Guimarães-Ferreira J, Gewalli F, David L, Olsson R, Friede H, Lauritzen C G
Sahlgrenska University Hospital, Götenberg, Sweden.
J Craniofac Surg. 2001 May;12(3):218-24; discussion 225-6. doi: 10.1097/00001665-200105000-00003.
The aim of the study was to evaluate the modified pi-plasty procedure for the treatment of sagittal synostosis, assessing the issues of safety, complications, morphological outcome, and degree of parental satisfaction. A retrospective evaluation of 110 patients with nonsyndromal single suture sagittal synostosis operated on with the modified pi-plasty procedure was undertaken. Cephalometric radiographs were obtained preoperatively and postoperatively at ages 3 and 5 years in three standardized projections. The Cephalic Index and the Axial Width Ratio were determined and used as objective outcome measures. An evaluation of the radiographic digital markings was carried out using a Beaten Copper Score. A parental questionnaire was used to obtain a subjective esthetical outcome assessment. The patient population consisted of 76% boys and 24% girls with a 20% incidence of a positive familial history of craniosynostosis. The mean age at surgery was 7.73 months. Morbidity from the procedure was minimal and there were no mortalities. The Cephalic Index changed from a mean preoperative value of 65% to a postoperative mean value of 72% (P = 0.00004). The mean Axial Width Ratio changed from a preoperative 80% to 72% at the 3-year evaluation (P = 0.00029). The Beaten Copper score changed from a mean preoperative value of 2.35 to 5.42 postoperatively at 3 years (P = 0.00001). The response rate to the questionnaire was 86%, and there were significant postoperative improvements in all studied aspects of the skull shape. The modified pi-plasty is a safe technique, and it induces significant objective changes in skull morphology toward normality. It also yields a high degree of parental satisfaction with regard to aesthetic outcome, as evaluated by a written questionnaire.
本研究的目的是评估改良π形颅骨成形术治疗矢状缝早闭的效果，评估其安全性、并发症、形态学结果以及家长满意度。对110例行改良π形颅骨成形术的非综合征性单缝矢状缝早闭患者进行了回顾性评估。在术前以及术后3岁和5岁时，以三种标准化投照方式获取头颅侧位X线片。测定头指数和轴向宽度比，并将其用作客观的结果指标。使用铜击评分法对X线数字标记进行评估。通过家长问卷获得主观美学结果评估。患者群体中男孩占76%，女孩占24%，有20%的患者有颅骨缝早闭的阳性家族史。手术时的平均年龄为7.73个月。该手术的发病率极低，无死亡病例。头指数从术前的平均65%变为术后的平均7 .2%（P = 0.00004）。在3年评估时，平均轴向宽度比从术前的80%变为72%（P = 0.00029）。3年后，铜击评分从术前的平均2.35变为术后的5.42（P = 0.00001）。问卷的回复率为86%，术后颅骨形状的所有研究方面均有显著改善。改良π形颅骨成形术是一种安全的技术，能使颅骨形态朝着正常方向产生显著的客观变化。通过书面问卷评估，该手术在美学效果方面也获得了家长的高度满意度。
