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中华神经创伤外科电子杂志 ›› 2021, Vol. 07 ›› Issue (05) : 297 -300. doi: 10.3877/cma.j.issn.2095-9141.2021.05.009

短篇论著

颅骨修补术后钛网外露的临床特点及手术疗效
赵卫良1, 李娟1, 郑永1, 谢森1, 缪国专1,()   
  1. 1. 100039 北京,解放军总医院第三医学中心神经外科
  • 收稿日期:2020-06-05 出版日期:2021-10-15
  • 通信作者: 缪国专

Clinical characteristics and surgical efficacy of titanium mesh exposure after cranioplasty

Weiliang Zhao1, Juan Li1, Yong Zheng1, Sen Xie1, Guozhuan Miao1,()   

  1. 1. Department of Neurosurgery, Third Medical Center of PLA General Hospital, Beijing 100039, China
  • Received:2020-06-05 Published:2021-10-15
  • Corresponding author: Guozhuan Miao
引用本文:

赵卫良, 李娟, 郑永, 谢森, 缪国专. 颅骨修补术后钛网外露的临床特点及手术疗效[J]. 中华神经创伤外科电子杂志, 2021, 07(05): 297-300.

Weiliang Zhao, Juan Li, Yong Zheng, Sen Xie, Guozhuan Miao. Clinical characteristics and surgical efficacy of titanium mesh exposure after cranioplasty[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(05): 297-300.

目的

探讨颅骨修补术后钛网外露的临床特点及手术疗效。

方法

回顾性分析解放军总医院第三医学中心神经外科自2011年7月至2019年6月收治的20例行颅骨修补术后钛网外露的患者,其中临床表现为切口处钛网外露者14例,皮瓣中心处钛网外露者4例,鼻根部外露者2例。所有患者行钛网去除+皮瓣移植术进行治疗,并观察手术疗效。

结果

20例患者中7例钛网部分切除,13例钛网完全去除。术后随访3~24个月,均未复发。

结论

钛网外露是颅骨修补术后常见的并发症,早期预防和治疗可减少此类并发症的发生。钛网切除+皮瓣移植是治疗钛网外露的有效方法。

Objective

To investigate the clinical characteristics and surgical efficacy of titanium mesh exposure after cranioplasty.

Methods

The clinical data of 20 patients with titanium mesh exposure after cranioplasty admitted to Neurosurgery Department of the Third Medical Center of PLA General Hospital from July 2011 to June 2019 were retrospectively analyzed. The clinical manifestations at admission included titanium mesh exposed at the incision in 14 cases, 4 cases exposed at the center of the flap, and 2 cases exposed at the root of the nose. All patients with removal of the titanium mesh removal and transfer skin flap for treatment, and the curative effect was observed.

Results

Among 20 patients, 7 cases were partially removed titanium mesh and 13 cases were completely removed. All patients were followed up for 3-24 months, and no recurrence was found.

Conclusion

The exposure of titanium mesh is a common complication after cranioplasty. Early prevention and treatment can reduce this complication. It is an effective method to treat the exposure of titanium mesh by titanium mesh removal and skin flap transfer.

