Microscopic versus open approach to craniosynostosis: a long-term outcomes comparison.
Microscopic versus open approach to craniosynostosis: a long-term outcomes comparison.
复制标题
显微手术与开放手术治疗颅缝早闭：长期结果比较。
DOI：
10.1097/scs.0000000000000925
复制
发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Xia,JamesJ
中科院分区：
文献类型：
--
作者：
Teichgraeber,JohnF;Baumgartner,JamesE;Viviano,StephenL;Gateno,Jaime;Xia,JamesJ
本回顾性研究的目的是评价使用显微微创方法治疗非综合征型颅缝早闭的长期结局。在过去的10年中，连续180例非综合征型颅缝早闭患者接受了治疗：67例患者采用显微微创方法治疗，113例患者采用开放方法治疗。在显微镜组中，有1例术中并发症（1.5%）。有10例术后并发症（14.9%），其中9例需要大手术，1例需要小手术。主要并发症发生在7例单冠患者（58.3%）和2例异位患者（25.0%）。在开放手术组中，有8例并发症（7.1%），2例患者需要大手术，6例需要小手术。卡方检验显示，显微镜和开放手术的总体并发症发生率无统计学显著差异。但在单冠患者中，显微镜组的并发症发生率明显高于显微镜组（P< 0.001）。总之，显微镜入路是我们治疗矢状面和矢状面颅缝早闭非综合征患者的首选方法。由于并发症发生率高，我们不再对单冠或额颞颅缝早闭患者使用显微镜入路。
The purpose of this retrospective study was to evaluate the long-term outcomes of using the microscopic minimally invasive approach for the treatment of nonsyndromic craniosynostosis. During the last 10 years, 180 consecutive patients with nonsyndromic craniosynostosis were treated: 67 patients were treated with microscopic minimally invasive approach, and 113 were treated with the open approach. In the microscopic group, there was 1 intraoperative complication (1.5%). There were 10 postoperative complications (14.9%), of which 9 required major reoperations and 1 required a minor procedure. The major complications occurred in 7 unicoronal patients (58.3%) and 2 metopic patients (25.0%). In the open-approach group, there were 8 complications (7.1%), 2 patients required major reoperations and 6 required minor procedures. Chi-squared test showed that there was no statistically significant difference in the overall complication rate between the microscopic and open approaches. However, in the unicoronal patients, the complication rate was significantly higher in the microscopic group (P< 0.001). In conclusion, the microscopic approach is our treatment of choice in nonsyndromic patients with sagittal and lambdoidal craniosynostosis. We no longer use the microscopic approach in patients with unicoronal or metopic craniosynostosis because of the high complication rate.