The Temporal Region in Unilateral Coronal Craniosynostosis: A Volumetric Study of Short- and Long-Term Changes after Fronto-orbital Advancement
The Temporal Region in Unilateral Coronal Craniosynostosis: A Volumetric Study of Short- and Long-Term Changes after Fronto-orbital Advancement
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DOI：
10.1097/prs.0000000000000284
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发表时间：
2014-07-01
影响因子：
3.6
通讯作者：
Bartlett, Scott P.
中科院分区：
文献类型：
--
作者：
Derderian, Christopher A.;Wink, Jason D.;Bartlett, Scott P.
背景：颞区受到单侧冠状颅缝早闭的限制性和代偿性生长的显着影响。额眶前移后该区域的复发性畸形通常需要在青春期进行修正手术。作者对单侧冠状颅缝早闭患者的颞区进行了三维分析，以确定基线畸形以及额眶前移后近期和远期的变化。方法：对 2005 年至 2010 年间接受额眶前移重建或额眶前移后修正颅骨成形术的非综合征性单侧冠状颅缝早闭患者进行回顾性分析。执行。从双侧颞区获得体积和颅骨测量计算机断层扫描数据，并使用适当的统计检验进行分析。结果：包括额眶前移前后的 15 名患者和 14 名颅骨成形术前患者。在所有组中，缝合侧的眶上在横向尺寸上显着收缩。所有组中，缝合侧的颞窝体积均发生移位，且显着小于非缝合侧。缝合侧的颞肌较小，但与颞窝不成比例地大。结论：在单侧冠状颅缝早闭中，缝缝侧眶上横向尺寸存在基线和持续的缺陷。颞肌在缝接侧较小，但与受影响侧的颞窝不成比例地大，由于代偿性生长，颞窝向下外侧移位且较小。骨尺寸和软组织之间关系的这些微妙异常似乎导致了额眶前移后经常观察到的颞中空畸形。
Background: The temporal region is significantly affected by both restricted and compensatory growth in unilateral coronal craniosynostosis. Recurrent deformity in this region after fronto-orbital advancement often requires a revision operation in adolescence. The authors performed a three-dimensional analysis of the temporal region in patients with unilateral coronal craniosynostosis to define the baseline deformity and the immediate and long-term changes after fronto-orbital advancement.Methods: A retrospective analysis of patients with nonsyndromic unilateral coronal craniosynostosis who underwent reconstruction with fronto-orbital advancement or revision cranioplasty after fronto-orbital advancement between 2005 and 2010 was performed. Volumetric and craniometric computed tomographic data were obtained from the bilateral temporal regions and analyzed using the appropriate statistical tests.Results: Fifteen patients immediately before and after fronto-orbital advancement and 14 precranioplasty patients were included. In all groups, the supraorbits on the synostotic sides were significantly constricted in the transverse dimension. The temporal fossa volume on the synostotic side was displaced and significantly smaller than the nonsynostotic side in all groups. The temporalis muscle of the synostotic side was smaller but disproportionately large for the temporal fossa.Conclusions: In unilateral coronal craniosynostosis, there is a baseline and persistent deficiency in the transverse dimension of the supraorbit on the synostotic side. The temporalis muscle is smaller on the synostotic side but is disproportionately large for the temporal fossa of the affected side, which is inferolaterally displaced and smaller because of compensatory growth. These subtle abnormalities in the relationships between the bony dimensions and soft tissues appear to contribute to the temporal hollow deformity often observed after fronto-orbital advancement.