The influence of titanium mesh repair outside and under the temporal muscle on the cerebral hemodynamic status and postoperative brain function of patients with skull defects after decompressive craniectomy
10.3760/cma.j.cn431274-20241129-01774
- VernacularTitle:颞肌外和颞肌下钛网修补术治疗对去骨瓣减压术后颅骨缺损患者脑血流动力学状态及术后脑功能的影响
- Author:
Boyuan WANG
1
;
Donghua WANG
;
Shengfu ZHOU
;
Yixin FU
Author Information
1. 宜宾市第六人民医院神经专科，宜宾 644600
- Publication Type:Journal Article
- Keywords:
Skull defects;
Extratemporal titanium mesh repair;
Subtemporal titanium mesh repair;
Cerebral hemodynamics;
Brain function
- From:
Journal of Chinese Physician
2025;27(6):880-884
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the influence of titanium mesh repair outside and under the temporal muscle on the cerebral hemodynamic status and postoperative brain function of patients with skull defects after decompressive craniectomy (DC).Methods:A retrospective analysis was performed on clinical data of patients with skull defects after DC who underwent titanium mesh cranioplasty at Yibin Sixth People′s Hospital from January 2019 to January 2024. Patients were divided into a control group ( n=35, subgaleal cranioplasty) and an observation group ( n=35, subtemporal cranioplasty). Surgical outcomes, 1-year complication rates, cerebral hemodynamic parameters [mean velocity (Vm) of the middle cerebral artery (MCA), regional cerebral blood flow (CBF) in the cerebral cortex, basal ganglia, and thalamus], and functional scores [National Institutes of Health Stroke Scale (NIHSS), Minimum Mental State Examination (MMSE), and Fugl-Meyer Assessment (FMA)] were compared preoperatively, at 14 days postoperatively, and 3 months postoperatively. Results:The observation group had significantly longer operation time and postoperative swelling duration, as well as higher intraoperative blood loss than the control group (all P<0.05). At 6 months postoperatively, the complication rate in the observation group was significantly lower than that in the control group ( P<0.05). At 14 days postoperatively, MCA Vm and regional CBF in the cortex, basal ganglia, and thalamus increased in both groups, with more significant improvements in the observation group (all P<0.05). At 3 months postoperatively, NIHSS scores decreased while MMSE and FMA scores increased in both groups compared to preoperative levels. The observation group showed significantly lower NIHSS scores and higher MMSE/FMA scores than the control group (all P<0.05). Conclusions:Both surgical approaches are clinically valuable for repairing skull defects after DC. Patients should choose the appropriate procedure based on their individual conditions.
