Give back to patients with skull defects

In all types of injuries, traumatic brain injury often leaves serious consequences, resulting in death or disability for the victim. Many victims survived but had skull defects, the inner brain parenchyma was protected only by a layer of skin and thin software organization outside. In addition, occupational accidents and cranial diseases like u Cranial bones, sequelae of war wounds and after the treatment of brain pathology also created a small number of patients. The lack of a box compared to the " Skull Blood Syndrome " includes symptoms: headache, dizziness, nausea when changing positions or changing weather, when it is too hot or too cold, causing anxiety. fear when working, living because they must always find ways to avoid colliding with hard objects, making patients afraid to contact people for aesthetic reasons.

With large skull defects, the underlying brain structure can be altered, thereby affecting brain function. Moreover, always carrying with him a skull defect, making patients feel guilty and difficult to integrate with the community.

Studies have been published in 10,466 cranial trauma patients treated at Cho Ray Hospital, showing that the number of patients aged 18 to 35 accounted for more than 60%, the male rate for women was 4.64. For patients aged 18 to 50 accounting for 72%. Thus, most victims of traumatic brain injury in Vietnam are young and working age. Consequences of traffic accidents not only affect patients, but also heavily affect the whole society.

Therefore, the application of research and finding effective methods of economics and technology to create puzzle pieces to replace skulls is always a necessary task, helping the patients to have skull concealment. enter the community.

Technical solutions applied

The traditional treatment for cranial patients was previously the surgery of using pieces of material available made of tantalium, titanium, acrylic, polyethylene, silicone, and ceramics, and more recently the "intost-2" carbon composite material to cover the defect. Another method currently also being used in Central Military Hospital 108 is to make pieces (hand-molded) with dental cement (duracry) right after revealing the defect. Over the past 4 years, doctors here have operated on more than 60 patients, bringing them back to normal life. The advantage of using a piece of material is: Skull fragments are made on the spot. However, this method has some disadvantages :

- Large fragments cannot be built, in complicated areas such as eyebrow arches or eye sockets;

- Because it is a manual squeeze on some narrow surgery schools, it is not smooth, the aesthetics are not high. If using pieces of available material, the aesthetics are low because their curvature is different from the actual curvature of the patient's skull. The edge of the puzzle piece cannot fit into the skull bone defect;

- Creating a composite image in a short time of surgery will increase the duration of treatment. Moreover, because the graft is shaped and sterilized in a short time, especially when using polymerization materials such as PMMA, these factors will reduce the bioequivalence and life of the puzzle piece;

- Only simple and easy to use biological materials can be used for making shapes. For highly bioequivalent materials such as Titanium, Hydroxy-Apatite-derived material, it will be very difficult, and in most cases it is impossible to shape during surgery.

Surgery by the old method has many risks

In the case of patient Tran Thi T, born on May 16, 1956, she had surgery to remove tumors from the left and right occipital area on August 25, 1998, then install the mica piece to cover the defect. Currently the graft does not fit into the rest of the skull. When changing weather, changing seasons, overheating, storms or when it is about to rain, there is often an increase in intracranial pressure, the area of ​​the graft is swollen, stiff as the car and the patient has a sudden vomiting phenomenon. Without timely intervention, the patient suffers from loss of muscle tone, speech loss and loss of consciousness, complete inability to recognize. If left untreated, the body will have seizures, full body seizures. After stable treatment, it takes at least 2 to 3 months to restore function as the initial state. To remedy this situation, the patient's family members must learn how to treat, always closely monitor the patient for prevention.

Biomedical technology for effective diagnosis and treatment

Biomedical Engineering (Biomedical Engineering) is a multi-disciplinary field, requiring the participation of experts in many different fields such as: Image diagnosis, information technology, mechanics, surgery. , . Biomedical technology includes the design, manufacture of medical models, surgical aids, implants for the human body, hardware and software solutions that help For diagnosis and treatment of diseases that are accurate and effective.

For the first time in Vietnam, the biomedical engineering team consists of experts in the field of engineering and medicine established and operating effectively, aiming to apply high technologies in the world for shaping and treating. image, graphics, design and manufacturing physics in improving the ability to diagnose and treat diseases in Vietnam.

From 1999 until now, the Department of Imaging Diagnosis, Hospital 108 has been assisted effectively in Biomedical Technology of leading experts in the world. Especially the help of the Belgian Government, through the Catholic University of Leuven (Jos Vander Sloten professor) and the active transfer and implementation of the application of Biomedical Technology in Vietnam Le Chi Hieu, Cadiff University, UK.Currently, 108 Hospital has successfully organized a team of experts in different fields such as: Diagnostic imaging, neurosurgery, information technology and mechanics, for research, design and manufacturing. and transplant graft for patients with cranial defects, suitable for human conditions and technology and technology in Vietnam.

L.Khanh - Medinfo