'Medical Miracle': Rare Brain Surgery Performed on Toddler to Restore Skull Bone in India

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Brain Image - Sputnik International, 1920, 11.02.2022
In January 2020, an infant from India faced serious head injuries after he fell from a roof. Several attempts were made by the doctors to treat him.
Calling it a "medical miracle", Indian doctors have successfully restored a toddler's skull bone through complex brain surgery performed on him at Apollomedics Super Specialty Hospital in the state of Uttar Pradesh.
In November 2021, the boy underwent surgery. After remaining under observation for months, the doctors declared him fit on Friday but will continue to monitor his health for a few more months.
The surgery was performed with the help of biomaterial implants made from porous polyethylene (a high-density polymer used in medical procedures since 1985).

"The injury had damaged [the toddler's] skull bone and a section of the left brain. But saving his life was more important at that point. The boy survived the trauma in the intensive care unit for a month," neurosurgeon Dr Sunil Kumar Singh from Apollomedics Super Specialty Hospital, Lucknow city, told IANS news agency.

But the doctors had to wait a while before performing such complex surgery, because the boy was too young.
To restore the skull, Dr Singh had to undertake the DECRA (Decompressive Craniectomy in Patients with Severe Traumatic Brain Injury) procedure according to the standard protocol.
"This is a neurosurgical procedure in which a part of the skull is removed to allow room for a swelling brain to expand without being squeezed. At the same time, the broken bone was taken away and preserved to be implanted when the child grew enough to face the surgery. Meanwhile, the boy's scalp was sealed," Dr. Singh explained.
When doctors performed another operation in July 2021 to restore the broken bone back in the boy's skull, the surgery didn't go as expected which meant that the boy was readmitted to the hospital in September 2021.

"We found that the bone had been rejected which meant that implants were the only option. Now, had the patient been an adult, things would have been simpler. But with children, the skull still has some way to grow whereas implants do not grow and would soon be the wrong size," the surgeon said.

Faced with new challenges, the surgeon looked for other options and decided to explore biomaterial implants made from porous polyethylene.
With the bio-implant in place, the surgeons said, there will be no problem as the boy ages as the implant will grow in line with the rest of the skull.
The chief executive of Apollomedics Super Specialty Hospital, Dr Mayank Somani, said: "This is the first time this type of surgery has been achieved in Uttar Pradesh. Until now it has only been available in big centres such as New Delhi and Mumbai."
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