E-ISSN: 1019-5157
ISSN: 2651-5024
Research
En-Bloc And Central Bone Strip Preservation Bifrontal Decompressive Craniectomy For Traumatic Bifrontal Contusion : A Comparative Analysis Of Surgical Safety And Clinical Outcome
Sathia Anbazhagan✉ ,
Rajinder Kumar ,
Manoranjitha Mani ,
Dinesh Verma ,
Kashyap Vyas ,
Mahenderan Ramasamy
Article in Press
Corresponding Author:
Sathia Anbazhagan (drasprabhu@gmail.com)
Abstract
Aim
En-bloc and central bone stripsparing techniques are two approaches for bifrontal decompressive craniectomy (DC), commonly performed in patients with traumatic bifrontal contusions. While en-bloc DC is more widely practiced, central bone strip preservation has been suggested to reduce intraoperative blood loss and minimize sinus injury. We conducted a retrospective analysis of patients undergoing bifrontal DC at our institution to compare intraoperative and postoperative outcomes between these techniques.
Material and Methods
Clinical data were collected and parameters recorded include preoperative Glasgow Coma Scale (GCS), surgical technique, intraoperative blood loss, operative duration, ICU stay, total hospital stay, in-hospital mortality, and functional outcome at 6 months Modified Rankin Scale (mRS). Patients were divided into two groups according to the surgical technique for analysis.
Results
Mean intraoperative blood loss was slightly higher in Group A compared to Group B, but the difference was not statistically significant (p = 0.48). Operative time was significantly longer in Group B than in Group A (p = 0.017), although subgroup analysis by age (1850 and 5170 years) showed non-significant differences. ICU ,total hospital stay and In-hospital mortality were comparable between the two groups. At 6 months, functional outcomes assessed by mRS were similar between groups (p = 0.45).
Conclusion
There were no statistically significant differences between en-bloc and central bone stripsparing bifrontal DC in terms of intraoperative blood loss, perioperative morbidity, mortality, or long-term functional outcome. Central bone strip preservation may result in slightly longer operative times but appears safe and effective.
En-bloc and central bone stripsparing techniques are two approaches for bifrontal decompressive craniectomy (DC), commonly performed in patients with traumatic bifrontal contusions. While en-bloc DC is more widely practiced, central bone strip preservation has been suggested to reduce intraoperative blood loss and minimize sinus injury. We conducted a retrospective analysis of patients undergoing bifrontal DC at our institution to compare intraoperative and postoperative outcomes between these techniques.
Material and Methods
Clinical data were collected and parameters recorded include preoperative Glasgow Coma Scale (GCS), surgical technique, intraoperative blood loss, operative duration, ICU stay, total hospital stay, in-hospital mortality, and functional outcome at 6 months Modified Rankin Scale (mRS). Patients were divided into two groups according to the surgical technique for analysis.
Results
Mean intraoperative blood loss was slightly higher in Group A compared to Group B, but the difference was not statistically significant (p = 0.48). Operative time was significantly longer in Group B than in Group A (p = 0.017), although subgroup analysis by age (1850 and 5170 years) showed non-significant differences. ICU ,total hospital stay and In-hospital mortality were comparable between the two groups. At 6 months, functional outcomes assessed by mRS were similar between groups (p = 0.45).
Conclusion
There were no statistically significant differences between en-bloc and central bone stripsparing bifrontal DC in terms of intraoperative blood loss, perioperative morbidity, mortality, or long-term functional outcome. Central bone strip preservation may result in slightly longer operative times but appears safe and effective.
Keywords
Bifrontal decompressive craniectomy
Surgical outcomes
Central bone strip preservation