Islamic International Medical College, Rawalpindi, Pakistan.
Neurosurg Rev. 2024 Oct 10;47(1):768. doi: 10.1007/s10143-024-03003-w.
Free bone flap reconstruction is essential to the retrosigmoid method of microvascular decompression (MVD) and can completely transform surgical methods worldwide. According to studies like Liao et al. (2023), 92.3% of patients report feeling better after receiving treatment. The study by Shize Li et al. emphasizes the affordability and accessibility of free bone flap reconstruction, demonstrating shorter recovery times, lower expenses, and similar rates of complications to those of conventional fixation techniques. With benefits like fewer headaches and a quicker recovery in the free bone flap group, their retrospective analysis of 189 patients showed no significant differences in hospital stay or complication rates between the fixed and unfixed bone flap groups.Despite these results, larger sample sizes and longer-term studies are needed to confirm these findings and address issues such as leakage of cerebrospinal fluid. Furthermore, adding Artificial Intelligence (AI) to this method may improve accuracy and results. AI has the potential to enhance MVD procedures and patient outcomes through its capacity to create 3D models, direct bone flap placement, and track postoperative progress. Standardizing AI's application in clinical practice still presents difficulties, though. In the end, even though Shize Li et al.'s research significantly advances the body of knowledge already in existence, more creativity and investigation are required to maximize free bone flap reconstruction in MVD.
游离骨瓣重建对于乙状窦后入路微血管减压术(MVD)至关重要,可彻底改变全球的手术方式。廖等(2023 年)的研究表明,92.3%的患者在接受治疗后感觉好转。李诗泽等人的研究强调了游离骨瓣重建的经济实惠性和可及性,表明其恢复时间更短、费用更低,且并发症发生率与传统固定技术相当。游离骨瓣组头痛更少,恢复更快,他们对 189 名患者的回顾性分析显示,固定骨瓣组和未固定骨瓣组在住院时间或并发症发生率方面无显著差异。
尽管有这些结果,但仍需要更大的样本量和更长期的研究来证实这些发现,并解决如脑脊液漏等问题。此外,在该方法中加入人工智能(AI)可能会提高准确性和结果。人工智能通过创建 3D 模型、指导骨瓣放置以及跟踪术后进展,具有改善 MVD 手术和患者预后的潜力。然而,将人工智能的应用标准化在临床实践中仍然存在困难。
总之,尽管李诗泽等人的研究极大地推进了现有知识体系,但为了最大限度地发挥游离骨瓣重建在 MVD 中的作用,还需要更多的创造力和研究。