https://scholars.lib.ntu.edu.tw/handle/123456789/516518
標題: | Decompressive Cranioplasty (Osteoplastic Hinged Craniectomy): A Novel Technique for Increased Intracranial Pressure—Initial Experience and Outcome | 作者: | Hsu, Yung-Chun ABEL PO-HAO HUANG FU-REN XIAO LU-TING KUO JUI-CHANG TSAI DAR-MING LAI |
關鍵字: | Complications;Cranioplasty;Decompressive craniectomy;Decompressive cranioplasty;Decompressive volume | 公開日期: | 2019 | 出版社: | Elsevier Inc. | 卷: | 124 | 起(迄)頁: | e431-e435 | 來源出版物: | World Neurosurgery | 摘要: | Background: We redesigned decompressive craniectomy and cranioplasty procedures to decrease the inherent risk of complications. This novel technique, called decompressive cranioplasty, not only may decrease the complication rate but also may improve the cosmetic result, obviate the need for artificial skull implant, and increase the decompressive volume compared with traditional craniectomy. Methods: In decompressive cranioplasty, the Agnes Fast craniotomy was adopted without cutting the temporalis muscle from the underlying bone flap. After opening the dura with or without removal of intracranial hematomas, duraplasty was performed with an intracranial pressure monitor inserted. Four miniplates were bent into a “Z” shape, and the vascularized bone flap was elevated approximately 1.2–1.5 cm above the outer cortex of the skull and fixed with the miniplates. Subsequent cranioplasty was done with a mini-incision on the miniplate sites and reshaping of the miniplate to align the outer cortex of the bone flap. Results: We successfully performed decompressive cranioplasty in 3 emergent cases—2 traumatic subdural hematomas and 1 malignant middle cerebral artery infarction. Postoperative brain computed tomography demonstrated adequate decompression in all cases. Cosmetic outcome was excellent, and there was no temporal hallowing. Mastication function was not affected. At 6-month follow-up, there was no bone flap shrinkage and no hydrocephalus. Conclusions: Decompressive cranioplasty is a safe and effective method in the management of patients with brain edema and intracranial hypertension. It is simple to perform and may reduce the morbidity associated with traditional decompressive craniectomy and subsequent cranioplasty. © 2018 Elsevier Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85060842256&doi=10.1016%2fj.wneu.2018.12.112&partnerID=40&md5=c70c9706d8a3eec8eacfe04f54dd2ba5 https://scholars.lib.ntu.edu.tw/handle/123456789/516518 |
ISSN: | 1878-8750 | DOI: | 10.1016/j.wneu.2018.12.112 |
顯示於: | 醫學系 |
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