Wong Sui-To, Ho Wan-Nok, He Zhexi, Yam Kwong-Yui
a Department of Neurosurgery , Tuen Mun Hospital , Hong Kong , Hong Kong.
Br J Neurosurg. 2018 Aug;32(4):400-406. doi: 10.1080/02688697.2018.1480749. Epub 2018 Jun 4.
Developing a surgical plane between the temporalis muscle and the dura is the most technically challenging step when performing cranioplasty for post-decompressive craniectomy defects. The authors report a simple technique to demarcate this surgical plane by laying a multi-slitted, microporous polyesterurethane (MPU) patch during decompressive craniectomy. Specifically, they tried to avoid creating potential spaces around the patch, which is the inherent drawback of published anti-adhesive techniques. In 21 patients undergoing decompressive craniectomy, and in 11 of them subsequently undergoing cranioplasty, there was no wound related complications. During cranioplasty, no epidural fluid collection was found; the patch could be separated from the temporalis muscle and the dura with blunt dissection leaving the muscle intact. They conclude that their epidural MPU patch technique is a safe technique, and appears useful to facilitate cranioplasty by helping the surgeon in developing the surgical plane between the temporalis muscle and the dura during cranioplasty.
在为减压性颅骨切除术缺损进行颅骨成形术时，在颞肌和硬脑膜之间形成一个手术平面是最具技术挑战性的步骤。作者报告了一种简单的技术，即在减压性颅骨切除术期间放置一个多 slit、微孔聚酯聚氨酯（MPU）贴片来划定这个手术平面。具体来说，他们试图避免在贴片周围形成潜在空间，这是已发表的抗粘连技术的固有缺点。在 21 例接受减压性颅骨切除术的患者中，其中 11 例随后接受了颅骨成形术，没有发生与伤口相关的并发症。在颅骨成形术期间，未发现硬膜外积液；通过钝性分离可以将贴片与颞肌和硬脑膜分离，肌肉保持完整。他们得出结论，他们的硬膜外 MPU 贴片技术是一种安全的技术，并且在颅骨成形术期间通过帮助外科医生在颞肌和硬脑膜之间形成手术平面，似乎有助于促进颅骨成形术。
