Shape of Skull and other questions

[wcrimi]

I have what might be some silly questions, but I want to ask them anyway.

Has anyone ever bothered to feel the area of their skull where the hole was cut to see if it is the same shape as the other side?

The reason I ask is that I have and it's not the same.  On the operated side the skull is flatter and indented a bit. It feels like the whole area where the incision was made is flatter, but it's actually indented a bit where I suspect the hole was made.  

Does anyone know how they keep the cut piece of your skull in place after surgery?

I know they use some kind of surgical glue and also supposedly use fat tissue (or something like that) to seal it.  But my operation was a little different. They never cut me anywhere else to get the fat tissue. So I don't know if they used the fat tissue already in the area or some other kind of sealant. If they used the fat already in the area, that might account for some of the different shape. 

Do they stable the skull or use any kind of metal to seal it also?

Finally, does anyone know how long it takes for the skull bone to fuse?

I never had any signs of leakage from the operated area, but I do often have a congested feeling in that ear and sometimes it actually feels like I have fluid in my ear (like when you just came out of the shower and some water got it in).  All this has me wondering whats going on in there.  The surgeons saw me at the 2 week point (to remove sutures) and 5 week (hearing tests) and didn't see any problems.  I am at 12-13 weeks now. I have no signs of leakage from my nose, don't taste anything funny etc... 

I'm not scheduled for a visit to my surgeon right now to ask him all these things and have it checked out.  He's supposed to contact me when he wants me to get an MRI and come in for another visit. So it probably won't be for at least a few weeks. 

I'm probably just being paranoid, but I am curious about some of these issues. 

Wayne   


 

[Catflower]

They used titanium mesh to repair the defect in my skull.  However, due to severe infection it had to be removed so I have a good sized dent in my skull behind my right ear.

Linda in WV

[texsooner]

Wayne, yes I can relate. The surgery side of my head feels like I a little ditch(or indention) about 3 inches long just below the surgery surface scar. It definitely feels a lot different than the non-AN side. I just figured this was normal as I haven't had any leakage, severe pain, etc from that side since a few weeks after surgery. I do have the surgical report from one of my surgeons(the neurotologist). That report just explains what they did to remove the tumor and talked about the hearing and facial nerves. I need to get the other report(from the neurosurgeon) as that should explain more on what they did with cutting into and sealing the skull. I'm sure others on the forum will have more details on their respective cases.

Patrick

[Pooter]

I'm with the others.  I have a little indentation area as well.  I don't think they replaced the skull piece that was taken out, but now I'm not sure (something I'll have to ask my surgeon).  I do know they put fat there, but whether or not they put the skull piece back, I don't know.  Additionally, I have a "raised" area on the bottom of the indentation area.  It feels more pronounced than it looks.  Like you, I've never had any leaks, etc (that actually leaked into my nose, mouth, etc..).  I had some swelling of CSF in that area, but it was concentrated to that area.

As explained, some surgeons use fat, some use glue stuff, some use titanium (or some combination of the 3).

Regards,
Brian

[wendysig]

Hi Wayne,

From what my doc told me some docs replacethe bone plate with the  retrosigmoid apporach (I believe this is what you had, but correct me if I'm wrong).  My understanding is that it is usually held in place by titanium straps and screws and sometimes titanium mesh as well.  Some docs just cover the area with titanium mesh.  I know some people on the forum didn't have either the bone replaced or titanium mesh and do have an indentation behind their ears.  I'm not sure what surgical approaches were used.  I know Lori67 had translabytinthine and no mesh or bone replacement.    Each doc has their own methods, there don't seem to be hard and fast rulles with regard to this.  I'd surprised if you don't have any fat in your head as most doctrors use it to help seal the surgical site and help prevent CSF leaks, but again, I'm not sure there are any hard and fast rules with regard to that either.  Even though you are not scheduled to see your doc anytime soon, if you have questions you feel you need answered you should call him -- I'm sure he will be happy to address your concerns.  If you do call, I'd be interested to hear what he has to say.  Oh, and I do have titanium mesh and a titanium plate, the spot where my mastoid bone used to be is a little raised compared to the other side -- you can't really see it, but I can feel the difference when I touch it.

Best wishes,
Wendy

[wcrimi]

Thanks to everyone for relieving some of my converns. I'm a bit on the nervous side when it comes to these things. I actually didn't sleep on the operated side of my head for almost 6 weeks because I was afraid I would cave something in.      Then when I finally felt the area carefully and it was different I thought I did cave it in or something.   :oo   As long as a slightly different skull structure is normal, I feel comfortable waiting until my next meeting with the surgeons to ask more questions.  Something is going on in the ear because I still think I feel fluid, but when I was very congested in that area at the 5 week mark the surgeon seemed to think it was normal and things would settle down after awhile. So maybe whatever it was is starting to drain a little because other symptoms (including my hearing) in that area are a tad better.

   

[MAlegant]

Hi Wayne
I also have a slight indentation (more like a flattening out) where they removed the bone.  I believe I was "spackled" back together.  No leaks, no problems.  It took forever not to feel like I was underwater but it got better slowly bit by bit.  I can't sleep on the operative side because I wake up with facial pain and extreme numbness if I do.  And it's been 6 months.  I'd like to sleep on that side again some day, but I can live with it.
Best,
Marci

[AMD]

Hello there,

I has retro-sigmoid and in my case, the hole was drilled and the bone turned into dust.  There was not a piece of skull bone (flap) saved.  In surgery, every doc is different, but in the OR I work in, unless the hole is big, we don't have a flap to put back.  A lot of docs use the same type of product I had for my AN surgery to fill the hole, and that is a special mix of extremely small bone "chips" mixed in putty.  This becomes the "spackle" some refer to.  Once in place, it dries and becomes very hard kinda like cement.  My scarred area feels pretty smooth right now and I have no probs sleeping on it.  My neurosurgeon did tell me though before I had the surgery that a slight indentation at the site would be normal too.

Now, if your doc had saved a flap, it was most likely held in place with a few very smal titanium screws and plates.  There are also special skull flap "staple" clips as well as the titanium mesh as mentioned before.  Just ask your doc.  Hope this helps.

Amy