颅缝早闭额眶后缩畸形的早期手术治疗

Early surgical management of fronto-orbital retrusion in craniosynostosis

目的探讨颅缝早闭引起的额眶后缩畸形早期手术治疗的方法。方法本组共10例额眶后缩患者，年龄6-9个月。非综合征性颅缝早闭8例，其中额缝早闭2例、单侧冠状缝早闭3例、双侧冠状缝早闭3例；综合征性冠状缝早闭2例，分别为阿佩尔综合征（Apert syndrome）和克鲁宗综合征（Crouzon syndrome）各1例。采取双侧额顶部开颅，眶周“C”型截骨、前移以及额骨放射状骨切开塑形的方法纠正额眶后缩畸形。结果手术后额眶后缩畸形明显改善，外形良好，无严重并发症。8例术后随访3-11个月，颅面部外形维持良好，额眶后缩畸形无复发。结论额骨、眶周联合截骨塑形前移的方法能够有效地矫正颅缝早闭所致额眶后缩畸形。

Objective To discuss the early surgical treament of fronto-orbital retrusion in craniosynostosis. Methods Operative techniques including “C” fronto-orbital osteotomies and advancement, frontal radially oriented osteotomies and remoulding were performed to correct the fronto-orbital retrusion. Ten patients aged from 6-9 monthes were included. There were two metopic syrfostosis, three unilateral coronal synostosis, three bilateral coronal synostosis, one Apert syndromic synostosis and one Crouzon syndromic synostosis. Results Fronto-orbital deformities of all patients were corrected. There were no complications happened in these patients. The post-operation results were kept well for 3-11 months follow-up in 8 cases. Conclusions Fronto-orbital osteotomies and advancement and frontal reshaping were effective to correct fronto-orbital retrusion in craniosynostosis.