20-YEAR EXPERIENCE WITH EARLY SURGERY FOR CRANIOSYNOSTOSIS .1. ISOLATED CRANIOFACIAL SYNOSTOSIS - RESULTS AND UNSOLVED PROBLEMS
20-YEAR EXPERIENCE WITH EARLY SURGERY FOR CRANIOSYNOSTOSIS .1. ISOLATED CRANIOFACIAL SYNOSTOSIS - RESULTS AND UNSOLVED PROBLEMS
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DOI：
10.1097/00006534-199508000-00004
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发表时间：
1995-08-01
影响因子：
3.6
通讯作者：
ZIDE, BM
中科院分区：
文献类型：
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作者：
MCCARTHY, JG;GLASBERG, SB;ZIDE, BM
孤立性颅缝早闭的早期手术旨在改善形态，防止功能障碍，同样重要的是，促进儿童的心理社会发展。作为两部分系列研究的第一部分，我们回顾性分析了104例孤立性颅面骨缝早闭患者。诊断包括双侧冠状面（10例），单侧冠状面（57例），额眶（29例）和矢状面骨性连接（8例）。所有患者均在18个月（平均8.1个月）内接受了一期额眶前移-颅骨穹隆重建手术。13%的患者（14例）需要二次颅顶手术（平均年龄22.6个月）来解决颅面形式的残留缺陷。围手术期并发症极少（5.0%），无死亡，术后平均随访时间为46.0个月。根据Whitaker等人的分类，在评估手术结果时，87.5%的患者在最近的评估中被认为具有至少令人满意的颅面形态（I-II类）。脑积水、分流器放置和癫痫发作的总体发生率（分别为3.8%、1.0%和2.9%）较低。在孤立的颅缝早闭中，单侧冠状缝早闭/斜头畸形造成了最复杂的问题，包括垂直眼眶异位、鼻尖偏斜和残留颅面不对称;在这个亚组中也有广泛的发现和生长模式。
Early surgery for isolated craniosynostosis is designed to improve morphology, to prevent functional disturbances, and equally important, to enhance the psychosocial development of the child. As the first of a two-part series, 104 patients with isolated craniofacial synostosis were retrospectively analyzed. Diagnoses included bilateral coronal (10), unilateral coronal (57), metopic (29), and sagittal synostosis (8).All patients underwent primary fronto-orbital advancement-calvarial vault remodeling procedures at less than 18 months of age (mean 8.1 months). Thirteen percent of patients (14) required a secondary cranial vault operation (mean age 22.6 months) to address residual deficits in craniofacial form. Perioperative complications were minimal (5.0 percent), and there was no mortality.Average length of postoperative follow-up was 46.0 months. By the classification of Whitaker et al., which assesses surgical results, 87.5 percent of patients were considered to have at least satisfactory craniofacial form (category I-II) at latest evaluation. Overall rates of hydrocephalus, shunt placement, and seizures (3.8, 1.0, and 2.9 percent, respectively) were low. Among the isolated craniosynostoses, unilateral coronal synostosis/plagiocephaly poses the most complex problems, including vertical orbital dystopia, nasal tip deviation, and residual craniofacial asymmetry; there is also a wide spectrum of findings and growth patterns in this subgroup.