Leaving part of the skull out

[aj44]

Is it standard practice not to put the part of the skull (that the surgeon had to cut out to get to the tumour) back in after getting an AN surgically removed?

[CHD63]

From what I can gather, this varies from neurosurgeon to neurosurgeon.  However, both holes from both of my skull-based surgeries (14 years apart and two different neurosurgeons) were filled in with other materials ..... not the original bone and I've had no problems (other than a lumpy head  ).

Clarice

[tenai98]

My hole was filled in with my belly fat and then closed over with my scalp...no bone replace, no tinanium mess, no nothing  but fat..
JO

[sues1953]

Hi AJ

From what I understand the norm is to drill out the skull so there isn't really anything left to put back.  Please Forum members correct me if I'm wrong.

Sue in Michigan

[Lynn Mc]

My hole was also filled in with Belly Fat (Unfortunately they didn't take all if it!).  Then covered with my scalp.  Nothing else put there.

Happy trails,
Lynn

[epc1970]

Hi AJ
I think that is a surgical preference more than anything. I have a couple of materials that I am unsure of the names and then a titanium mesh plate then scalp-no skull bone replacement.It seems freaky to me if I think about it too hard but physically...no problems except for the funky  dent 
Erin

[leapyrtwins]

From what I understand the norm is to drill out the skull so there isn't really anything left to put back. 

This is not correct.

Generally the surgeons take a "window" out of the skull and they work through that via microscope.  Whether the window is put back or not depends on the doctors involved, like Erin said.

My piece of skull was replaced but I also have titanium mesh, belly fat, and a titanium plate in my head.

Jan

[stevecms]

hi,they filled it with bellyfat but now my an ear pulses 

[lori67]

Jan,

I think in some cases, they do drill the bone out rather than making a window.  My surgeon sorta "sanded" it down with a drill until it was paper thin (that's actually what it said on my OR report) and then they just remove the paper thin part.  I'm pretty sure he came into the OR with a toolbox that said Craftsman on it!   

So, if it's done that way, there obviously wouldn't be any way to put the bone back when they close you up.  Some doctors use titanium mesh, screws, spackle, etc.  I just got the abdominal fat (and they didn't take all of mine either!   ) packed in there and got closed up.  If they do the "window", then they obviously can put the bone piece back in if they choose to.

I would think that it's safer to leave the bone out only if they do translab, since that area of your head gets a little protection from your ear anyway.  Some of the other approaches aren't afforded any protection and it might not be a good idea to walk around with a big soft spot on your head in a place you could easily bump.

Seems like with all other aspects of AN things, every doctor has his own way of doing things.

Lori

[rupert]

   I see by your post that you have already had your AN  removed.  So I'm guessing your wondering why they didn't put the bone back in.

   I have watched two videos on AN  surgery ( the internet has everything ).    In one case a "window"  was cut and the bone removed,  however it was not put back in.

  In the other the bone was "sanded"  down very thin and then removed.  Obviously not put back in.    I  have heard of many that were put back in or had a titanium mesh plate and many that did not have anything put back in.    I know that the neurosurgeons I saw said that they would be using titanium mesh.

  Seems to me,   just doctor preference and or  how they were trained.                 Bryan

[Denise S]

What kind of surgery did you have?

I had Middle Fossa and they did the window, put it back in and I have some titanium ??strips?? to hold it. 

By now I'm sure it is healed and have to say I have NO bulging, bumps, indents in my head at all.  It's all healed as smooth as it was before surgery.

(At 3 months I was looking & searching through my hair for my scare and could barely even see it, looks like nothing was ever done......and when compared to my post op pics, that is almost unbelievable!!)   

Definately have found every doctor seems to do each procedure a bit different.

[aj44]

Hi.

They didn't put my skull back in nor did they put anything else in. I was told that putting the skull back in causes further complications down the line.

The funny things is I have fluid that leaked from my brain into my skull. There is a bulge where the fluid is and the bulge feels like a sponge. It feels very weird.

I had it drained and plugged already but it has come back. My surgeon is hoping that he will not have to open me up for a third time. He's hoping it settles down, so hopefully my head will absorb it.

[leapyrtwins]

Lori -

maybe that explains the placement of your BAHA abutment?  I was just trying to explain things to Pooter http://anausa.org/forum/index.php?topic=11867.0

Perhaps you can give us your input.

aj -

I think it all gets down to the doctors and their "rules".  They all seem to have different procedures for things like this.

I had the retrosigmoid approach almost 3 years ago and haven't had any complications.  Wonder how many years "down the line" I should be concerned 

I have had no fluid leaking, no bulge, and sponge feeling.  I've had numbness, but that's it.

Hope your surgeon can solve the problem.

Jan

[lori67]

Jan,

You are exactly right!  That was where the doctor had to put my BAHA abutment to get it into "good bone".

Lori

[sues1953]

I watched the Translab video online , I bet thats where I got the sanding of the skull info.  I hadn't heard of the window.  Maybe that IS more common with approaches other than Trabslab.  (I have been told by 3 surgeons that Translab is the only choice I have)

See I learn Sooooo much on this forum  .

Sue in Michigan