额颞区颅骨缺损颞肌下颞肌外两种术式钛网修补特点及临床疗效

Analysis of the characteristics and clinical effects of the under and outside temporal muscle titanium cranioplasty in frontal-temporal skull defect

目的:比较额颞区颅骨缺损颞肌下颞肌外两种术式钛网修补特点及临床疗效。方法:回顾性分析2009年—2013年45例钛网修补颅骨缺损患者的临床资料。颞肌外修补29例(30侧),颞肌下修补16例。分别统计并比较两组的手术时间、出血量、钛钉使用数、切口愈合及术后并发症。结果:颞肌外修补组平均手时间短,出血少,但是与颞肌下修补组比较差异无统计学意义,颞肌下修补组术后咀嚼疼痛较轻,满意度明显优于颞肌外修补组。颞肌外修补组有2例出现钛网外露。结论:颞肌下、颞肌外两种术式在额颞区颅骨修补术中各有优缺点,颞肌下修复更符合正常生理解剖,患者远期满意度更好。

Objective： To compare the characteristics and clinical effects of the under and outside temporal muscle titanium cranioplasty in frontal-temporal skull defect. Methods： A series of patients with titanium cranioplasty in our department from 2009 to 2013 were retrospectively analyzed. 29 cases（ 30 sides） underwent outside temporal and 16 cases underwent under temporal muscle titanium cranioplasty. Compared with two groups of operation time,blood loss,titanium nail dosage,would healing and postoperative complications. Results： The operation time and blood loss of outside temporal muscle group was less than under temporal muscle group,but the difference was not statistically significant. Under temporal muscle group patients were less postoperative chewing pain and more satisfaction than outside temporal muscle group patients. Titanium mesh of two patients with outside temporal muscle cranioplasty was exposed. Conclusion： Two surgical methods have advantages and disadvantages. Under temporal muscle titanium cranioplasty meets the normal anatomy and has better long-term satisfaction.