Novel hemicraniectomy: Preserving temporal structures in severe traumatic brain injury patients.

Objective: This study evaluates the efficacy and safety of Novel Hemicraniectomy Technique (NHT) in Severe Traumatic Brain Injury (STBI) patients.

Methods: A retrospective analysis of 79 STBI patients who underwent decompressive hemicraniectomy was conducted. The study compared 25 patients treated with NHT and 54 patients treated with Classic Decompressive Craniectomy (CDC), focusing on therapeutic effects, complications, intracranial pressure, and prognosis.

Results: NHT resulted in shorter surgery duration (101.4 ± 11.8 min, p = 0.008) and greater decompressive effects (21.4 ± 5.6 mmHg, p = 0.018). It also prevented temporal muscle injury (0.0 %, p = 0.026), superficial temporal artery injury (0.0 %, p = 0.009), and masticatory dysfunction (5.9 %, p = 0.040). However, NHT showed no significant advantages in intracranial pressure normalization time (3.5 ± 0.9 days, p = 0.679), hospital stay length (34.3 ± 10.4 days, p = 0.805), intraoperative blood loss reduction (284.0 ± 82.6 ml, p = 0.190), or Glasgow Outcome Scale (GOS) scores (2.8 ± 0.9, p = 0.814) and prognosis (32.0 %, p = 0.831) compared to CDC.

Conclusion: NHT offers shorter surgery duration (101.4 ± 11.8 min vs 107.7 ± 8.2 min), superior decompressive effects (21.4 ± 5.6 mmHg vs 17.7 ± 6.9 mmHg), and better protection of temporal structures, but does not significantly reduce complications or improve prognosis compared to CDC. Prospective studies with larger sample sizes are needed to better understand the potential benefits of NHT in STBI treatment.