Ben*, a young reservist serving on Israel’s northern border, suffered a severe skull injury caused by an anti-tank missile. Following life-saving and reconstructive surgeries, expert physicians at Rambam Health Care Campus (Rambam) in Haifa, Israel, have repaired his skull; now Ben is looking forward to the life he once knew.
The multidisciplinary team during Ben's surgery. Bottom Inset: A model of the skull implant. Photography: Rambam HCC.
Rambam is the only Level 1 trauma center in Northern Israel, serving as a referral hospital for 12 district hospitals in the region and as well as the Israel Defense Forces Northern Command. After sustaining a battlefield injury a few weeks after the war broke out, Ben was airlifted by helicopter for treatment at Rambam. Complex surgeries and months of rehabilitation followed as Rambam’s medical teams fought for his life.
His injury involved the frontal bone, which protects the frontal lobe of the brain near the forehead. Frontal bone damage can affect cognitive abilities, including thought processes, problem-solving, memory, and more. In Ben’s case, the injury necessitated removal of the damaged bone, causing a visible depression in his forehead and significantly affecting his appearance and quality of life.
Dr. Amir Wolff, an attending physician in the Department of Oral & Maxillofacial Surgery and a world-renowned specialist in reconstructive neuroplastics, is also a member of the multidisciplinary team attending to Ben. “In the past, injuries of this type were treated with the sole thought of saving lives,” says Wolff, “but today there is a strong focus on what happens afterward in the rehabilitation stage and the patient’s adaptation to life. Reconstructive neuroplastics focuses on treatment, post-operative aesthetics, and reintegrating the patient into society. Our goal was to improve Ben’s appearance so he could adapt and return to the life he once knew.”
The complex planning for reconstructive surgery involved a multidisciplinary team: Dr. Gil Sviri, director of the Department of Neurosurgery, Dr. Vladimir Shapira, an attending physician in that department and Professor Adi Rachmiel, director of the Oral and Maxillofacial Surgery Department at Rambam’s Head and Neck Center. Computed tomography (CT) images were taken and sent to the USA, where a customized plastic implant was manufactured. The implant was tailored to suit the surrounding tissues. During surgery it was screwed into the skull, restoring its appearance to the normal shape that existed before the injury.
During his recovery, Ben focused on each important task as it came along. When it came time for the reconstructive surgery, the emphasis became his appearance. “I want to look the way I once did and find solutions to the limitations caused by the missing bone in my skull. The situation is not ideal, but I look forward to getting past this,” Ben shares.
According to Dr. Wolff, Ben’s cognitive abilities were not affected by the injury, and there is no neurological damage. “There was a large depression in his skull where the frontal bone once was. This reconstructive surgery improved his appearance. Now he can move on and live the life he once knew, go on a date or a job interview, and even resume his studies.”
Ben’s reconstructive surgery went well, but a long road to full recovery lies ahead; everyone at Rambam wishes him well.
“Appearance and functionality go hand-in-hand,” says Dr. Wolff. “Today, there are many solutions, but the future is around the corner. In the USA, the next generation of implants is being developed. These smart implants will contain microchips and transmit information directly from the brain.”
*Name changed to protect his identity
Comments