Roh Haewon, Kim Junwon, Kim Jang Hun, Chong Kyuha, Yoon Won Ki, Kwon Taek-Hyun, Kim Jong Hyun
Department of Neurosurgery, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Focused Training Center for Trauma, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Neurosurgery, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
World Neurosurg. 2019 Mar;123:e39-e44. doi: 10.1016/j.wneu.2018.10.227. Epub 2018 Nov 9.
To report outcomes of cranioplasty (CP) with a customized three-dimensional (3D) titanium mesh plate and identify the relationship between various clinical variables and complications after CP.
Twenty patients who underwent surgery with customized 3D titanium mesh plates and had follow-up for >6 months from January 2015 to December 2017 were enrolled. Complications related to CP were retrospectively reviewed. Patients were divided into 2 groups (no complication group and complication group), and clinical variables related to complications were compared between the 2 groups. Correlation analysis was performed to identify the clinical variable significantly correlated with complications after CP with a customized 3D titanium mesh plate.
Of 20 patients, 11 developed complications, including extrusion, intracranial infection, severe operative site pain, and wound dehiscence. Among the clinical variables, only the presence of a ventriculoperitoneal shunt was significantly correlated with the overall complication rate (odds ratio = 18.66; 95% confidence interval, 1.56-222.92; P = 0.021).
A customized 3D titanium mesh plate is associated with a lower risk of intracranial infection, but the rate of postoperative complications, mainly cosmetic problems, such as forehead mesh extrusion and dehiscence, was high at 55%. A ventriculoperitoneal shunt was significantly correlated with the overall complication rate after CP with a customized 3D titanium mesh plate.
报告使用定制三维（3D）钛网板进行颅骨修补术（CP）的结果，并确定CP后各种临床变量与并发症之间的关系。
纳入2015年1月至2017年12月期间接受定制3D钛网板手术且随访时间超过6个月的20例患者。回顾性分析与CP相关的并发症。将患者分为2组（无并发症组和并发症组），比较两组与并发症相关的临床变量。进行相关性分析，以确定与定制3D钛网板CP后并发症显著相关的临床变量。
20例患者中，11例出现并发症，包括钛网板外露、颅内感染、手术部位剧痛和伤口裂开。在临床变量中，只有脑室腹腔分流的存在与总体并发症发生率显著相关（比值比=18.66；95%置信区间，1.56-222.92；P=0.021）。
定制3D钛网板与颅内感染风险较低相关，但术后并发症发生率较高，主要是美容问题，如前额钛网板外露和裂开，发生率为55%。脑室腹腔分流与定制3D钛网板CP后的总体并发症发生率显著相关。
