CCI performed on 4-year-old

PUNE: After a fatal road accident, severe head injuries and massive trauma was the ordeal for a four-year-old girl and her family over the last 6 months. The 4-year-old had a miraculous survival after a fatal road accident in December 2017. The accident had left the tiny tot with a deformed cranial structure. There was practically no medical solution available in India to manage this deformity and the little girl had no option but to live with it for life.

Dr Vishal Rokade, a neurosurgeon at Bharati Hospital, who treated the young girl, said that due to severe head injury and swelling, the girl was admitted in the paediatric Intensive Care Unit (ICU) and was on ventilator support.

“She had already undergone two major cranial surgeries. Assessing the gravity of the situation, we had to surgically remove two of the frontal bones and the skull bone at the back of the head to reduce the swelling. Usually, when the cranial bone is removed, it is refrigerated and re-implanted when the swelling subsides. But owing to her age and the brittle nature of her cranial bone, it had to be discarded. Post the surgery, the young girl responded well to the treatment and recovered gradually,” said Rokade.

He further added that when she came for a follow-up, she was walking without help, talking independently and required minimal assistance.

Although the surgery was a success, the significant cavity on the sides and back of her skull left the girl emotionally disturbed.

As per the girl’s mother, she used to be a chirpy child who loved playing outdoors and making friends. 

“But the accident and a disfigured head left her low on confidence. She became hesitant to even interact with her friends. She often touched her head as if wondering when this cavity would fill and she would also look like her friends and other kids. Seeing her battle these thoughts was extremely painful for us. The very thought of what kind of challenges she would have to face in life due to a disfigured head, made us feel helpless,” said the mother.

He further added, “We did not have any evolved medical treatment for such patients. We could either use a graft from the patient’s rib cage to reconstruct the cranial bone, which involved further trauma to the patient. In some cases, a parent’s skull graft could be used for similar purposes,” said Rokade.

However, he added, “Last December, around the same time when this patient suffered head injuries, one of the leading medical device companies, had announced the launch of their Customised Cranial Implant (CCI) that could be used to reconstruct the cranial cavities or deformities in such cases.”

“What then seemed far-fetched, actually turned out to be a boon for this young girl. This CCI has given a new lease of life not only to this 4-year-old, who had a long life glaring at her but also her parents, who had been deeply distressed ever since the fatal accident,” said Rokade. 

With new technology, the implant can be customised as per the anatomical structure of the patient to fill the cranial bone cavity. Since it was the first-of-its-kind in India, Dr Rokade had initial apprehensions about conducting the procedure but after extensive research and consultation with surgeons from across the world, he decided to go ahead.

It was decided by the neurosurgeon that the cranial reconstruction surgery should be performed in a phased manner for better assessment of outcomes. In mid-May, Dr Rokade and his team of doctors conducted the first phase of procedure and were successfully able to fix two CCI implants on the frontal bones of the young girl’s head. The perfect fit of the implant added to the surgical success.

Just days post the procedure, the four-year-old was back to her cheerful self and so were her parents and family members. She recovered well and was discharged from hospital after two weeks.