Objective To compare the application of outside temporal muscle titanium mesh with under temporal muscle titanium mesh in repair of skull defect. Methods Forty two patients with skull defect were randomly divided into two groups: 21 patients underwent skull defect repairing with outside tempotal muscle titanium mesh and another 21 patients underwent skull repairing with under tempotal muscle titanium mesh; the mesh was designed by computer-aided 2D techniques. The operation time,volume of intraoperative hemorrhage, number of titanium nail, postoperative swelling time, incision healing and postoperative complications were compared between two groups. The overall satisfaction rate was surveyed 1 month after discharge. Results The outside tempotal muscle group was better than under temporal muscle group in operation time, volume of intraoperative hemorrhage, postoperative swelling time and postoperative complications (P ＜0.05 or P ＜0.01), but satisfaction rate of 1 month after discharge was opposite (P ＜0.05). Conclusion Skull repairing with titanium mesh outside tempotal muscle and under temporal muscle has advantages and disadvantages in each modality; but patients are more satisfied with the under temporal muscle modality.%目的 比较颞肌外和颞肌下两种术式在额颞区颅骨修补术中的临床效果.方法 将42例额颞区颅骨缺损患者分为颞肌外和颞肌下修补两组(各21例),采用计算机辅助塑形二维钛网分别行颞肌外和颞肌下两种颅骨修补术,观察比较两组的手术时间、术中出血量、钛钉使用数、术后术区肿胀时间、切口愈合及术后并发症情况,出院后1个月随访患者对颅骨修复后的总体满意率.结果 颞肌外组平均手时间短,术中出血少,损伤较轻,术后肿胀时间相对较短,与颞肌下组比较差异有统计学意义(P＜0.05或0.01),但术后1个月随访患者对修补术后的总体满意率颞肌下组要明显高于颞肌外组(P＜0.05).结论 颞肌下、颞肌外两种术式在额颞区颅骨修补术中各有优缺点,但从患者角度出发,颞肌下修补术后的总体满意率更高.
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