Department of Neurosurgery, Children's Hospital of Soochow University, 92 Zhongnan Street, Suzhou, Jiangsu, 215006, People's Republic of China.
Childs Nerv Syst. 2021 May;37(5):1723-1728. doi: 10.1007/s00381-021-05073-3. Epub 2021 Feb 8.
The aim of this study is to conduct a retrospective review of data obtained in all consecutive patients who had undergone cerebral decompression using the 3-pillar expansive craniotomy (3PEC) in our hospital between 2016 and 2020.
We developed a novel craniotomy technique using expansion cranioplasty in patients with traumatic brain injury or stroke, which could relieve intracranial hypertension, maintain cerebral protection, and avoid subsequent cranial repair. Sixteen patients aged 2-18 years old underwent the 3PEC. Two patients, who presented very severe neurological conditions at the admission, died. All surviving patients showed good neurological outcome. None of the survived patients presented with bone flap resorption or sinking flap syndrome.
The role of decompressive craniectomy has been recently questioned in the pediatric population by the use of decompressive craniotomy. In this limited study of children patients experiencing stroke or traumatic brain injury, 3PEC was proved useful in reducing intracranial pressure (ICP), thus, questioning the role of decompressive craniectomy in children. The technique effectively reduces postoperative complications and eliminates subsequent cranioplasty procedures otherwise introduced by traditional decompressive craniectomy.
本研究旨在回顾性分析 2016 年至 2020 年期间在我院接受三柱式扩张性开颅术（3PEC）治疗的所有连续患者的数据。
我们开发了一种新的开颅技术，在创伤性脑损伤或中风患者中使用扩张性颅骨成形术，可以缓解颅内高压，保持脑保护，避免后续颅骨修复。16 名 2-18 岁的患者接受了 3PEC。两名入院时神经状况非常严重的患者死亡。所有存活的患者均表现出良好的神经功能预后。无存活患者出现骨瓣吸收或下沉瓣综合征。
最近，通过使用减压性颅骨切开术，对儿童人群中减压性颅骨切除术的作用提出了质疑。在这项针对经历中风或创伤性脑损伤的儿童患者的有限研究中，3PEC 被证明有助于降低颅内压（ICP），从而质疑减压性颅骨切除术在儿童中的作用。该技术有效地减少了术后并发症，并消除了传统减压性颅骨切除术引入的后续颅骨成形术。
