Pukšec Mirjana, Semenski Damir, Ježek Damir, Brnčić Mladen, Karlović Sven, Jakovčević Antonia, Bosanac Goran, Jurlina Martin
Department of Otorhinolaryngology, Vukovar General Hospital, Vukovar, Croatia.
Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia.
J Neurol Surg B Skull Base. 2019 Feb;80(1):23-30. doi: 10.1055/s-0038-1661349. Epub 2018 Jun 19.
The purpose of our research is to prove that elastic biomechanical characteristics of the temporalis muscle fascia are comparable to those of the fascia lata, which makes the temporalis muscle fascia adequate material for dural reconstruction in the region of the anterior cranial fossa. Fifteen fresh human cadavers, with age range from 33 to 83 years (median age: 64 years; mean age: 64.28 years), were included in the biomechanical study. Biomechanical stretching test with the comparison of elasticity among the tissues of the temporalis muscle fascia, the fascia lata, and the dura was performed. The samples were stretched up to the value of 6% of the total sample length and subsequently were further stretched to the maximum value of force. The value of extension at its elastic limit for the each sample was extrapolated from the force-extension curve and was 6.3% of the total sample length for the fascia lata (stress value of 14.61 MPa), 7.4% for the dura (stress value of 6.91 MPa), and 8% for the temporalis muscle fascia (stress value of 2.09 MPa). The dura and temporalis muscle fascia shared the same biomechanical behavior pattern up to the value of their elastic limit, just opposite to that of the fascia lata, which proved to be the stiffest among the three investigated tissues. There was a statistically significant difference in the extension of the samples at the value of the elastic limit for the fascia lata in comparison to the temporalis muscle fascia and the dura ( = 0.002; Kruskal-Wallis test). Beyond the value of elastic limit, the temporalis muscle fascia proved to be by far the most elastic tissue in comparison to the fascia lata and the dura. The value of extension at its maximum value of force for the each sample was extrapolated from the force-extension curve and was 9.9% of the sample's total length for the dura (stress value of 10.02 MPa), 11.2% for the fascia lata (stress value of 23.03 MPa), and 18.5% (stress value of 3.88 MPa) for the temporalis muscle fascia. There was a statistically significant difference in stress values at the maximum value of force between the dura and the temporalis muscle fascia ( = 0.001; Mann-Whitney U test) and between the dura and the fascia lata ( < 0.001; Mann-Whitney test). Because of its elasticity and similarity in its mechanical behavior to the dura, the temporalis muscle fascia can be considered the most suitable tissue for dural reconstruction.
我们研究的目的是证明颞肌筋膜的弹性生物力学特性与阔筋膜相当，这使得颞肌筋膜成为前颅窝区域硬脑膜重建的合适材料。15具新鲜人类尸体被纳入生物力学研究，年龄范围为33至83岁（中位年龄：64岁；平均年龄：64.28岁）。对颞肌筋膜、阔筋膜和硬脑膜组织进行了弹性比较的生物力学拉伸试验。将样本拉伸至总样本长度的6%，随后进一步拉伸至最大力值。从力-伸长曲线外推每个样本在其弹性极限时的伸长值，阔筋膜为总样本长度的6.3%（应力值为14.61兆帕），硬脑膜为7.4%（应力值为6.91兆帕），颞肌筋膜为8%（应力值为2.09兆帕）。硬脑膜和颞肌筋膜在达到其弹性极限值之前具有相同的生物力学行为模式，这与阔筋膜相反，阔筋膜在三种被研究组织中最硬。阔筋膜在弹性极限值时样本的伸长与颞肌筋膜和硬脑膜相比存在统计学显著差异（P = 0.002；Kruskal-Wallis检验）。超过弹性极限值后，与阔筋膜和硬脑膜相比，颞肌筋膜是弹性最大的组织。从力-伸长曲线外推每个样本在最大力值时的伸长值，硬脑膜为样本总长度的9.9%（应力值为10.02兆帕），阔筋膜为11.2%（应力值为23.03兆帕），颞肌筋膜为18.5%（应力值为3.88兆帕）。硬脑膜与颞肌筋膜之间以及硬脑膜与阔筋膜之间在最大力值时的应力值存在统计学显著差异（P = 0.001；Mann-Whitney U检验）以及（P < 0.001；Mann-Whitney检验）。由于其弹性以及力学行为与硬脑膜相似，颞肌筋膜可被认为是硬脑膜重建最合适的组织。
