
« Reply #4 on: November 06, 2009, 02:33:44 pm »
Melissa .....

I am not a medically trained person, but I did look at the operative reports from both of my brain surgeries (1994 and 2008) and both stated a cranioplasty was performed ..... first one saying gelfoam was used, second one saying titanium plate.  From what I can determine that simply means fixing the hole made in the skull.

I am a bit confused why your doctors are recommending a cranioplasty now unless the one done at the time of your surgery has failed for some reason (fat reabsorption, e.g.).  Both of my surgeries were via retrosigmoid approach and I did not have a fat graft in either one so I know nothing about that situation.  I think I would get a second opinion but additional surgery may be the only way to resolve your pain.

Best wishes and let us know what you find out.

Clarice
Right MVD for trigeminal neuralgia, 1994, Pittsburgh, PA
Left retrosigmoid 2.6 cm AN removal, February, 2008, Duke U
Tumor regrew to 1.3 cm in February, 2011
Translab AN removal, May, 2011 at HEI, Friedman & Schwartz
Oticon Ponto Pro abutment implant at same time; processor added August, 2011

cin605

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Re: Cranioplasty
« Reply #5 on: November 11, 2009, 03:03:17 pm »
I went for the "works" cranioplasty and titanium mesh n screws....fat from ab to patch hole titanium mesh n screws to seal the deal??I have a spot that kind of drops off to no skull behind my ear going to my neck the other side i can feel skull going to base of my neck. ???
2cm removed retrosig 6/26/08
DartmouthHitchcock medical center lebanon,N.H.
43yrs old

ombrerose4

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Re: Cranioplasty
« Reply #6 on: November 11, 2009, 03:11:35 pm »
My cranioplasty consisted of a muscle graft, gelfoam, artificial bone and titanium mesh , all done at time of surgery. Perhaps they didn't fill the area enough and that's why they need to go in and fix it. I had really bad headaches for the first five weeks, but they have been tapering off finally. Good luck and let us know what's going on.
Retrosigmoid 9/24/09
AN 2.4+ cm left side
Mount Sinai Hospital, NYC (Dr. Bederson and Dr. Choe)
BAHA surgery 1/4/2010

leapyrtwins

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Re: Cranioplasty
« Reply #7 on: November 11, 2009, 09:45:56 pm »
From the last two posts I just read, I guess I had a cranioplasty as part of my surgery and just didn't realize it.

I, too, have titanium mesh and screws and a titanium plate as well as fat in my head.  No headaches for me - thankfully.

Great news about your BAHA site, Melissa.   I guess your doc doesn't make you wait the 90 days like some docs do (?) 

Are you getting the new BP100? 

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

Kathy M

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Re: Cranioplasty
« Reply #8 on: November 12, 2009, 07:21:25 pm »
Hi Melissa!

My cranioplasty consisted of a titanium plate, mesh, screws, but no fat...got lots elsewhere though!!!  I've not had the first headache.  I hope you find some relief from your pain - the procedure to put in all the hardware was really a breeze compared to the original surgery to remove the AN.

And good luck on the BAHA!!!

Kathy
AN diagnosed 11/14/08, 3+cm, Retrosigmoid 1/13/09, Univ. Hosp., Cincinnati, Drs. Tew and Pensak
no facial nerve or eye issues!
3 more surgeries related to staph infections & osteomylitis over next 13 months.  New diagnosis of breast cancer.  Treatment completed 08/27/10.  Moving on!!!

salamander

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Re: Cranioplasty
« Reply #9 on: November 13, 2009, 05:17:05 am »
Hi Melissa,

I am in a similar spot as you.  After a year, I am still having bad headaches.  The doctors think that the bone piece that they returned to my head at the time of surgery failed to get a blood supply and has dissolved.  (at Mayo they replace the bone rather than use fat)  That has caused continuing irritation/damage to the dura (lining around brain, inside skull).  We did discuss that I may need a cranioplasty to help with my headaches.  However, I was in no hurry to have anyone reopen my head for a "possible" cure, so we agreed to give it time to heal.  By cranioplasty, I mean that they open things up, scrape scar tissue away, insert acrylic material between the dura and the mesh, and then close you back up.

The theory, from what I can understand, is that the bone (or in your case, fat), fails to become integrated into your body and dissolves.  The titanium mesh or scar tissue, without a buffer (ie skull), is then directly touching the dura and causing pain.  However, the pain could also be caused by the nerves being cut and damaged at the site of the surgery.  So, I don't believe it is proven, but one of the current attempts at trying to figure out why some of us have such bad headaches long term.  From what I can tell, it helps some people and not others.

So, I can't tell you about the effectiveness of the surgery, but I am familiar with what you are talking about.  I look forward to hearing about anything you find out as you continue forward.

I'm still grappling with this issue myself, so I stand corrected if anyone has more definitive information!!

Samantha
2.9 cm right side AN;
Retrosigmoid/Sub-occipital surgery 11/08;
SSD(w/tinnitus), facial weakness, dry eye, eye weight, headaches.
Some movement of face at 7 months

LOIS

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Re: Cranioplasty
« Reply #10 on: November 16, 2009, 10:55:53 pm »
Mellisa,

I had cranioplasty as part of the closing surgery, no fat.  That was 15 months ago.  Its not a guarantee that you wont have headaches.  Mine have let up some but I still wake up everyday with one and sometimes still get them during the day.  My 1 year posy op mri showed enhanced scar tissue plus I did have a complication of meningitis after surgery and have been told the headaches are partly because of those 2 things.  I'd be afraid more surgery would make more scar tissue.  Just my opinion, of course, no medical degree here.

Lois
Diagnosed 07/08   1.2 x 1.1 cm. left AN Retosigmoid surgery 08/08 with Dr. Bartels  @ Tampa General Hospital

AMD

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Re: Cranioplasty
« Reply #11 on: November 29, 2009, 08:28:13 pm »
I had cranioplasty as part of my retrosigmoid closing process.  I have fat, piece of neck muscle, bone matrix/putty (basically ground up bone filler), and then the circle of skull they cut out at the beginning of the procedure held in with titanium plate and a few screws.  Luckily, I have had minimal neck problems and minimal headaches.  My surgeon feels the neck strain and headaches are relieved when the neck muscles have skull to adhere back to instead of dura. 

It also made for less of s deformity in appearance.  Unless I run my finger across the area and feel the small dip, nobody can tell.

Hope things go well for you and you find what you need.


-Amy
Left side 1.7 cm AN diagnosed 7/30/08
Misdiagnosed for 8 + years
Surgery, Sub-occipital, 11/17/2008 at Indiana University Hospital
Left SSD
Tumor much larger than expected. Facial nerves intact, but had RARE swelling resulting in brachial plexus injury and tracheostomy after surgery.