Guo Jian, Hou Xu, Zeng Junying, Chen Xiaodong, Zheng Shizhong, Xu Bingchu, Zheng Shoulian, Liu Zhiliang, Ling Gengqiang
Department of Neurosurgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Department of Internal medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
World Neurosurg. 2025 Feb;194:123538. doi: 10.1016/j.wneu.2024.11.121. Epub 2024 Dec 26.
Cranioplasty is a common neurosurgical procedure aimed at providing structural protection to cerebral tissues and enhancing neurological function. The choice of implant material, particularly polyetheretherketone (PEEK) and titanium mesh, significantly influences postoperative outcomes, including the incidence of subgaleal fluid collections (SFC). This study investigates the incidence of SFC associated with PEEK and titanium mesh in cranioplasty, identifying risk factors and implications for clinical practice.
A retrospective analysis was conducted on 70 patients who underwent cranioplasty. The incidence of SFC, postoperative complications, and demographic data were collected and analyzed. Statistical comparisons were made between the 2 implant materials.
The incidence of SFC was significantly higher in the PEEK group (46.2%) compared to the titanium mesh group (20.5%) (P = 0.023). PEEK was identified as an independent risk factor for SFC. Additionally, approximately 60% of postoperative epidural hematoma cases presented with SFC, highlighting the importance of meticulous hemostasis during surgery. The overall reoperation rate was 5.7%, consistent with existing literature. Although diabetes mellitus did not show a statistically significant association with SFC (P = 0.064), its potential impact on postoperative complications warrants further investigation.
The selection of implant materials in cranioplasty significantly affects postoperative outcomes, with PEEK associated with a higher incidence of SFC. Careful material selection, particularly in patients with comorbidities, and meticulous surgical techniques are essential to improve patient outcomes. Future research should focus on the biological interactions between implant materials and cranial tissues to refine guidelines for clinical practice.
颅骨修补术是一种常见的神经外科手术，旨在为脑组织提供结构保护并增强神经功能。植入材料的选择，特别是聚醚醚酮（PEEK）和钛网，对术后结果有显著影响，包括帽状腱膜下积液（SFC）的发生率。本研究调查颅骨修补术中与PEEK和钛网相关的SFC发生率，确定危险因素及其对临床实践的影响。
对70例行颅骨修补术的患者进行回顾性分析。收集并分析SFC的发生率、术后并发症及人口统计学数据。对两种植入材料进行统计学比较。
PEEK组SFC的发生率（46.2%）显著高于钛网组（20.5%）（P = 0.023）。PEEK被确定为SFC的独立危险因素。此外，约60%的术后硬膜外血肿病例伴有SFC，凸显了手术中细致止血的重要性。总体再手术率为5.7%，与现有文献一致。虽然糖尿病与SFC未显示出统计学上的显著关联（P = 0.064），但其对术后并发症的潜在影响值得进一步研究。
颅骨修补术中植入材料的选择显著影响术后结果，PEEK与较高的SFC发生率相关。仔细选择材料，特别是对有合并症的患者，以及采用细致的手术技术对于改善患者预后至关重要。未来的研究应聚焦于植入材料与颅骨组织之间的生物学相互作用，以完善临床实践指南。