图1 颅骨修补术后钛网外露部位
[1]
Jeyaraj P. Efficacy and versatility of the 3-D titanium mesh implant in the closure of large post-craniectomy osseous defects, and its therapeutic role in reversing the syndrome of the trephined: clinical study of a case series and review of literature[J]. J Maxillofac Oral Surg, 2016, 15(1): 82-92.
[2]
Thien A, King NK, Ang BT, et al. Comparison of polyetheretherketone and titanium cranioplasty after decompressive craniectomy[J]. World Neurosurg, 2015, 83(2): 176-180.
[3]
朱剑萍,张明,张磊,等.多层螺旋CT灌注在评价大面积颅骨修补术后覆盖皮瓣存活中的作用[J].中国临床医学影像杂志, 2018, 29(11): 761-763.
[4]
Coulter IC, Pesic-Smith JD, Cato-Addison WB, et al. Routine but risky: a multi-centre analysis of the outcomes of cranioplasty in the Northeast of England[J]. Acta Neurochir (Wien), 2014, 156(7): 1361-1368.
[5]
Klinger DR, Madden C, Beshay J, et al. Autologous and acrylic cranioplasty: a review of 10 years and 258 cases[J]. World Neurosurg, 2014, 82(3-4): e525-e530.
[6]
Brommeland T, Rydning PN, Pripp AH, et al. Cranioplasty complications and risk factors associated with bone flap resorption[J]. Scand J Trauma Resusc Emerg Med, 2015, 23: 75.
[7]
Kim JK, Lee SB, Yang SY. Cranioplasty using autologous bone versus porous polyethylene versus custom-made titanium mesh: a retrospective review of 108 patients[J]. J Korean Neurosurg Soc, 2018, 61(6): 737-746.
[8]
Kim H, Sung SO, Kim SJ, et al. Analysis of the factors affecting graft infection after cranioplasty[J]. Acta Neurochir (Wien), 2013, 155(11): 2171-2176.
[9]
张宏兵,苏宝艳,李加龙,等.颅骨成形术后钛网外露的治疗体会[J].中国临床神经外科杂志, 2018, 23(2): 122-123.
[10]
Sheng HS, Shen F, Wang MD, et al. Titanium mesh implants exposure after cranioplasty in two children: involvement of osteogenesis?[J]. Chin Neurosurg J, 2017, 3(3): 170-173.
[11]
Yeap MC, Tu PH, Liu ZH, et al. Long-term complications of cranioplasty using stored autologous bone graft, three-dimensional polymethyl methacrylate, or titanium mesh after decompressive craniectomy: a single-center experience after 596 procedures[J]. World Neurosurg, 2019, 128: e841-e850.
[12]
Watanabe S, Amagasaki K, Naemura K, et al. Exposure of titanium mesh after cranioplasty for microvascular decompression surgery: two case reports[J]. NMC Case Rep J, 2015, 2(4): 132-134.
[13]
Yoshioka N, Tominaga S. Titanium mesh implant exposure due to pressure gradient fluctuation[J]. World Neurosurg, 2018, 119: e734-e739.
[14]
肖文勇,杨国平,雷丹,等.颅骨成形术后钛网外露16例临床分析[J].中国临床神经外科杂志, 2019, 24(3): 169-170.
[15]
向琰,杨辉,黄其林,等.颅骨修补术后大面积钛网外露1例[J].中国医药科学, 2013, 3(22): 147-148.
[16]
阿木约布,王俊勇,廉坤,等.颅骨成形术后钛网外露原因分析及防治[J].中国临床神经外科杂志, 2017, 22(10): 698-700.
[17]
Oliver JD, Banuelos J, Abu-Ghname A, et al. Alloplastic cranioplasty reconstruction: a systematic review comparing outcomes with titanium mesh, polymethyl methacrylate, polyether ether ketone, and norian implants in 3591 adult patients[J]. Ann Plast Surg, 2019, 82(5S Suppl 4): S289-S294.
[18]
包志军,许济,王治国,等.皮瓣转移修复颅骨修补术后钛网外露[J].中国医师进修杂志, 2017, 40(3): 244-246.
[19]
刘代宏,冯剑,孙超峰,等.颅骨缺损修补术后钛网外露31例[J].中华烧伤杂志, 2013, 29(2): 212-213.
[20]
白晓东,柳晓杰,刘维维,等.扩张器预置皮瓣预防颅骨修补材料外露[J].中国美容整形外科杂志, 2016, 27(1): 18-20.
[21]
Shonka DC Jr, Potash AE, Jameson MJ, et al. Successful reconstruction of scalp and skull defects: lessons learned from a large series[J]. Laryngoscope, 2011, 121(11): 2305-2312.
[22]
梁日初,崔晟华,杨锋,等.颞浅筋膜转移联合游离植皮修补颅骨钛网外露16例疗效分析[J].中南医学科学杂志, 2014, 42(6): 613-615.
[23]
Zhao J, Song G, Zong X, et al. Using the reversed temporal island flap to cover small forehead defects from titanium mesh exposure after cranial reconstruction[J]. World Neurosurg, 2018, 112: e514-e519.
[24]
Reiss S, Zemmoura I, Joly A, et al. Muscle forehead flap: salvage surgery for closure of cutaneous fistula after cranioplasty exposure[J]. World Neurosurg, 2019, 122: 210-214.
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