■去骨瓣减压术和开颅术是神经外科手术中最常见的手术。近年来,越来越多的注意力集中在切口类型之间的关系上,减压程度,头皮的血管供应,美容结果,和并发症。这里,我们回顾了目前关于头皮切口用于单侧前颞顶骨大开颅术和开颅术的文献。
■回顾了过去50年中用于前颞顶骨切除/开颅手术的头皮切口的出版物。最后只考虑全文。共有27项符合标准的研究被认为是最终手稿。本研究采用PRISMA指南。
■已经描述了五种主要切口类型。除了问号切口,其他常见的切口包括T-Kempe,为了获得广泛的头骨,耳后切口,设计用来保留枕骨分支,以及与翼状入路结合的N形和苜蓿叶切口。优点和缺点,与现有切口整合,与主要动脉的关系,美容结果,和伤口并发症的风险,包括裂开,坏死,和感染进行了评估。
■反向问号切口,尽管是创伤神经外科的支柱,可以使头皮的血管供应处于危险之中,有利于伤口裂开和感染。几个切口,比如T-Kempe,耳后,N形,和苜蓿叶法已被开发来保存供应头皮的主要血管。切口选择需要根据患者的解剖结构仔细加权,主要船只的位置和大小,伤口开裂的风险,和所需的减压量。
UNASSIGNED: Decompressive craniectomy and craniotomy are among the most common procedures in Neurosurgery. In recent years, increased attention has focused on the relationships between incision type, extent of decompression, vascular supply to the scalp, cosmetic outcomes, and complications. Here, we review the current literature on scalp incisions for large unilateral front-temporo-parietal craniotomies and craniectomies.
UNASSIGNED: Publications in the past 50 years on scalp incisions used for front-temporo-parietal craniectomies/craniotomies were reviewed. Only full texts were considered in the final analysis. A total of 27 studies that met the criteria were considered for the final manuscript. PRISMA guidelines were adopted for this study.
UNASSIGNED: Five main incision types have been described. In addition to the question mark incision, other common incisions include the T-Kempe, developed to obtain wide access to the skull, the retroauricular incision, designed to spare the occipital branch, as well as the N-shaped and cloverleaf incisions which integrate with pterional approaches. Advantages and drawbacks, integration with existing incisions, relationships with the main arteries, cosmetic outcomes, and risks of wound complications including dehiscence, necrosis, and infection were assessed.
UNASSIGNED: The reverse-question mark incision, despite being a mainstay of trauma neurosurgery, can place the vascular supply to the scalp at risk and favor wound dehiscence and infection. Several incisions, such as the T-Kempe, retroauricular, N-shaped, and cloverleaf approaches have been developed to preserve the main vessels supplying the scalp. Incision choice needs to be carefully weighted based on the patient\'s anatomy, position and size of main vessels, risk of wound dehiscence, and desired volume of decompression.