Dear Friends and PreOps,In March I had another surgery and I posted asking if anyone had ever heard of methylmethacrylate I received a very interesting and thought provoking answer from MK or Marianna from Toronto, Canada and the surgery was at Vancouver General:I haven't heard about the procedure that you mentioned, but my neurosurgeon uses methylmethacrylate "bone cement" to put back the piece of the skull that he removes during retrosigmoid, without using a titanium mesh at all. That way it seems that he avoids lots of the related headache side-effects. It seems to me that what you describe is somewhat similar.Good luck with your procedure and I hope you will find relief.MariannaWhen I asked my surgeon Dr. Frederic Schwartz about not using Titanium mesh but actually using your original skull bone to close up, he replied that's because they don't have as much money as we do in the United States.My PT said well it was paid for by your insurance companySince when is expensive always better? Wouldn't you want to have your original skull bone piece instead of something foreign used to close up? Just take a look at the Headache section of the Forum and notice all the complications of having something foreign in you head. The last few months as I watch TV, I see a commercial from some big Malpractice firm asking if you've had Titanium mesh for Gynecologic surgery. So it's not a problem with AN patients but with others. I've only known two people that have not had Titanium mesh put in to replace their skull: Tod down in Richmond at the Virginia Commonwealth University Medical Center and Marianna at the Vancouver General. They don't have Post Op Headaches.Speaking from my side of the Posties, you don't want to EVER have these headaches. They are worse than migraines and some on the Forum have talked of suicide. Maybe you might get headaches from occipital nerve damage and Dr. Ducic at Georgetown can fix that. He's good at that. Let's hope that doesn't happen to you. You want to come out of the surgery with the least possible post op damage.With your list of questions when you go surgeon shopping, include the question of whether they would be willing to put back the bone your mother and father gave you and not put it in the trash. Would they be willing to NOT use Titanium mesh as they do in POOR impoverished but better off Canada and Richmond, VA? If not, my best advice to you is to pick yourself up along with your insurance card and continue shopping until you hear what you want to hear.Titanium is expensive and more expensive than gold. The only winners in this situation are the Titanium makers of America. What I wish for all of you is that you come out a winner instead of the Titanium lobby.In good health,Mei Mei
Dr. L., from Washington, D.C., asks:
I am curious to know how many of you out there are using titanium mesh?
Link to Yaoan Wiremesh
I graduated perio residency over a year ago and never used titanium mesh to build up a ridge. During residency I mostly used block autografts, block allografts or particulate grafting with titanium ePTFE or Ossix Membrane with tenting screws. However, recently I noticed advertising for titanium mesh systems in several dental implant journals, which piqued my interest.
I have several questions for experienced users: Have you used titanium mesh and what is your opinion? How was the outcome? What are some pitfalls, indications and contraindications? Describe how hard or easy is it to use? Decribe your surgical technique? Any good technique articles out there that you would recommend? Type of graft you favor with this technique? How hard is it to get the mess out at stage I?
Thanks for any responses.