3-Dimensional Morphometric Outcomes After Endoscopic Strip Craniectomy for Unicoronal Synostosis.
3-Dimensional Morphometric Outcomes After Endoscopic Strip Craniectomy for Unicoronal Synostosis.
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内窥镜带状颅骨切除术治疗单冠状骨性连接后的 3 维形态测量结果。
DOI：
10.1097/scs.0000000000009010
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Elawadly A
中科院分区：
文献类型：
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作者：
Elawadly A
背景：与额眶重建术（FOR）相比，内窥镜下带状颅骨切除术（埃施）治疗单冠骨性结合是一种较低的病态手术。我们的目的是在这个试点研究报告的客观方法和定量形态学的结果内镜治疗的单冠骨性结合使用3维表面scans.Methods：我们的电子记录进行了审查眼科，神经发育的结果，头盔相关的并发症。对于形态学结局，使用了以下参数：颅骨指数、颅骨穹窿不对称指数、前部对称比（ASR）和头部正常侧与骨性结合侧之间的均方根。在术前、术后6个月和治疗结束时3个时间点对三维立体摄影测量扫描进行评价，并与正常对照组和FOR患者的年龄匹配扫描进行比较。非参数检验用于统计分析。结果：没有埃施病例发生斜视，主要神经发育迟缓，或头盔并发症。术后6个月，除颅穹窿不对称指数外，所有形态学参数均显著改善。ASR是术后6个月和最终扫描之间唯一显著变化的参数。在头盔治疗结束时，ASR和均方根差异埃施和两个FOR和control groups.Conclusions：内窥镜下带颅骨切除术与术后头盔为单一的单冠骨缝具有良好的临床效果。头部形态的大部分改善发生在治疗的前6个月。尽管整体头部形状正常化，但在头部的额部和颞部区域仍存在残留的不对称。
Background:Endoscopic strip craniectomy with postoperative helmeting (ESCH) for unicoronal synostosis has shown to be a less morbid procedure when compared with fronto-orbital remodeling (FOR). We aim in this pilot study to report objective methods and quantitative morphologic outcomes of endoscopically treated unicoronal synostosis using 3-dimensional surface scans.Methods:Our electronic records were reviewed for ophthalmological, neurodevelopmental outcomes, and helmet-related complications. For morphologic outcomes, the following parameters were used: Cranial Index, Cranial Vault Asymmetry Index, Anterior Symmetry Ratio (ASR), and Root Mean Square between the normal and synostotic sides of the head. Three-dimensional stereophotogrammetry scans were evaluated at 3 time points preoperative, 6 months post-op, and at the end of the treatment, which was compared with age-matched scans of normal controls and FOR patients. Nonparametric tests were used for statistical analysis.Results:None of the ESCH cases developed strabismus, major neurodevelopmental delay, or helmet complications. All morphologic parameters improved significantly at 6 months post-op except for the Cranial Vault Asymmetry Index. The ASR was the only parameter to change significantly between 6 months post-op and final scans. At end of helmet treatment, ASR and Root Mean Square differed significantly between the ESCH and both FOR and control groups.Conclusions:Endoscopic strip craniectomy with postoperative helmeting for single unicoronal synostosis had excellent clinical outcomes. Most of the improvement in head morphology occurred in the first 6 months of treatment. Despite the normalization of the overall head shape, there was residual asymmetry in the frontal and temporal regions of the head.