Abstract
BACKGROUND: This study evaluates the impact of cranial reconstruction therapy combined with lumbar drainage on inflammatory cytokine levels (IL-6, IL-1b, IL-8), serum albumin, and cerebrospinal fluid (CSF) biochemical markers in patients with lateral skull base temporal bone fractures and cerebrospinal fluid leakage. It also assesses the role of nutritional and psychological care in patient recovery. METHODS: A total of 130 patients with temporal bone fractures and CSF leakage who underwent craniotomy repair surgery between May 2022 and May 2024 were enrolled. Patients were randomly assigned to either a control group (CG), receiving craniotomy and standard nutritional care, or an observation group (OG), receiving cranial reconstruction combined with lumbar drainage and nutritional intervention. CSF protein, glucose, and chloride levels were measured on postoperative day 7. Systemic inflammation was assessed by measuring temperature, WBC count, CRP, IL-6, IL-1b, and IL-8 at 7 and 15 days postoperatively. Nutritional status was evaluated using serum albumin (ALB), total protein (TP) levels, and Subjective Global Assessment (SGA) scores before and after treatment. RESULTS: By postoperative day 7, IL-6 levels were significantly lower in OG (10.5±2.3 pg/mL) compared to CG (18.2±4.1 pg/mL), IL-1b was 8.4±1.7 pg/mL in OG versus 14.3±3.5 pg/mL in CG, and IL-8 levels were 15.2±3.1 pg/mL in OG versus 22.5±4.2 pg/mL in CG (all P<0.05). CSF protein levels were lower in OG, and glucose and chloride levels were higher (P<0.05), with all values within the normal range. Inflammatory markers (IL-6, IL-1b, IL-8, WBC, and CRP) showed a further reduction by day 15 (P<0.01) in OG. Serum albumin levels were significantly higher in OG postoperatively (P<0.01). No significant differences were observed between groups for TP and SGA scores. CONCLUSIONS: Cranial reconstruction therapy combined with lumbar drainage accelerates the resolution of inflammation (IL-6, IL-1b, IL-8), improves cerebrospinal fluid biochemical markers, and enhances nutritional recovery (albumin levels), leading to better clinical outcomes. Including nutritional and psychological support further enhances patient recovery and quality of life. These findings underscore the importance of monitoring inflammatory and nutritional biomarkers to optimise postoperative management in patients with temporal bone fractures and CSF leakage.