减压性颅骨切除术中使用双层硬脑膜补片以保留颞肌：技术说明
Double dural patch in decompressive craniectomy to preserve the temporal muscle: technical note.
作者信息
Missori Paolo, Polli Filippo Maria, Peschillo Simone, D'Avella Elena, Paolini Sergio, Miscusi Massimo
机构信息
Department of Neuroscience, Neurosurgery, University of Rome La Sapienza, Rome, Italy.
出版信息
Surg Neurol. 2008 Oct;70(4):437-9; discussion 439. doi: 10.1016/j.surneu.2007.03.029. Epub 2007 Aug 17.
BACKGROUND
In frontotemporal decompressive craniectomy and subsequent cranioplasty, temporal muscle damage is frequently observed as a result of surgical manipulation, lack of bone attachment, and prolonged muscle inactivity. We investigated the use of a double dural patch in decompressive craniectomy to favor the safe surgical dissection of the temporal muscle in the subsequent cranioplasty and reduce temporal muscle damage.
METHODS
In 11 patients submitted to a decompressive craniectomy and duraplasty, a second (external) dural sheet was positioned to separate the inner dural patch from the temporal muscle.
RESULTS
When bone repositioning was performed, the detachment of the deep temporal muscle surface, covered by the external dural sheet, was easy and fast, with reduced blood loss. All the muscle fibers were preserved.
CONCLUSION
The technique described in this article reduces the damage to the temporal muscle and can improve the functional and cosmetic results after decompressive craniectomy and cranioplasty.
背景
在额颞部减压性颅骨切除术及随后的颅骨成形术中，由于手术操作、缺乏骨附着以及肌肉长期不活动，经常会观察到颞肌损伤。我们研究了在减压性颅骨切除术中使用双层硬脑膜补片，以利于在随后的颅骨成形术中安全地进行颞肌手术分离，并减少颞肌损伤。
方法
对11例行减压性颅骨切除术和硬脑膜成形术的患者，放置第二（外侧）层硬脑膜片，以将内层硬脑膜补片与颞肌分开。
结果
进行骨复位时，外侧硬脑膜片覆盖的颞肌深层表面的分离轻松快速，失血减少。所有肌纤维均得以保留。
结论
本文所述技术可减少对颞肌的损伤，并可改善减压性颅骨切除术和颅骨成形术后的功能及美容效果。
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