The Monobloc Distraction With Facial Bipartition: Outcomes of Simultaneous Multidimensional Facial Movement Compared With Monobloc Distraction or Facial Bipartition Alone.
The Monobloc Distraction With Facial Bipartition: Outcomes of Simultaneous Multidimensional Facial Movement Compared With Monobloc Distraction or Facial Bipartition Alone.
复制标题
面部二分的整体注意力分散：同时多维面部运动与单独的整体注意力分散或面部二分相比的结果。
作者：
P. Goel;Naikhoba C. O. Munabi;E. Nagengast;Madeline Williams;A. Fahradyan;M. Urata
背景
尽管单块面部二分割术(MFBD)可以同时纠正综合征颅缝畸形患者的多个面部尺寸，但并发症风险限制了它的使用。这项研究重新评估了MFBD的并发症和结果，以比较单一牵张(MD)和面部双分割(FB)的安全性和有效性。
方法
对一家三级儿童医院10年来的MFBD、MD和FB病例进行了回顾性研究。患者人口统计学和手术变量在队列之间进行了比较。比较MFBD组和MD组的分心距离。通过术前和术后的CT扫描测量MFBD与FB的泪腺间距离的矫正度。数据分析采用SPSS17统计软件。
结果
共有22名患者符合纳入标准，其中11名为MFBD，4名为MD，7名为FB。3例(27.3%)MFBD患者出现并发症，包括1例骨髓炎和2例硬件移位。1例MD患者(25%)术后出现伤口感染等并发症。3例(42.9%)FB患者出现脑脊液漏、浆液瘤、粘液囊肿、硬件暴露和/或眼眶异位(n=1)。MFBD患者的重症监护病房住院时间明显延长(P≤0.05)，但住院时间差异无统计学意义(P=0.421)。平均牵张长度在MFBD组和MD组相似(P=0.612)。MFBD和FB患者泪道间距离在最终(P=0.243)和变化(P=0.189)方面均无显著差异。
结论
在我们的经验中，与MD和FB相比，MFBD的并发症发生率相似。考虑到同等的安全性和术后面部尺寸的矫正，MFBD可以被更广泛地考虑用于特定的患者。
BACKGROUND
Although combined monobloc facial bipartition with distraction (MFBD) may simultaneously correct multiple facial dimensions in patients with syndromic craniosynostoses, complication risks limit its use. This study reassesses MFBD complications and outcomes to compare safety and efficacy to monobloc distraction (MD) and facial bipartition (FB) alone.
METHODS
A retrospective review of MFBD, MD, and FB cases for 10 years at a tertiary children's hospital was performed. Patient demographics and surgical variables were compared between cohorts. Distraction distance was compared between MFBD and MD. Correction of interdacryon distance in MFBD compared with FB was measured on preoperative and postoperative computed tomographic scans. SPSS 17 was used for data analysis.
RESULTS
Twenty-two total patients, 11 MFBD, 4 MD, and 7 FB, met the inclusion criteria. Three MFBD (27.3%) patients experienced complications, including 1 osteomyelitis and 2 hardware displacements. One MD patient (25%) experienced a postoperative complication consisting of a wound infection. Three FB patients (42.9%) experienced either cerebrospinal fluid leak, seroma, mucocele, hardware exposure, and/or orbital dystopia (n = 1 each). Patients with MFBD had significantly longer intensive care unit stay (P ≤ 0.05), but no difference in hospital stay (P = 0.421). Mean distraction length was similar between MFBD and MD (P = 0.612). There was no significant difference in final (P = 0.243) or change (P = 0.189) in interdacryon distance between MFBD and FB patients.
CONCLUSIONS
In our experience, MFBD has similar complication rates compared with MD and FB alone. Given equivalent safety and postoperative correction of facial dimensions, MFBD could be more widely considered for select patients.