婴幼儿颅缝早闭的额眶畸形矫正

The correction of fronto-orbital deformity in infant craniosynostosis—a one year experience

目的 探讨手术治疗婴幼儿颅缝早闭引起的额眶骨畸形的手术方法和手术时机。方法 采用额骨上眶骨联合截骨塑形前移的手术方法。连续收治了 11名患儿 ,2名女性 ,9名男性 ,年龄 6～ 9个月。其中 ,额缝早闭 6例 ,非综合征性单侧冠状缝早闭 2例 ,多骨缝早闭 1例 ,Apert综合征和Saethre Chotzen综合征累及冠状缝等骨缝早闭各 1例。结果 随访 2～ 11个月 ,均取得满意的矫正效果。其中 1例术后发现颅骨顶部 (非术区 )局部隆起 ,经戴头盔 3个月得以控制。未发生明显并发症。结论 额骨上眶骨联合截骨塑形前移方法能够安全、有效地矫正颅缝早闭引起的额眶发育不良。

Objective To evaluate the correction of fronto-orbital deformation in infant craniosynostosis and to discuss the timing of treatment and surgical technique. Methods Eleven consecutive patients with craniosynostoses underwent bilateral fronto-orbital osteotomies and advancement via coronal approaches. There were two females and 9 males with an age range from 6 to 9 months. Among the patients,Six had trigonocephaly secondary to metopic synostosis,two had non-syndromic plagiocephaly secondary to unilateral coronal synostosis,one had turricephaly secondary to multi-sutural synostosis and two patients had brachycephaly due to syndromic synostosis(Apert syndrome and Saethre-Chotzen syndrome). Results The shape of forehead,bilateral orbit and bilateral temples in all patients markedly improved with 2～11 months follow-up. There were not obvious complications except that the unilateral parietal bossing happened to the child with turricephaly postoperatively. Conclusions Satisfactory results show that frontoorbital advancement is safe and effective way to correct frontal and orbital retrusion secondary to craniosynostosis. ;