颞肌外钛网修补大面积额颞区颅骨缺损

目的：探讨颞肌外钛网修补大面积颅骨缺损的临床疗效。方法：对22例涉及额颞区的大面积颅骨缺损患者采用颞肌外钛网修补术。从颞肌外、帽状腱膜下间隙钝性游离皮辩，显露骨窗上、前、后边缘达颅骨表面，骨窗下部即颞肌覆盖部分不显露，取钛网按取样修剪，其边缘超出骨窗范围约1-1．5cm。用配套钛自攻螺钉将钛网固定于骨窗边缘上，钛网下部帖服在颞肌表面。其中1例脑膨出患者先作脑室腹腔分流术，再行颅骨修补。结果：22例平均手术时间65分钟，术中出血平均55ml，均未输血；术中分离时分破硬脑膜2例，采用自体组织修补。切口均一期愈合。1例术后发热。经过抗生素治疗后痊愈。平均随访10个月，未发现新的并发症或原有症状加重。结论：颞肌外颅骨缺损修补法硬脑膜分破几率低，出血少，手术时间短，修补术后并发症少，是大面积颅骨缺损修补的良好方法。

Outside tempotal muscle titanium mesh to repair large amount of temporal skull defect

Objective： To study the-clinical efficacy of titanium mesh Cranioplasty outside tempotal muscle in repairing extensive skill defect. Methods： 22 cases involving a large amount of temporal area of skull defects treated with cranioplasty outside temporal muscle. Between the temporalis muscle and Galeal space dissociated the skin, until bone window shows, pre- post-and up to the edge of the surface of the skull, the muscle of lower part of the temporal bone window is not revealed, trim titanium mesh according to the shame of the bone window, the fringe beyond the scope of the window was about 1-1.5cm. Matching titanium screw titanium mesh were fixed at the edge of the window of bone. 1 case with encephalocele was V-P shunt firstly. Results ： Average operating time was 65 minutes, the average blood loss was 55ml, no case needs blood transfusion; 2 cases of subdural breaking during separation, repaired with autologous tissue. All the wounds healed primarily. 1 case was with postoperative fever, who fully recovered after antibiotic treatment. The average follow-up was 10- month, no new complications or symptoms of the original increased. Conclusion： Titanium mesh cranioplasty outside tempotal muscle had low-breaking probability, less bleeding, shorter operative time, and less postoperative complications, Which was the better method for repairing skull defect of large area.