Referral pattern and surgical outcome of sagittal synostosis
Referral pattern and surgical outcome of sagittal synostosis
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DOI：
10.1016/j.bjps.2007.10.042
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发表时间：
2009-02-01
影响因子：
2.7
通讯作者：
Nishikawa, Hiroshi
中科院分区：
文献类型：
--
作者：
Chatterjee, Justin S.;Mahmoud, Mahtab;Nishikawa, Hiroshi
颅缝早闭（SS）是颅缝早闭最常见的形式，在伯明翰颅面单位，当婴儿年龄在6个月以下时，最好通过条形颅骨切除术或6个月以上时颅骨重塑进行治疗。该单位使用头指数（CI）作为头部形状的客观测量。这项回顾性研究分析了转诊模式和手术年龄与CI之间的相关性。回顾了1999年7月至2003年12月间因SS转诊的47例患者的患者单元记录和图像。研究了33例非综合征型SS患者，记录了人口统计学资料、转诊信息以及术前和术后CI测量结果。91%的病例（平均年龄15个月）由儿科医生转诊，9%的病例（均超过6个月）由全科医生转诊。对于手术时间小于12个月的患者，术前和术后CI之间存在显著差异（P = 0.02）。手术时间大于12 month.Conclusion：SS的早期手术与该系列中更好的美学结果相关，尽管Cl可能是头部形状分析的粗略形式。后期转诊与更复杂的转诊途径相关。全科医生和儿科医生的快速通道系统，以帮助早期转诊可能会改善手术结果。(C)2007年英国整形、重建和美容外科医生协会。出版社：Elsevier Ltd. rights reserved.
Sagittal synostosis (SS) is the commonest form of craniosynostosis and in the Birmingham Craniofacial Unit has been preferably managed by strip craniectomy when the baby is under 6 months of age or calvarial remodelling when over 6 months old. The unit uses cephalic index (CI) as an objective measure of head shape. This retrospective study analysed referral patterns and the correlation between age at operation and Cl.Patients' unit notes and images of 47 patients referred for SS between July 1999 and December 2003 were reviewed. Thirty-three non-syndromic SS patients were studied and demographics, referral information and preoperative and postoperative Cl measurements were recorded.Paediatricians referred 91% (mean age 15 months) of cases and general practitioners 9% (all beyond 6 months). There was a significant difference between pre- and postoperative Cl for patients operated at less than 12 months (P = 0.02). No difference was demonstrated for patients operated at greater than 12 months.Conclusion: Early surgery for SS was associated with a better aesthetic result in this series, although Cl may be a crude form of head shape analysis. Later referral was associated with a more complex referral pathway. A fast track system for general practitioners and paediatricians to aid early referrals may improve surgical outcome. (C) 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All. rights reserved.