数字化钛网颅骨成形198例分析

背景:传统的颅骨缺损修复方法存在反复修整塑形时间长、修复后外观不满意等弊端。计算机辅助设计及成型技术(即数字化塑形)引入神经外科,使颅骨缺损个体化修复获得满意效果。目的:观察应用数字化塑形钛网进行颅骨成形的临床效果。方法:应用钛网进行Ⅱ期颅骨成形198例,数字化塑形钛网组(96例)进行头颅CT扫描取得颅骨及缺损的数据,传至数字化塑型钛网制造公司,获得个体化的预制钛网材料进行颅骨修复;传统手工成形组(102例)术中临时对钛网用手工裁剪、塑形进行颅骨修复。结果与结论:数字化组钛网置于颅骨缺损处,达到与骨窗缘紧密贴合,外形满意度达100%,每台手术时间较传统组平均少用约45min,术后无头皮下积血、感染、修补材料裸露等并发症,传统组修补材料裸露1例,切口感染2例,头皮下积血4例。结果可见数字化塑形钛网进行颅骨成形缩短了手术时间,降低了修补材料裸露、继发性感染等并发症,可获得满意的成形效果。

Application of digital titanium mesh shaping for cranial defects in 198 cases

BACKGROUND: Traditional method of cranioplasty has many disadvantages such as modeling and shaping for long time in-operation and patients unsatisfied with their appearance after repair. Since introducing the computer aided design technology (digitalization-shaping) to neurosurgery, the clinical effect of individual repair for cranial defect is satisfactory. OBJECTIVE: To evaluate the clinical effect of digital titanium mesh shaping on skull. METHODS: Totally 198 patients were treated with Phase Ⅱ skull shape using titanium mesh, and then were divided into two groups: digital titanium mesh group (96 cases) and tradition-method group (102 cases). In the digital titanium mesh group, head CT scanning was used for obtaining skull and cranial defect data which was transmitted to the digital titanium mesh shaping manufacturing company in order to get individual prefabricated titanium mesh material for cranial repair. In the tradition-method group, titanium mesh was made by hand temporary for repair during intraoperation. RESULTS AND CONCLUSION: In the digital titanium mesh group, the digital titanium mesh was tight fit with bone window edge, the satisfaction of appearance was 100%, average operating time was shortened about 45 minutes and no complications occurred in hematoma under the scalp, infection and repair materials exposed postoperatively. In tradition-method group, one case with repair materials exposed, two cases with incision infection and four cases with hematoma under the scalp were found postoperatively. So digital titanium mesh shaping for cranioplasty can shorten the operation time, reduce the complications in repair materials exposed and secondary infection, and obtain the satisfactory effect on shaping.