Comparison between lower temporal large decompressive craniectomy and standard large trauma craniectomy in the treatment of severe head injury

Abstract

Objective To compare the efficacy between lower temporal large decompressive craniectomy and standard large trauma craniectomy in the treatment of patients with severe head injury. Methods The data of 173 patients in Armed Police Jiangxi Corps Hospital from January 2008 to March 2014 with severe head injury, who received lower temporal large decompressive craniectomy(the research group)or standard large trauma craniectomy(the control group), were retrospectively analyzed. Lower temporal large decompressive craniectomy was conducted in the research group(92 cases), while standard large trauma craniectomy was conducted in the control group(81 cases). GCS rating, incidence rate of complications, prognosis and other indicators were observed and compared between two groups. Results At 6 months after surgery, no statistically significant differences were reported between these two groups in terms of good recovery, moderate disability, severe disability, vegetative state and dead as defined by GOS rating (27.2%, 15.2%, 29.3%, 8.7% and 19.6% in the research group vs. 22.2%, 21.0%, 23.5%, 7.4% and 25.9% in the control group, respectively) (P>0.05). The average incidence rate of postoperative complications (8.1%) in the research group was lower than that in the control group (11.8%), suggesting a statistically significant difference (P<0.05). Conclusion In the treatment of severe head injury, lower temporal large decompressive craniectomy can achieve a comparable prognosis to standard large trauma craniectomy while effectively reduce the complications, demonstrating it is worth clinical promotion. Key words: Severe head injury; Lower temporal large decompressive craniectomy; Standard large trauma craniectomy