Long-term osseous morphologic outcome of surgically treated unilateral coronal craniosynostosis
Long-term osseous morphologic outcome of surgically treated unilateral coronal craniosynostosis
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DOI：
10.1097/01.prs.0000200613.06035.51
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发表时间：
2006-03-01
影响因子：
3.6
通讯作者：
Kane, AA
中科院分区：
文献类型：
--
作者：
Becker, DB;Fundakowski, CE;Kane, AA
背景：单侧冠状颅缝融合症具有特征性的骨性畸形，如果不进行治疗，这种畸形会持续到成年。对手术治疗的单侧冠状颅缝融合患者的长期体内骨形态结果的了解有限。方法：对3组单侧冠状面颅骨融合症患儿进行研究：1组为婴儿期单侧冠状面颅缝融合手术患者，年龄13.5~32.7岁(n=9)；2组为单侧冠状面颅缝融合未治疗者，年龄1.1~21岁(n=11)；第3组为单侧冠状面颅缝融合术后1年的I组患者，年龄1.2~2.6岁(n=6)。分析了来自头部高分辨率薄层计算机断层扫描的数据。使用ETDIPS成像软件将35个可重现的骨性标志记录为三维坐标。非中线标志物被指定为融合的同侧或对侧。一名研究人员以较高的仪器内可靠性(平均误差为2 mm)完成了所有路标。结果：欧氏距离矩阵不对称分析显示，组1(135例中68例)比组3(135例中25例)有更多的同侧-对侧不对称对，但比组2(93例)有统计学意义的同侧-对侧不对称对。结论：婴儿期单侧冠状颅缝融合手术治疗可减少青春期颅面骨骼的不对称。然而，与术后1年评估的患者相比，随访至牙齿骨骼成熟的患者具有更大程度的不对称性。这些结果支持这样的结论，即随着时间的推移，部分恢复到未经处理的表型。
Background: Unilateral coronal craniosynostosis has characteristic osseous dysmorphology that persists into adulthood if untreated. Knowledge of the long-term in vivo osseous morphologic outcome of surgically treated unilateral coronal craniosynostosis patients is limited. The purpose of this Study was to define the osseous morphology of adolescent patients who underwent surgery for unilateral coronal craniosynostosis in infancy, compared with both their 1-year postoperative morphology and the morphology of other individuals with untreated unilateral coronal craniosynostosis.Methods: Three populations of unilateral coronal craniosynostosis were studied: group 1, patients with surgical treatment of unilateral coronal craniosynostosis in infancy who had reached dentoskeletal maturity, ranging in age from 13.5 to 32.7 years (n = 9); group 2, individuals with untreated unilateral coronal craniosynostosis, ranging in age from 1.1 to 21 years (n = 11); and group 3, a subset of group I patients 1 year after surgical correction of unilateral coronal craniosynostosis, ranging in age from 1.2 to 2.6 years (n = 6). Data from high-resolution, thin-slice computed tomographic scans of the head were analyzed. Thirty-five reproducible osseous landmarks were recorded as three-dimensional coordinates using ETDIPS imaging software. Nonmidline landmarks were designated as either ipsilateral or contralateral to the synostosis. One researcher performed all landmarking with high intrarater reliability (average error, < 2 mm). Data from the three groups were analyzed for asymmetry using Euclidean distance matrix analysis techniques.Results: Euclidean distance matrix analysis asymmetry analysis demonstrated more statistically significant ipsilateral-contralateral asymmetric pairs in group 1 (68 of 135) than in group 3 (25 of 135), but fewer statistically significant ipsilateral-contralateral asymmetric pairs than in group 2 (93 of 135).Conclusions: Surgical treatment of unilateral coronal craniosynostosis in infancy results in a less asymmetric craniofacial skeleton in adolescence than nontreatment. However, patient who have been followed to dentoskeletal maturity have a greater degree of asymmetry than those evaluated at 1 year postoperatively. These results support the conclusion that with time there is a partial reversion to the untreated phenotype.