单层皮肌瓣入路小曲率钛网植入在颅骨修补术中的应用

Application of small curvature titanium mesh implantation with single cutaneous muscle flap approach in cranioplasty

目的分析单层皮肌瓣入路小曲率钛网植入在颅骨修补术中的应用效果。方法回顾性分析2018-05—2022-05行颅骨修补术的60例患者,其中观察组30例采用单层皮肌瓣入路小曲率钛网植入,常规组30例采用常规颞肌下钛网植入。比较2组患者的手术时间、切口缝合张力、切口拆线时间、切口愈合等级、钛网周围积液、钛网外露、额纹消失、颞肌萎缩、咀嚼乏力情况。结果与常规组比较,观察组切口缝合张力小,拆线时间缩短,切口愈合更佳,差异有统计学意义(P<0.05);观察组术后钛网周围积液、钛网外露、额纹消失、颞肌萎缩、咀嚼乏力总体并发症较常规组少,差异有统计学意义(P<0.05)。结论单层皮肌瓣入路小曲率钛网植入可减小切口缝合张力,术后手术部位皮瓣厚实,切口愈合更佳,钛网两侧组织与钛网良好贴合,避免钛网周围积液和钛网外露并发症,并有效保护面神经颞支和颞肌功能,避免额纹消失、颞肌萎缩、咀嚼乏力等并发症。

Objective To investigate the effect of small curvature titanium mesh implantation with single cutaneous muscle flap approach in cranioplasty.Methods A retrospective analysis was performed on 60 patients who underwent cranioplasty from May 2018 to May 2022.In the observation group,30 patients were implanted with small curvature titanium mesh through a single cutaneous muscle flap approach,and in the conventional group,30 patients were implanted with conventional subtemporalis titanium mesh.The operation time,incision suture tension,incision suture removal time,incision healing grade,fluid collections around titanium mesh,titanium mesh exposure,frontal stria disappearance,temporalis atrophy and mastication were compared between the two groups.Results Compared with the conventional group,the observation group had lower incision suture tension,shorter suture removal time and better incision healing,with statistical significance(P<0.05).The overall complications of postoperative fluid collections around titanium mesh,titanium mesh exposure,frontal striae disappearance,temporal atrophy and mastication fatigue in the observation group were less than those in the conventional group,and the difference was statistically significant(P<0.05).Conclusion Single-layer skinmuscle flap approach with small curvature titanium mesh implantation was conductive to reduction of incision suture tension,thick postoperative skin flap,better incision healing,good fit of tissue on both sides of titanium mesh and titanium mesh,avoidance of the complications of fluid around titanium mesh and titanium mesh 881 exposure,which effectively protect the temporal branch of facial nerve and temporalis muscle function,and avoid the disappearance of frontal lines,temporalis muscle atrophy,mastication fatigue complications.