Face of hope

Face of hope
Courtesy: TIffany Kay Photography

Tuesday, September 4, 2012

What Exactly Is Going On?

I found an excellent description of what Meagan will be going through and thought I would post it here:


Cranial Vault Reconstruction also known as CVR or traditional surgery is  a complex surgery and will require the use of both a pediatric neurosurgeon and pediatric craniofacial surgeon.
Some surgeons prefer to do either just the front of the skull(anterior CVR) or just the back of the skull(posterior CVR). While other surgeons might choose an overall CVR depending on the degree of reconstruction needed. In some cases a front orbit advancement(FOA) is performed to reconstruct the orbits around the eyes. FOA's are hardly ever performed without an accompanying CVR. 
An incision is made in the scalp from ear to ear in either a zig-zag pattern or u-shape. The skull bones are then cut and removed by a pediatric neurosurgeon. A CVR should never be performed without the neurosurgeon who's job is to protect the duram that surrounds and protects the brain. A pediatric craniofacial surgeon then will reconstruct and piece the skull bones back together using plates, screws, and stitches. Most of these foreign objects are absorbable which means as the new bone grows the plates and screws will slowly disappear.
The pro's of CVR Surgery are:
  • Immediate and often lasting correction of the deformity without any visible or palpable bony defects
  • Drastically reduced occurrences of secondary surgeries
  • More qualified surgeons available to perform CVR surgery
  • CVR is most successful when performed on children younger than one year of age but is highly successful when performed on even older children
  • Any complications with the duram or blood loss can be immediately handled.
  • Most successful treatment for multi-suture synostosis and severe cranial deformity.
The Cons of CVR Surgery Are:
  • Blood loss with the need of blood transfusions(although this risk can be greatly reduced with the use of procreate shots and blood recycling procedures.)
  • Highly invasive surgery that last 5 to 9 hours typically
  • Plates and screws most often are needed
  • 48 hour stay in PICU required followed by 3 or 4 more days in hospital
  • Swelling and bruising




In Other News..........

Meagan went back to the OR around 8:30am.  Around 10:55am, Dr. Reisner (Neurosurgeon) came to see us... said Meagan did well the first part of the surgery.   He has mostly finished his part of the brain surgery.  He said her ridges are all broken and her bones removed. She did require a blood transfusion, and could need another before surgery is over. She seems to be tolerating the anesthesia fairly well so far.

Dr. Williams, the pedatric plastic surgeon, is now going to start to work on putting Meagan's head back together. Dr. Reisner went back to the OR in to be with Dr. Williams while he works. He said at least another 2 hours, but will update us as they work because that can change... could be more or less.  Will update as we hear more. 



Meggy before being wheeled back

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