Prosthetic restoration of the human body involves restoring both form and function. In craniofacial prosthetics we usually concenterate on restoring form, or in other words, restoring the appearance of the body. However, in this case we were called upon by the plastic surgeon to restore a specific function – protecting the patient’s brain! Our patient was referred to our facility in Madison, WI from the University of Wisconsin Hospital and Clinics, Division of Plastic Surgery following her craniectomy operation. This surgery left her with a large part of her skull bone missing. This means the woman’s brain no longer had the protection of frontal and parietal bone in that area of her skull. If something heavy or sharp fell on her head where the bone was missing the trauma to the brain could be life-threatening!
Our challenge was to create a prosthesis with a singular function: to protect her vulnerable brain. In doing this a secondary challenge was to avoid having the prosthesis erode the thin delicate tissue overlying the bony margins of the cavity. The prosthetic process involved first capturing the surface anatomy of the entire top of her head, including the defect cavity overlying the brain. We used both our Artec Spider handheld scanner to create a digital image (middle top image) and traditional impression techniques with alginate and plaster bandages. Our final craniofacial prosthesis included 2 pieces: The inner piece was a very soft and supple silicone conformer cast hollow to reduce weight and pressure on the tissues. The outer piece was a hard shell made of PMMA acrylic to protect the brain from impact. The two integral pieces separate for easy cleaning.
Our patient has endured a long journey of health concerns. She is to be commended for her patience and positivity in taking an active and interested part in our design and fitting sessions for the creation of her craniofacial prosthesis. The prosthesis stays in place without adhesive and is completely hidden under her favorite wigs. Our Wisconsin practice location is near the University of Wisconsin Hospital in Madison. We work as a team to provide eye, nose, ear, and other custom craniofacial prostheses for Wisconsin and the Upper Midwest.
