Pune: 4-year-old gets India's first successful skull implant
In what makes for a medical marvel, doctors in Pune have successfully replaced 60% damaged skull of a 4-year-old girl, making it India's first. The damaged part of her brain was replaced by a three-dimensional individualized polyethylene bone, which was made by a US-based company as per measurements. The girl had suffered major injuries after an accident on May 31 last year. Here's more.
An accident and two critical surgeries later, girl was discharged
The girl was discharged from the hospital after two critical surgeries. She was in a car when it collided with an auto rickshaw. In May this year, she was re-admitted, and the doctors performed a successful surgery. The family hails from Kothrud. The mother said her daughter is back to being a chirpy girl and plays with her friends.
A fractured skull led to accumulation of fluid in brain
When the girl was admitted initially, her condition was critical. Bharti Hospital's Jitendra Oswal, a paediatrician, who operated her said she was bleeding profusely. He said CT scan showed severe brain swelling, with a fractured rear bone of the skull. "This had led to the excess accumulation of fluid (edema) in the spaces of the brain," Dr Oswal told TOI.
Despite treatment, her condition didn't improve
Further, Dr Oswal said the girl's condition didn't improve after 48 hours. A second CT scan showed malignant cerebral edema. He said the damage was so severe that the entire brain was pushed off center. In an operation, neurosurgeons removed full frontal, parietal and temporal bones of the skull to release pressure in the brain. After the skull-bone removal, she responded well and recovered.
Initially, doctors had apprehensions about new technology
In her subsequent visits to the hospital, the girl walked and talked on her own. But she was emotionally disturbed and didn't mingle with her friends. Meanwhile, a US-based company announced customized cranial implant (CCI) , that would fill the cranial bone of the patient, as per requirement. Neurosurgeon Vishal Rokade said they had apprehensions, but after consulting doctors worldwide, they went ahead.
Neurosurgeon explains why they took the option
"We selected polyethylene material as it's biocompatible, porous and light-weight. The pores in the CCI implant are interconnected and omni-directional, which help in fibrovascular growth of the surrounding tissue. Also, the customization aspect allowed us to trim and perfectly fit the implant," Dr Rokade said.
This was first such successful operation in Asia Pacific
Dr Rokade said a skull grows till the age of 14, so it was important that the implant didn't hamper its growth. "There could be chances of skull disfigurement," he said. He added the implant should allow the surrounding tissue to grow inside, and the CCI technology fulfilled all these requirements. Further, he told this was not only the first successful surgery in India, but Asia Pacific.
