Material Selection And Clinical Effect Analysis Of Skull Repair

Objective:To explore the application value of 3D titanium mesh digitally formed and polyetherketone(PEEK),a non-metallic artificial material,in the treatment of skull defects,postoperative complications and neurological function recovery.Methods:Retrospective analysis selected 78 patients with skull defects who underwent cranioplasty in the Second Affiliated Hospital of Kunming Medical University from January 2018 to December 2019 as the study subjects.The 3D titanium mesh repair with digital forming was used as the reference group(n=64),and PEEK repair was used as the control group(n=14).The occurrence of surgical complications and postoperative recovery were compared between the two groups.Results:A total of 78 patients were included in the study.(1)Age:titanium mesh group(43.98 ± 14.31 years old),PEEK group(36.14±12.47 years old),P>0.05;(2)course;Titanium mesh group(4.31 ± 2.55 months),PEEK group(5.21 ± 4.49 months),P>0.05;(3)preoperative KPS score:titanium mesh group(61.72±25.30),PEEK(77.14±16.37),P>0.05;(4)preoperative GCS score:titanium mesh group(10.72±3.78),PEEK(13.14±1.70),P>0.05;(5)The defect area:titanium mesh group(150.12±57.60cm2),PEEK(173.35±67.89cm2),P>0.05;(6)hospitalization cost:titanium mesh group(65179.47 ± 33815.64 yuan),PEEK group(193341.68±60041.00 yuan),P<0.05;(7).Operation duration:titanium mesh group(3.18±1.30h),PEEK group(3.31±0.95h),P>0.05;(8)Intraoperative blood loss:titanium mesh group(238.28±131.02ml),PEEK group(257.14±138.48ml),P>0.05;(9)Days of hospitalization after surgery:patients in the titanium mesh group(15.78±7.03 days),patients in the PEEK group(14.64±6.54 days),P>0.05;There were 12 patients with postoperative epilepsy in the PEEK group,among which 6 patients had new postoperative epilepsy,with a rate of 9.37%,and the combined incidence of the two groups was 7.69%.Postoperative material exposure PEEK did not see material exposure.Two patients in the titanium mesh group had material exposure,with an incidence of 3.13%.The incidence of subcutaneous effusion in the PEEK group was 42.86%.The incidence of subcutaneous effusion was 80%before and 22.22%after the improved drainage method,and 17.1 8%in the titanium mesh group.No secondary hematoma occurred in the PEEK group,while 1 case of epidural+intracerebral hematoma occurred in the titanium mesh group,with an incidence of 1.6%.The total incidence of complications was 42.86%in the PPEK group,22.22%in the improved drainage method,and 28.12%in the titanium mesh group.Twenty-five patients in the titanium mesh group were followed up with improved neurological function,and four patients were followed up with improved neurological function after PEEK.The neurological function of both groups was improved.Conclusions:The hospitalization cost of patients with PEEK patch was significantly higher than that of the titanium mesh group.There was no significant difference in the incidence of postoperative complications between the two groups.The main complication after PEEK material repair was subcutaneous hydrops,and the improved drainage method could effectively reduce the incidence of subcutaneous hydrops.Both groups had a certain degree of neurological function recovery after surgery.