Implantation of Acellular Dermal Matrix to Prevent Frontotemporal Depression Following Minipterional Craniotomy for the Surgical Clipping of Unruptured Intracranial Aneurysms

초록

-OBJECTIVE: The objective of the study was to assess the esthetic efficacy of acellular dermal matrix (ADM) implantation to prevent frontotemporal depression (FTD) following minipterional craniotomy (MPT) to clip -nruptured intracranial aneurysms.-METHODS: We retrospectively compared the incidence of FTD in 100 patients treated without ADM from March to July 2019 and 100 patients treated with ADM from August to December 2019. ADM was implanted in the interfascial layer to cover the temporalis muscle. The specific location and degree of FTD were analyzed by measuring the thickness and area of multiple points (P1-P12) and regions (S1-S3) through brain computed tomography preopera-tively and 1 year postoperatively. -RESULTS: In the non-ADM group, the thickness at P1, P2, P5, P6, and P9 was reduced and the area of S1 and S2 was smaller after surgery than before surgery (P< 0.05), similar to the incision and suture site of the temporalis muscle. However, in the ADM group, the preoperative and post-operative measurements were not different. FTD recogni-tion was significantly lower in the ADM group (6.0%) than that in the non-ADM group (17.0%) (P = 0.015) and occurred in the retroorbital region through P1, P2, P5, and P6, with the area under the receiver operating character-istic curves of 0.840, 0.766, 0.811, and 0.751, respectively. ADM implantation was the only significant predictive factor for FTD recognition in multivariate logistic regres-sion analysis (odds ratio = 0.30; 95% confidence interval: 0.11-0.79; P = 0.015). -CONCLUSIONS: Even MPT cannot completely prevent FTD in the retroorbital region. ADM implantation in MPT can help to improve esthetic satisfaction.

키워드