Kortesis Bill, Richards Todd, David Lisa, Glazier Steven, Argenta Louis
Department of Plastic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1075, USA.
J Craniofac Surg. 2003 Jul;14(4):538-44. doi: 10.1097/00001665-200307000-00028.
Enlarged parietal foramina are rare congenital skull defects identified on physical examination and confirmed radiographically. They are round or oval defects situated on each parietal bone approximately 1 cm from the midline and 2 to 3 cm superior to the lambdoid suture. Although small parietal foramina are common variants in up to 60% to 70% of normal skulls, large parietal foramina ranging from 5 mm to multiple centimeters are less common, with a prevalence of 1:15,000 to 1:25,000. We present a case series of four patients with large persistent parietal foramina managed surgically for the correction of this deformity. Two infants were treated with autologous calvarial bone grafts, and two were treated with a mesh plating system and hydroxyapatite. No patient developed any perioperative complications. No perioperative or delayed infections occurred in our patient population. The mean postoperative follow-up was 36 months. One patient required a second procedure with methylmethacrylate because of late bone graft failure, whereas the others were successfully treated by the initial procedure. Foramina parietalia permagna, otherwise known as fenestrae parietals symmetricae, enlarged parietal foramina, giant parietal foramina, or Catlin marks, are a rare clinical entity. A spontaneous decrease in the size of these defects with growth of the infant has been reported, but this closure is usually incomplete. Surgical intervention of persistent large foramina protects the child against potential injury to the underlying brain. We advocate cranioplasty for active young children and those at risk for injury (i.e., seizure disorder) to decrease the risk for potential intracranial injury.
顶骨孔扩大是一种罕见的先天性颅骨缺损，通过体格检查发现并经影像学检查证实。它们是圆形或椭圆形的缺损，位于每块顶骨上，距中线约1厘米，在人字缝上方2至3厘米处。虽然小顶骨孔在高达60%至70%的正常颅骨中是常见变异，但直径从5毫米到数厘米的大顶骨孔则较少见，患病率为1:15,000至1:25,000。我们报告了一组4例大的持续性顶骨孔患者的病例系列，他们接受了手术治疗以矫正这种畸形。2例婴儿接受了自体颅骨骨移植治疗，2例接受了网状钢板系统和羟基磷灰石治疗。没有患者发生任何围手术期并发症。我们的患者群体中没有发生围手术期或延迟感染。术后平均随访36个月。1例患者因后期骨移植失败需要进行第二次甲基丙烯酸甲酯手术，而其他患者通过初次手术成功治愈。顶骨大孔，也称为对称顶骨窗、顶骨孔扩大、巨大顶骨孔或卡特林氏痕，是一种罕见的临床病症。据报道，随着婴儿生长，这些缺损的大小会自发减小，但这种闭合通常不完全。对持续性大孔进行手术干预可保护儿童免受潜在的脑损伤。我们主张对活跃的幼儿和有受伤风险（如癫痫症）的儿童进行颅骨成形术，以降低潜在颅内损伤的风险。
