Few people can appreciate the difficulties everyday life presents for those who are missing part of their skull, either due to injury or as a consequence of past surgery, for example the removal of a brain tumour. This is the reality which two patients, Mr Mzinyathi Tyani and teenager Johnathan Matthews, had to live with until an intervention by neurosurgeon, Dr Sachin Naidoo and the Netcare Foundation enabled them to benefit from a skull repair procedure, known as cranioplasty.
Dr Naidoo, his assistant Dr Angelique Brookes, and anaesthetist, Dr Scholtz Marais, donated their time and expertise for the surgery, and the Netcare Foundation covered the theatre and hospital costs.
“Many patients who are dependent on public sector hospitals have to wait a considerable time for non-emergency neurosurgical procedures such as cranioplasty. Limited theatre availability necessitates that these hospitals prioritise traumatic injuries requiring life-saving surgery,” explains Dr Naidoo, who practises at both Netcare N1 City and Netcare Blaauwberg hospitals in Cape Town and remains associated with the University of Stellenbosch Neurosurgery Department at Tygerberg Hospital.
Pic: (Front left to right:) Mzinyathi Tyani and Jonathan Matthews, who benefited from life-enhancing skull repair surgery at Netcare N1 City Hospital a while ago, are pictured with nursing services manager, Sr Molemoeng Shebi-Magadla, and neurosurgeon, Dr Sachin Naidoo. Dr Naidoo, his assistant, Dr Angelique Brookes and anaesthetist, Dr Scholtz Marais donated their time and expertise to assist the patients pro bono, while the Netcare Foundation covered the theatre and hospital costs.
“As most people can imagine, the skull provides vital protection for the brain. For patients who have had part of their skull surgically removed, and where this protective bony covering of the brain could not be repaired or replaced at the same time, it can significantly restrict their quality of life.
“Such patients have to be extremely cautious about any activity that could possibly cause a bump to the vulnerable area of their head, as this could result in severe brain injury. In addition, some patients may feel self-conscious about the cosmetic aspect of a conspicuous cranial defect. The cranioplasty procedure assists in addressing both of these problems.”
Head of the University of Stellenbosch Neurosurgery Department, Professor Adriaan Vlok, and Dr Naidoo played a leading role in the development of a pioneering approach to cranioplasty, in which a tailor-made patient-specific 3D silicon mould of the piece of skull to be repaired is developed prior to the operation.
“In sterile conditions within the operating theatre, the sterilised mould is filled with bone cement to create a precisely fitting implant. The bone cement implant is then positioned to close the gap in the skull, and is secured in place with pins,” Dr Naidoo explains.
“This technique has demonstrated a low risk of complications and achieved excellent patient satisfaction results. The use of the moulded bone cement enables us to achieve an optimal match to the curve of the skull, and align the implant so that it fits like a piece of jigsaw puzzle to complete the skull.”
One of the patients who benefitted from the skull repair, Mr Tyani, suffered a severe head injury during an assault in 2018, which resulted in part of his skull being surgically removed. “The fear of sustaining a brain injury meant that I couldn’t do many things that I used to. I couldn’t risk using public transport, for example, because I wore a hat and people were unaware that there was only skin covering my brain, and the smallest knock could have caused me serious injury,” Mr Tyani explains.
“Before I had the skull repair procedure at Netcare N1 City Hospital, I expected that I would need to use a wheelchair again as part of my recovery. However, I had no need for a wheelchair and was discharged from the hospital the following day.
“I have gained so much confidence now that I no longer have to worry about part of my brain being unprotected. I can now again do many things that I was prevented from doing before. I am so grateful to Dr Naidoo, the excellent nurses and staff of Netcare N1 City Hospital, and the Netcare Foundation for making this possible, as well as the healthcare professionals at Tygerberg Hospital,” Mr Tyani says.
Social worker Ronel Grobler, who practises at Netcare N1 City Hospital, says that the other patient, 16-year-old Johnathan Matthews, was an energetic youngster who found it difficult living with an incomplete skull. “For two years after his injury, Jonathan was unable to play sports or do many other activities that could risk injury to his brain. Although he handled it with great maturity, it must have been most frustrating for a young person to have to restrict their activities and I am sure that he will now enjoy greatly improved quality of life.”
Mande Toubkin, Netcare’s general manager for emergency, trauma, transplant and corporate social investment, says that the Netcare Foundation is planning to assist more patients in need of cranioplasty in the future.
“We hope that through this initiative, which Dr Naidoo initiated by bringing the tremendous need for this type of surgery to the Netcare Foundation’s attention, these patients will be able to live fuller lives after having received this pioneering skull repair technique.”
The general manager of Netcare N1 City Hospital, Dr Anton van Wyk, thanked Dr Naidoo for his passion and dedication to improving the lives of persons in need. “We were humbled to partner with Dr Naidoo and Tygerberg Hospital and make our facilities available so that Mr Tyani and Johnathan could undergo this life-enhancing surgery. We are grateful that together, we could make a meaningful difference in their lives,” he concluded.
Issued by: MNA on behalf of Netcare N1 City Hospital and Netcare Foundation
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville or Estene Lotriet-Vorster
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