Zöller Joachim E, Mischkowski Robert A, Speder Bernhard
Department of Oral and Maxillofacial Surgery, Medical Centre, University of Cologne, Köln, Germany.
J Craniomaxillofac Surg. 2002 Dec;30(6):343-8. doi: 10.1054/jcms.2002.0326.
Lambdoid synostosis can be found unilaterally, bilaterally or in combination with other forms of craniosynostosis. Based on the concept of frontoorbital advancement, we used the occipital advancement in order to correct unilateral or bilateral lambdoid synostosis.
The standardized technique consists of transverse osteotomies, removal, remodelling and advancement of the occipital region.
Standardized occipital advancement was performed in 21 patients at a multidisciplinary craniofacial centre. The surgery was carried out for patients between 5 and 28 months of age. Aesthetically satisfactory skull shape and normalization of the intracranial pressure could be achieved. A major complication in the form of a life-threatening intraoperative haemorrhage occurred in one case. Other complications like infections have not been experienced.
Standardized occipital advancement allows precise, reproducible and predictable positioning of the segments. Artificial 'sutures' are created as a result of the osteotomy. Remodelling leads to a well-proportioned skull shape and posterior advancement leads to an increase in intracranial volume.
人字缝早闭可单侧、双侧出现，或与其他形式的颅缝早闭合并存在。基于额眶前移的理念，我们采用枕骨前移来矫正单侧或双侧人字缝早闭。
标准化技术包括枕骨区域的横向截骨、切除、重塑和前移。
在一个多学科颅面中心对21例患者实施了标准化枕骨前移术。手术针对年龄在5至28个月的患者进行。可实现美学上令人满意的颅骨形状和颅内压正常化。1例出现了危及生命的术中大出血这一主要并发症。未出现感染等其他并发症。
标准化枕骨前移可实现各骨段精确、可重复且可预测的定位。截骨术形成了人工“缝线”。重塑可使颅骨形状比例协调，向后移位可增加颅内容积。
