Long-Term Follow-Up on Bone Stability and Complication Rate after Monobloc Advancement in Syndromic Craniosynostosis
Long-Term Follow-Up on Bone Stability and Complication Rate after Monobloc Advancement in Syndromic Craniosynostosis
复制标题
颅缝早闭症整体进展后骨稳定性和并发症发生率的长期随访
DOI：
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发表时间：
2020
影响因子：
3.6
通讯作者：
C. Raposo
中科院分区：
文献类型：
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作者：
C. Raposo;R. Denadai;Guilherme Luis Zanco;E. Ghizoni;C. Raposo
文本中提供了补充数字内容。背景：整体推进是一种复杂的手术，用于治疗颅缝早闭症患者。直接解决整体推进与牵引成骨的长期稳定性的研究在文献中报道较少。本研究的目的是评估对综合征性颅缝早闭患者进行整体推进后 5 年中面骨稳定性，确定复发的危险因素，并提出预防和管理并发症的策略。方法：对 1994 年至 2013 年间接受牵张成骨整体推进的连续 Apert、Crouzon 或 Pfeiffer 综合征患者 (n = 23) 进行观察性回顾性研究。总共使用 130 幅头颅侧位片评估牵张成骨整体推进后的长期稳定性和复发的危险因素。所有严重并发症均被识别并记录。方差分析检验用于评估中面部和下颌平面的水平复发。结果：头影测量分析显示，无论是否存在测试变量，使用牵引成骨术的额面部前移的长期稳定性。使用牵引成骨进行整体推进引起的严重并发症包括 6 名患者（26%）出现脑脊液漏，2 名患者（8.7%）伴有脑膜炎，7 名患者（30.4%）癫痫发作，以及 1 名患者（4.3%）一只眼睛视力受损。结论：前面部整体推进与牵引成骨提供了长期的中面部骨稳定性。临床问题/证据水平：治疗，IV。
Supplemental Digital Content is available in the text. Background: Monobloc advancement is a complex procedure used to treat patients with syndromic craniosynostosis. Studies directly addressing the long-term stability of monobloc advancement with distraction osteogenesis are underreported in the literature. The objectives of this study were to assess 5-year midface bone stability following monobloc advancement performed on patients with syndromic craniosynostosis, identify risk factors for relapse, and present strategies for prevention and management of complications. Methods: An observational retrospective study was performed on consecutive patients with Apert, Crouzon, or Pfeiffer syndrome (n = 23) who underwent monobloc advancement using distraction osteogenesis between 1994 and 2013. A total of 130 lateral cephalograms were used to assess both long-term stability after monobloc advancement with distraction osteogenesis and risk factors for relapse. All serious complications were identified and recorded. The analysis of variance test was used to assess horizontal relapse of the midface and mandibular plane. Results: Cephalometric analysis revealed long-term stability of frontofacial advancement using distraction osteogenesis, regardless of the presence of tested variables. Serious complications arising from monobloc advancement using distraction osteogenesis included cerebrospinal fluid leakage in six patients (26 percent), accompanying meningitis in two patients (8.7 percent), seizures in seven patients (30.4 percent), and impaired visual acuity in one eye of one patient (4.3 percent). Conclusion: Frontofacial monobloc advancement with distraction osteogenesis provides long-term midface bone stability. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.