Safety and efficacy of three-dimensional shaping of titanium plate in subtemporal repair of skull defects: study protocol for a data analysis of 38 patients

Qian Wei; Zhang Wei; Jin Hao; Zhu Yang-qing; Zou Yu

doi:10.3969/j.issn.2095-4344.2017.34.002

Abstract：BACKGROUND: Skull damage is necessary after decompressive craniectomy. Previously used autologous bone, allogeneic bone, and organic material are associated with the risk of an unsatisfactory cosmetic outcome and infection. Titanium mesh is an ideal material for cranioplasty. Digital three-dimensional shaping of titanium mesh allows it to perfectly match the skull defect and can restore the anatomic appearance of the defective area.OBJECTIVE: To explore the safety and effectiveness of the three-dimensional shaping of titanium plate in subtemporal repair of skull defects.METHODS: We retrospectively analyzed the surgical and follow-up data of 38 patients with skull defects who underwent subtemporal repair using three-dimensional shaping of a titanium plate at the Department of Neurosurgery, Wujiang Hospital (The First People's Hospital of Wujiang District), Nantong University, China, from January 2015 to December 2016. The primary outcome measure was the incidence of complications within postoperative 12 months. The secondary outcome measures were the Glasgow outcome scale score, Karnofsky performance scale score, National Institutes of Health stroke scale score, and skull computed tomography scan results at 1, 6, 12, 18, and 24 months after repair. This trial was registered in the Chinese Clinical Trial Registry (identifier: ChiCTR-IOC-17012947) at October 11th, 2017. RESULTS AND CONCLUSION: Partial results have been obtained from 38 patients who have been followed up for 6 to 24 months. No complications or adverse reactions occurred. Skull computed tomography scan results revealed that the titanium mesh and nail were well fixed, the skull shape was symmetrical, and no subcutaneous effusion or intracranial hemorrhage occurred. Complications, neurological function, and imaging findings in patients with frontotemporal skull defects provide an experimental basis for three-dimensional shaping of titanium plates in subtemporal repair of frontotemporal defects.