应用牵张成骨术扩大后颅窝治疗综合征型颅缝早闭

Management of syndromic craniosynostosis using posterior cranial vault distraction osteogenesis：preliminary findings

目的 探讨应用牵张成骨术扩大后颅窝治疗综合征型颅缝早闭的效果.方法 回顾性分析2015年1月至2016年3月以后颅窝牵张成骨扩大术进行治疗的4例综合征型颅缝早闭患儿的临床资料,在枕骨隆突上缘顶、枕骨进行截骨后,于矢状缝两侧各安置1个延长器,术后3d开始延长,每侧延长0.5 mm/d,延长结束后固定6个月,然后取出延长器.结果 4例术后延长25- 30 mm,平均27.3 mm,除1例患儿出现脑脊液漏外,其余均无明显并发症.所有患儿在停止延长后6个月复查头颅三维CT,均提示颅骨牵张成骨良好,顺利取出延长器.4例患儿获得7～ 20个月随访,平均12.8个月,后颅平坦的外观均得到较好地改善.结论 应用牵张成骨术扩大后颅窝治疗综合征型颅缝早闭,可以有效地改善后颅外观、扩大颅腔容积.

Objective To explore the effect of managing syndromic craniosynostosis using posterior vault distraction osteogenesis.Methods The authors conducted a retrospective cohort study of four children with syndromic craniosynostosis treated between 2015 January to 2016 March using posterior vault distraction osteogenesis.The posterior craniotomy was performed from vertex,biparietally to a point above the occipital protuberance.Two distraction devices were fixed in the parasagittal,collinear position.After a latency of 3 days,the device was activated at 0.5 mm/day.After the distraction,the consolidation period was about 6 months.Results The average distraction distance was 27.3 mm （range,25 to 30 mm）.Cerebrospinal fluid leak happened in one patient.After taken the 3D CT scan,all of them were undertaken the second operation of removing the distraction devices.All the patients were followed up at a mean of 12.8 months （range,7 to 20 months）.Conclusions It is effective to enlarge the posterior cranial vault using distraction osteogenesis for the syndromic craniosynostosis.