Abstract: BACKGROUND: More and more emerging repair materials are used for the repair of skull defects, and it is not clear which repair material is the best choice. 
OBJECTIVE: To preliminarily compare the application of three-dimensional digital shaping polyether ether ketone and titanium mesh in skull repair. 
METHODS: The clinical data of 174 patients who underwent skull repair in the Department of Neurosurgery of First Affiliated Hospital of Zhengzhou University from January 2017 to September 2020 were analyzed retrospectively. There were 126 males and 48 females with an average age of (43.9±12.0) years. Among them, 95 cases were treated with polyether ether ketone repair materials and 79 cases with titanium mesh. The intraoperative data, postoperative complications and follow-up results (including seizures, hematoma which requiring surgical treatment, infection, subcutaneous effusion, cerebrospinal fluid leakage, loosening or depression of repair materials, exposure of implants, and subjective feelings) were obtained. The differences between the two groups were compared. The protocol was in accordance with the requirements of the Ethics Committee of First Affiliated Hospital of Zhengzhou University.
RESULTS AND CONCLUSION: (1) The postoperative follow-up time was from 2 to 37 months, and the average follow-up time was (17.2±12.4) months in 174 patients. (2) The total incidence of postoperative complications in the polyether ether ketone group and the titanium mesh group was 20% and 26%, respectively, and there was no significant difference between the two groups (P > 0.05). (3) There was no significant difference in epilepsy, hematoma, surgical site infection, subcutaneous effusion, cerebrospinal fluid leakage, loosening or depression of repair materials between the two groups (P > 0.05). There was no significant difference in proportion of bilateral symmetry of head between the two groups (P > 0.05). Occurrence ratios of exposure of repair materials, vibration sensation, hot and cold experience were lower in the polyether ether ketone group than those in the titanium mesh group (P < 0.05). (4) Both the polyether ether ketone and the titanium mesh have good bioaffinity. The exposure of repair materials and the experience of vibration and hot and cold sensation in the polyether ether ketone group are better than those in the titanium mesh group.  

Key words: skull repair, polyether ether ketone, titanium mesh, repair material, postoperative complications, repair material leakage, local sensory abnormality