ITTE20090014A1 - SKULL-FLIP MEDICAL DEVICE FOR THE IMPLEMENTATION OF A DECOMPRESSIVE CRANIECTOMY MAINTAINING THE OSSEO OPERCOLO LIFTED IN THE SEAT. AFTER THE OPERCOLUS IS REPOSITIONED IN ITS NATURAL ANATOMICAL SEAT DIRECTLY FROM OUTSIDE WITHOUT THE - Google Patents

Description

Description of the invention having as title Skull-flip medical device suitable for the realization of a compressive craniectomy keeping the bone operculum raised in place,

DESCRIPTIONS;

In the case of severe intracranial hypertension following severe head trauma, sub-araenoid and intra-cerebral hemorrhage. malignant ischemia of large arterial axes, thrombosis of the venous cerebral sinuses and in all those conditions of severe edema (tumor) a decompressive craniectomy is performed to reduce? intracranial hypertension. Generally, the removed bone operculum is either preserved in a bank of the bone and treated for its subsequent reimplantation, or preserved at the level of the abdominal fat of the patient itself or reconstructed in a subsequent phase using various biomaterials (acrylic resin, porous hydroxyapatile, titanium , etc.). the patient will have to? however be reoperated for the reconstruction of the skull cap.

In the acute phase, this intervention protects the brain from irreversible damage caused by intracranial hypertension; at a later stage for? various problems can arise Saw from the fact that the skull remains open, exposing the brain to possible external trauma (iatrogenic damage), circulatory disturbances and local emod inanics due to the preponderance of atmospheric pressure over the intracerehral one, without counting the delay of the the beginning of rehabilitation and, last but not least, the psychological problems caused by aesthetic factors. The inspiring principle of this system? aimed at the realization of a craniectomy, it decorates press iva keeping the bone operculum in place raised (10.15 mm approximately) for as long as necessary, operculum which will be? repositionat? later in the anatomical seat without having to carry out a new hey.urgical intervention (after about 2-3 weeks). In addition, this system would make it possible to avoid the problems related to craniacunia (brain protection, delayed rehabilitation, possible local and global cerebral hemodynamic disorders, psychological problems of the patient). Benefits and improvements over existing solutions There are currently no similar systems known on the international market. Has the possibility been proposed by some surgeons? to use mini plates a '??? not specific to keep the bone suspended, but this technique necessarily requires a re-operation for their removal, the repositioning of the bone in its seat and its fixation; still others have proposed leaving a floating streak above the brain connected to a system of wires. subsequently pulled, they would guide Topercolo in place (threads to be removed always with surgery under local anesthesia), this system for? it does not guarantee effective cerebral decompression and the formation of adhesions with underlying tissues (dura mater and brain) in contact! with the bone could prevent the regular repositioning of the operculum. The prototype of this device? already? been tested (experimental models) on a cadaver to verify the feasibility? of the project and, specifically, yes? experienced if? It is possible to close the skin above the raised operculum. The tests conducted have shown that there? ? possible up to a height d? 10/15 ititn and it is therefore believed that in the operated patient the raised operculum does not constitute a problem with the closure of the skin, considering that in the living it cures it? much more? elastic and extensible, the present prototype made of steel? been tested by practicing different types of cranieetom? a (location and size). L? device showed the following performances during the crash test: Zwick 1485 universa mediated load test! machine {Zwick, IN'C.Ulm, Germany); by imposing a constant load force (quasi-static, V-5nim / min.) until the bony operculum subsides with respect to the skull cap by 2 mm, (position of the operculum raised and / or closed), Not? a market study has been carried out, but the decompression cranieetom? a is a procedure more and more? used and its indications have been extended to numerous conditions and pathologies.

Claims (1)

Claims de ll? invention having as its object Skull-flip medical device suitable for the realization of a compressive craniectomy while keeping the bone operculum raised in place, CLAIMS 1 Hinge system that connects the skull to the free part of the bone operculum removed in place d? craniectomy. 2) The part of the operculum that remains raised? connects to a sliding plate / rail (11g 2) in turn connected to a wire which, in the surgical phase,? tunnel lysed and externalized at the cutaneous level at a distance from the surgical site. 3) the wire then (when possible, usually after 2-3 weeks) serve? by traction for the repositioning of the bony operculum in its natural anatomical seat. 4) the system also guarantees osteosynthesis in the second line.