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Health and Medicine

Exploradio - The art of the skull menders
A small start-up in Cleveland uses cutting edge technology and an artist's eye to create custom implants for brain surgery patients
This story is part of a special series.

Reporter / Host
Jeff St. Clair
"Love of Country" a SKULLpture by Grace Abreo. Employees at Osteosymbionics make custom skull implants, and skull art.
Courtesy of Osteosymbionics
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This spring, congresswoman Gabrielle Giffords underwent surgery in which doctors patched her bullet-damaged skull with a custom-made piece of plastic.  In this week’s Exploradio we visit a Cleveland start-up that creates skull implants like the one doctors used for Giffords.  It’s equal parts high-tech science and hands-on artistry.

Exploradio - The art of the skull menders

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Meeting the need

Grinders buzz in the small workshop of OsteoSymbionics, where workers polish custom-made plastic skull implants.   Cynthia Brogan founded the company five years ago to meet the growing trend where, following an injury, patients have large sections of bone removed to reduce pressure inside their skull - 

“These decompressive craniectomies have become more common.  And they’ll take very large bone flaps from both sides of the head.”

Lab director Lindsay Parker brings up a 3-D image of a skull with all but a narrow ridge across the top removed.

“This is the bilateral case we had just this month.  We’re looking at two huge pieces of bone removed from both sides.” 

Parker says, after surgery, doctors sometimes store skull fragments in the patient’s abdomen or in the freezer, but…

“If time elapses and the bone is not able to be saved of for whatever reason they can’t reuse the bone flap that’s when they have to go to a custom prosthesis.”

OsteoSymbionics crafts biocompatible plastic to patch damaged skulls.  The process begins with a CAT scan translated into a life-size plastic model of the damaged skull.

Then Brogan says -  it can move one of two ways –

“And that is analogue, old-school design, or state-of-the-art digital design.  And since we’re standing right here I will first show you state-of-the art digital design.”

The High-tech route

Jessica San manipulates a robotic stylus that allows her to feel her way around a 3-D image of the skull on her computer –

“This is like a sculpt tool, and you and actually go inside the bone and feel it.” 

San studied anatomy, she’s been in the operating room and watched surgery, but her degree is biomedical arts from the Cleveland Institute of Art.

“What you do is train in both the medical side and the art side.”

Biomedical Engineer Michael Nilsson helped design the software San uses .  He says it takes an artist to make the most of the high-tech equipment –

“A human skull is not round, it is not oval shaped  -  it is oval here, dips here, holes there, comes back out again.  And that’s where someone like Jessica is very valuable to refine and detail the actual implant.”

The hands-on approach

For cases that are too complex for the computer, sculptor David Hutson takes the second route for making skull implants - the hands-on approach.   Hutson adds layers of putty onto the model skull, filling the hole with a patch that mimics the bumps and dips of the original...

“Sometimes these skulls are not symmetrical to begin with so you have to find a middle ground where you’re making the one side flow into the other side with a balance.”

Lab Supervisor Lindsay Parker is also an art school grad specializing in medical illustration.  She says making custom skull implants stimulates both sides of her brain–

“I’m a huge geek and I’m an artist -  so it plays to both sides of my personality.”

“That’s what makes us unique is that we do have people who have that three-dimensional thinking, that artistry to be able to craft these products to help people.”

The skull as art

The artistry is not limited to surgical implants.  At  OsteoSymbionics, the skull itself becomes an art object.   Each employee decorated one for a series of ‘skullptures’.

Grace Abreo calls hers Love of Country .“I had 3 nephews that were sent to Afghanistan so the skull represents our United States, the outside is our soldiers protecting our U.S. and the inside is a tribute to the lost soldiers that we have lost.”

Photos of the SKULLptures were presented as posters at this year’s meeting of the Association of Neurosurgeons.

OsteoSymbionics is part of the MAGNET small business incubator in Cleveland.

I’m Jeff St. Clair with this week’s Exploradio.

Related Links & Resources
Osteosymbionics SKULLpture webpage

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Listener Comments:

I absolutely loved this piece on the art of the craniectomy. It is so important for these patients to have an avenue for replacement when their own bone is not available due to complications or infections. I have used these products as a neurosurgical operating room nurse and it was wonderful to hear the story behind such a necessary invention. Without these bone flap replacement products many patients have to live in padded helmets to protect their heads. I did not realize that there was a local company producing these flaps or that there were CIA graduates involved. This story made for a lovely completion to my care of these patients. Thank you so much. Julie

Posted by: Julie Cahn, MSN, CNOR (Cleveland) on October 31, 2011 8:10AM
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