ABSTRACT
Objective To analyze and compare the effect,safety and prognosis of early and late digital shaping titanium mesh cranioplasty after skull bone flap defect.Methods One hundred and twelve patients with craniocerebral trauma or cerebral hemorrhage treated by decompressive craniectomy from Jan.2012 to Dec.2013 were included.Seventy-six cases were treated by digital shaping titanium mesh cranioplasty after average 38.9 (32～ 52) d after decompressive craniectomy (early repair group),and thirty-six cases were given operation after 114.2 (90～153) d (advanced repair group).The operation time,skin flap free time,operation blood loss,complications,postoperative patients' activities of daily living (ADL) score,Fugl-Meyery score,neurological deficit score and the recovery of cognitive function of the two groups were compared and analyzed.Results Operation time of early repair group and late repair group were (92.33±13.71) min and (141.67±18.12) min,flap free time were (13.29± 3.43) min and (38.56±7.35) min,and operation bleeding volume were (352.36 ± 21.83) ml and (523.53±32.51) ml (P＜0.01).The subdural effusion rate and the dural rupture rate during skin flap free of early repair group was significantly less than that of late repair group (P＜0.01).ADL and Fugl-Meyery scores in early repair group were increased obviously compared with advanced repair group with significant difference (P＜0.05 or P＜0.01),while the neurological deficit score decreased significantly (P＜0.05).The Montreal cognitive assessment suggested that cognitive function in early repair group was better than that of the late repair group with significant difference (P＜0.05).Conclusions Early digital shaping titanium mesh cranioplasty after skull bone flap defect is better than late treatment with easy soft tissue separation,reduced bleeding and improved prognosis.Digital titanium mesh shaping can ensure precise fit with skull defect,significantly shorten the operation time,and reduce the operation risk.Early digital shaping titanium mesh cranioplasty may have promising clinical application.