Surgical treatment of neonatal skull depression. If the depression of the newborn skull is large and deep, it is very likely to affect the development and function of the baby's brain tissue, and surgery must be performed to correct it. Let's take a look at the operation process of neonatal skull depression with me.
Surgical procedures for neonatal skull depression 1 There are two reconstruction methods: ① free bone flap reconstruction; ② pry up the depressed fracture block and reset it.
1, free bone flap reduction
① Make horseshoe skin flap at the edge of depressed fracture.
② Four bone holes were drilled around the depressed fracture and sawed off between them, leaving periosteum on the surface of the bone flap.
③ Stripping between the outer dura mater and the inner skull plate, and taking out the whole bone flap.
④ Use hands or other surgical instruments to reduce the depressed fracture.
⑤ Check whether the dura mater is complete and whether there is hematoma or brain contusion under the dura mater. If the dura mater has been torn and the fracture fragments have penetrated into the brain, the smaller bone fragments should be taken out, the blood and crushed brain tissue under them should be removed, and the dura mater should be sutured after strict hemostasis.
⑥ Replace the repaired free bone flap, suture the cut periosteum, and finally suture the scalp layer by layer.
2, pry up the sunken fracture block for repair.
① scalp incision and free bone flap reduction.
② Drill a hole in the normal skull near the fracture edge and bite off some overlapping bones along the fracture edge.
③ After peeling off the dura mater under the depressed fracture, pry up the fracture block for reduction. Reset it.
④ suture the scalp.
Matters needing attention in operation
1. Small bone fragments separated from periosteum in depressed fracture should be removed.
2. If the dura mater is not torn, but the color turns purple, the tension is high, and the brain has no pulsation, the dura mater should be cut to explore whether there is subdural and intracerebral hematoma.
3. If the repaired fracture flap is unstable and easy to sink, it can be fixed on the surrounding normal skull with silk thread or steel wire.
4. Try to use suspension suture instead of epidural drainage to prevent infection.
The above contents have been comprehensively introduced. I believe that many parents have fully understood the operation process of neonatal skull depression. Therefore, after full understanding, in order to ensure a higher success rate of children's skull depression surgery, we must choose a regular large hospital, and only through surgery can we ensure the safety of children.
The second step of neonatal skull depression surgery First, let's learn about the skull and skull depression. The skull is located above the spine and consists of 23 flat bones and irregular bones with different shapes and sizes. It plays a role in protecting and supporting the brain, sensory organs and the initial parts of digesters and respirators. Generally speaking, the skull is divided into two parts: the skull and the face skull. According to the morphology of skull fracture, it can be divided into linear fracture, concave fracture, comminuted fracture, foraminous fracture and penetrating fracture. It can be seen that skull depression is a kind of skull fracture. Depressed fractures are more common in forehead and top. Generally, the scalp of simple depressed fracture is intact, mostly closed injury, without brain injury. However, crushing depressed fractures are often accompanied by dura mater and brain tissue damage, and even cause intracranial hemorrhage.
Because the baby's skull is not fully developed, it is very soft. Therefore, if the baby accidentally falls from a height such as a bed or sofa, it will cause a skull depression. This is a newborn skull depression caused by external forces, and treasure moms must be optimistic about their babies at home! In addition, if the baby is born with a sunken skull, it is likely to be hereditary or congenital.
Symptoms of neonatal skull depression
The symptom of neonatal skull depression is obviously that the baby's skull has a depressed part. If there is no injury inside the brain, there will generally be no symptoms, but as the baby grows up, the deformed skull may hinder the baby's brain development.
Most parents who find a depression in their baby's skull will find that the depression is as big as a ping-pong ball. Because the newborn baby's skull is mainly composed of organic components, it is not easy to break when injured. Only the stressed part of the skull was crushed and deformed like table tennis, but there was no fracture line. Generally, the injured have no obvious symptoms of brain injury and can recover automatically. In addition, if the baby's skull depression is caused by forceps delivery, the baby is generally a linear or concave fracture, and the lighter is asymptomatic and can generally be repaired by itself. In severe cases, it may lead to symptoms such as intracranial hemorrhage.
In addition, if the adult skull is depressed by 0.5cm, surgery is needed, especially in the functional area. If the baby's skull is deeply sunken, it is likely to exert pressure on the brain tissue as the baby grows up. Although there is no abnormality now, long-term stress will soften the brain tissue, affect the baby's brain development, and may also affect the baby's ability to speak and exercise.
In short, if you find that your newborn has symptoms of neonatal skull depression, you should go to the hospital as soon as possible for diagnosis, so as not to affect your baby's future brain development.
Treatment of neonatal skull depression
The influence of neonatal skull depression can be large or small, so the treatment of neonatal skull depression is still necessary. Now, let's have a look!
If the newborn's skull is squeezed only under stress, such as during childbirth or other reasons, because the baby's skull is mainly composed of organic components, it is not easy to break, so the skull will only appear ping-pong depression, which can generally be repaired by itself without surgical treatment.
However, when the depression of the newborn skull is large and deep, it is likely to affect the development and function of the baby's brain tissue, which must be corrected by surgery, but conservative treatment is ineffective. Generally speaking, there are two reduction methods, one is free bone flap reduction, and the other is pry up the depressed fracture block reduction. During the operation, the small bone fragments that have left the periosteum at the depressed fracture should be taken out. If the dura mater is not torn, but the color turns purple, the tension is high, and there is no pulse in the brain, the dura mater should be cut open to explore whether there is subdural and intracerebral hematoma. Finally, in repairing the depression of newborn skull, hanging suture should be used instead of epidural drainage to prevent infection.
Although it sounds risky to operate on the baby's head, if this serious skull depression is not repaired in time, the baby's future brain development will be limited. If the newborn's skull is depressed and there is intracranial hemorrhage caused by external force, the consequences will only be more serious if it is not treated and cleaned up in time.
How to prevent neonatal skull depression
If Ma Bao asks me, how to prevent the newborn's skull from sinking? There are only two words, that is, "protection". If it is congenital, it can be detected during prenatal examination, so that Ma Bao can prevent it in advance. If the baby is born without any problems, then Ma Bao should look after her baby and don't let him hit the baby. Ma Bao should realize how fragile the baby's skull is.
First of all, regular check-ups can help Ma Bao check whether the baby has a skull depression. In addition, physical examination can also prevent other diseases. In a word, regular inspection is very important. Secondly, because some babies with sunken skulls are caused by doctors' violent delivery, that is, doctors are very strong when delivering babies, and babies' skulls are very soft, it is easy to have sunken skulls at this time. Therefore, Ma Bao can avoid this situation to a great extent by choosing a big hospital during childbirth. Third, take good care of the baby and don't let him fall from a height. In order to prevent the baby from hitting a hard place, Ma Bao can put something soft under the bed or on the sofa, such as a sponge pad, so as to reduce some injuries in case the baby falls.
In short, the newborn's head is very fragile and must be taken care of. In addition to the skull depression, newborns should also pay attention to their sleeping posture, because the newborn's skull is very soft and developing. If the baby always sleeps on his side, his skull will be deformed and his face will be asymmetrical. Therefore, it is a relatively safe and ideal sleeping position for newborns to adopt the lateral position with frequent exchange of both sides.