A Quantification of Scalp Thickness before and after Posterior Vault Distraction Osteogenesis.
A Quantification of Scalp Thickness before and after Posterior Vault Distraction Osteogenesis.
复制标题
后穹窿牵引成骨前后头皮厚度的量化。
DOI：
10.1097/prs.0000000000008767
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发表时间：
2022
影响因子：
3.6
通讯作者：
Taylor,JesseA
中科院分区：
文献类型：
--
作者：
Zapatero,ZacharyD;Morales,CarrieZ;Wes,AriM;Kalmar,ChristopherL;Kosyk,MychajloS;Swanson,JordanW;Bartlett,ScottP;Taylor,JesseA
先前的文献已经记录了后穹窿牵张成骨后颅骨测量的变化、颅内体积的增加和基亚里畸形的消退。没有研究分析后穹窿牵张成骨后软组织包膜的变化。在这项研究中，作者旨在提供接受后穹窿牵引成骨的患者头皮厚度的客观测量值，利用面部软组织厚度作为控制生长的代表。作者假设牵引过程不会使头皮的软组织变薄，无论是在牵引区域还是在邻近区域。受试者接受后穹窿牵引成骨治疗颅缝早闭，在每次手术后100天内进行高分辨率牵引前和牵引器移除后计算机断层扫描。在Materialise Mimics版本21软件（Materialise，根特，比利时）上分析扫描。在法兰克福水平面的三维骨模板上确定了6个关键的颅骨测量标志（眉间、颏点、颧点、顶点、宽颅点和后颅点）。将这些点覆盖在软组织厚度掩模上，并记录厚度。术后面部软组织厚度的百分比变化用于控制研究期间颅面软组织包膜的生长。术前和术后后穹窿牵张成骨队列在眉间、颏点、后颅、头顶和颧弓没有显著差异。后穹窿牵张成骨队列中的校正后中位厚度显著增加[2.67 mm（IQR，2.49 mm至4.02 mm）vs 5.26 mm（IQR，3.83 mm至7.82 mm），p= 0.002]。这是第一项量化接受后穹隆牵张成骨的患者术前和术后软组织厚度变化的研究，证明了头皮厚度的维持。
Previous literature has documented craniometric changes of the bony calvaria, increases in intracranial volume, and resolution of Chiari malformations following posterior vault distraction osteogenesis. No studies have analyzed changes to the soft-tissue envelope after posterior vault distraction osteogenesis. In this study, the authors aimed to provide objective measurements of scalp thickness in patients undergoing posterior vault distraction osteogenesis, utilizing facial soft-tissue thickness as a proxy to control for growth. The authors hypothesized that the soft tissues of the scalp are not made thinner by the distraction process, either in the region of distraction or in neighboring areas. Subjects who underwent posterior vault distraction osteogenesis for a craniosynostosis diagnosis who had high-resolution predistraction and post–distractor removal computed tomographic scans within 100 days of each operation were included. The scans were analyzed on Materialise Mimics version 21 software (Materialise, Ghent, Belgium). Six key craniometric landmarks (glabella, pogonion, zygion, vertex, euryon, and opisthocranium) were identified on the three-dimensional bone masks in the Frankfort horizontal plane. The points were overlaid onto soft-tissue thickness masks and thicknesses were recorded. Percent change in postoperative facial soft-tissue thickness was used to control for growth of the craniofacial soft-tissue envelope during the study interval. The preoperative and postoperative posterior vault distraction osteogenesis cohorts did not differ significantly at the glabella, pogonion, opisthocranium, vertex, and zygion. The corrected median thickness at the euryon was significantly increased in the post–posterior vault distraction osteogenesis cohort [2.67 mm (IQR, 2.49 mm to 4.02 mm) versus 5.26 mm (IQR, 3.83 mm to 7.82 mm), p= 0.002]. This is the first study to quantify changes in soft-tissue thicknesses preoperatively and postoperatively in patients undergoing posterior vault distraction osteogenesis, demonstrating maintenance of scalp thickness.