The Clinical Evaluation Of Three-dimensional Shaping Titanium Mesh On Repairing Skull Defect

Objective:To explore the value of three-dimensional(3D)shaping titanium mesh on cranial defect repairing in terms of complications surgery, postoperative aesthetic, preoperative and postoperative electroencephalogram improvement rate.Method: Set 52 cases of patients with cranial defect who accepted treatment in Neurological Surgery of Anqing Municipal Affiliated to Anhui Medical University from July 2013 to June 2014 as research objects. Divided them into experimental group who accepted 3D shaping titanium mesh surgery(31 cases).The average age is(47.78±8.77) years, mean defect area(8.15±2.41)cm×(9.51±2.49)cm. and control group who accepted plate titanium mesh surgery(21 cases). The average age is(41.75±11.52)years. The average area of skull defects:(8.72±2.58)cm×(10.41±2.60)cm. Cranial defect repairing surgery were applied smoothly for all patients. Performed statistic analysis on occurrence rate of complications of the surgery, postoperative aesthetic, preoperative and postoperative electroencephalogram variation. Applied Spss16.0 statistical software and compared the differences on occurrence rate of complications, postoperative aesthetic, preoperative and postoperative electroencephalogram improvement of 3D shaping titanium mesh surgery and plate titanium mesh surgery through t-test of two independent samples, χ2 test or Fisher’s Exact Test and Ridit analysis. Evaluated clinical value of 3D shaping titanium mesh surgery on cranial defect repairing and guided its clinical application.Results:1. Occurrence rate of surgical complication: one case of patients with epiduraleffusion in experimental group. The occurrence rate of surgical complication is 3.22%(1/31). One case of epidural effusion, one case of incision infection, two cases of postoperative intractable pain and one postoperative epilepsy in control group, with an occurrence rate of 23.81%(4/21). Performed inspection by adopting Fisher Exact Test. The difference on occurrence rate of surgical complications of the two groups is not statistically significant(P<0.05);2. Postoperative aesthetic: The postoperative aesthetic of experimental group is(1.06±0.12)mm, and that of control group is(5.44±0.32)mm. Applied 3D shaping titanium mesh on cranial defect repairing and the surgical side and uninjured side skull are almost symmetric in shape. The difference on postoperative aesthetic of the two groups is statistically significant(P<0.01);3. Electroencephalogram improvement: 11 cases of patients in experimental group obtained improvement on postoperative electroencephalogram with an improvement rate of 35.48%(11/31). 6 cases of patients in control group obtained improvement with an improvement rate of 28.57%(6/21). The difference on electroencephalogram improvement of the two groups is not statistically significant(P>0.05);4. Preoperative and postoperative electroencephalogram improvement rate: Set electroencephalogram improvement status of 52 cases of patients as ranked data. The amount of normal electroencephalogram increased from three cases to ten cases. After cranial defect repairing, there is a tendency concentrating to normal group. It has been proved by Ridit analysis that the difference on preoperative and postoperative electroencephalogram improvement rate is statistically significant(P<0.05).Conclusion: 1. While compared with titanium plate mesh surgery, the occurrence rate of surgical complications has been significantly reduced by applying 3D shaping titanium mesh surgery;2.the postoperative aesthetic of 3D shaping titanium mesh surgery on cranial defect repairing only reaches(1.06±0.12)mm. The surgical side and uninjured side skull arealmost symmetric in shape, especially with remarkable superiority on application on injuries of frontotemporal angle and top nodules, the surgical effects can hardly be achieved by plate titanium mesh surgery;3. After cranial defect repairing, the electroencephalogram results are tend to be normal which father indicates that cranial defect repairing can improve neurological functions of patients. But both for 3D shaping titanium mesh surgery and plate titanium mesh surgery, there is no significant difference on electroencephalogram results of patients.