颞肌外与颞肌下数字化成型钛网修补额颞区大面积颅骨缺损的疗效比较

目的 比较颞肌外与颞肌下数字化成型钛网修补额颞区大面积颅骨缺损的治疗效果,探讨最佳手术方式.方法 回顾性分析42例数字化成型钛网修补额颞区颅骨缺损的临床资料,按手术方式分为颢肌外组22例,颞肌下组20例.比较两组手术情况(手术时间、失血量、钛钉用量)、术后并发症(刀口感染、皮下积液、癫痫、颅内血肿、咀嚼受限、面瘫)及患者出院1个月后的外形满意度.结果 颞肌外钛网组修补的手术时问明显少于颞肌下组(t=2.42,P＜0.05),但外形满意度低于颞肌下组(x2=36.31,P＜0.05),两组术后并发症发生率差异无统计学意义(x2=1.80,P＞0.05).结论 颢肌外与颞肌下两种术式各有优缺点.在大面积额颞区颅骨修补术中,应根据患者的具体情况、手术医生的临床经验等因素综合考虑,个体化地选择手术方式.

Comparison of clinical effects between the outside and under temporal muscle method in frontal-temporal cranioplasty by digital forming titanium mesh

Objective To compare the clinical effects of the outside and under temporal muscle titanium cranioplasty in mass frontal-temporal skull defect.Methods Clinical data of forty-two frontal-temporal skull defect patients who had cranioplasty with digital forming titanium nets were analyzed retrospectively.Two groups were divided according to the surgical method.Twenty-two cases underwent outside temporal and twenty cases under went temporal muscle titanium mesh.Compared with two groups of surgery condition（operation time,blood loss,titanium nail dosage） and postoperative complications（wound infection,subcutaneous effusion,epilepsy,intracranial hematoma,chew limited,facial paralysis） and the satisfaction rate of appearance discharged after one month.Results The operation time of outside temporal muscle group was obviously less than under temporal muscle group（t=2.42,P＜0.05）,but the under temporal muscle group patients were more satisfied with the postoperative appearance（χ2=36.31,P＜0.05）.There was no obvious difference of the postoperative complication between the two groups（χ2=1.80,P＞0.05）.Conclusion Both the outside and under temporal muscle method had its advantages and disadvantages.Operation methods selection should comprehensively and individually according to the specific condition of patients,surgical doctor＇s clinical experience.