Titanium plate reconstruction - go or no

I have read about the titanium plate that is used by some NS to reconstruct a sort of "false skull" that covers the decompressed area in the CM1 decompression surgery. It makes sense to me that it would add protection, and help with the human barometer sensation of having your brain hanging out.

The NS I saw today does not use the technique. I am trying to get another consultation with a NS who specializes in CM. My question is, for those who have had the decompression, and maybe the titanium plate too, what are teh pros and cons? Why wouldn't al doctors do it if they could?

Also, doctors seem to differ in opinion of electrocautery of the tonsils in some cases whereCSF flow is especially a problem. It leaves me confused, and I am a CM1 patient, I didn't need more confusing, really.

Now that I know decompression is inevitable, I am curious to know what to look for in the NS who will do it. I have checked the lists. The one I saw today is not on it, though he does about 15 a year in this area. I don't want to rush into a decision if better choices are out there. I am trying to get in with a Chiari specialist in Arkansas, but I don't have all the tests he requires in order to get an appointment, (working on that). I have also submitted a request to see a doctor in CO, and I should hear from them next week re:scheduling.

Please advise if you have any experience with some of the side effects/outcomes of the procedures in the surgeries. It's mighty helpful to have someone's real life experience to consider.

Hope you are having a "good day".
Thanks, Abby

[selmaS]

  Hi, I had the decompression and no titanium plate.....if the surgeon knows what they r doing, and the bone that is chipped away is not too much a plate is not needed.The plate is more in need for re-do's for cerebral ptosis.

I do know of someone that has a plate and needs to have it removed as it is causing problems post op.

U also want to rule out EDS, those with it may have issues with rejection and a plate will only cause infection and other problems.

"selma"

[pamk5]

Hello,

I am scheduled for surgery next Wednesday with what I consider to be a pioneer in the field of CM.  He does not use a plate.  He also does disect the tonsils.  What I look at as far as NS goes is have they been published on the subject of Chiari? Will he give you a list of patients who have had surgery and are willing to share their good experience?  In his clinical interests does he list Chiari as his specialty? 15 surgeries a year doesnt seem like alot to me. What is his complication rate? If he tells you that surgery will cure you.... RUN!  If he tells you this is an easy surgery.. you know just open and shut... RUN!  Dr Heffez is in Wisconsin if that is close enough for you?  Or Dr Oro in Colorado?  Just suggestions!

I hope this helps.  Good luck!

Pam

[*Stormy*]

I'm not sure if this is the same thing but in a book I read, they is a new procedure they are experimenting with, putting a mesh plate in place of the skull. The reason is not for protection but to give the neck muscles a place to reattach to. One of the complications they are finding is that sometimes people's neck muscle attach directly to the dura causing muscular neck headaches. I can definitely vouch for that as I have them all the time HOWEVER I have no idea if that is the cause, I have to wait to have my MRI. As far as the plate goes though...I am with Selma, I have only heard that being used in a second surgery to fix the problem of too much skull being take out. Pam is right too, if you have the option of getting several opinions or seeking out a true Chiari Dr, then that is what I would do.

Good luck!
Stormy