Murray Dylan J, Kelleher Michael O, McGillivary A, Allcutt David, Earley Michael J
The Children's University Hospital, Temple Street, Dublin 1, Ireland.
J Plast Reconstr Aesthet Surg. 2007;60(9):991-7. doi: 10.1016/j.bjps.2007.02.003. Epub 2007 Apr 25.
The role of sagittal suturectomy in the treatment of scaphocephaly remains controversial. The purpose of this study was to report the experience of the National Craniofacial Unit in Dublin. This unit is the referral centre for the Republic of Ireland and serves a population of approximately 3.5 million. Quantitative assessments were made using radiographs and the pre- and postoperative cephalic index (CI) was calculated. Patients were asked to score their head shapes in a questionnaire. The mean age at surgery for the 53 children was 4.9 months with a mean follow up of 8 years. Pre- and postoperative radiographs were available for analysis in 24 patients. The mean preoperative CI was 65.3. There was a statistically significant increase in the CI postoperatively to 73.7. Seventy five per cent of children achieved a 'normal' CI and 86% scored their head shapes as good to excellent. There was no correlation between the age at surgery and the CI achieved. Although only one child was not happy with the shape of the head, the impression was that the CI correlated poorly with the clinical assessment of the head shape. There were no significant complications. We therefore conclude that the sagittal suturectomy is a safe procedure that has a limited but definite potential to improve the CI. This procedure still has a place in the surgical repertoire of the craniofacial surgeon dealing with scaphocephaly.
矢状缝切除术在舟状头畸形治疗中的作用仍存在争议。本研究的目的是报告都柏林国家颅面科的经验。该科室是爱尔兰共和国的转诊中心，服务人口约350万。使用X线片进行定量评估，并计算术前和术后的头指数（CI）。让患者在问卷中对头形进行评分。53名儿童的平均手术年龄为4.9个月，平均随访8年。24例患者有术前和术后的X线片可供分析。术前平均CI为65.3。术后CI有统计学意义地增加至73.7。75%的儿童达到了“正常”CI，86%将自己的头形评为良好至优秀。手术年龄与术后达到的CI之间无相关性。虽然只有一名儿童对头部形状不满意，但感觉CI与头部形状的临床评估相关性较差。无显著并发症。因此，我们得出结论，矢状缝切除术是一种安全的手术，在改善CI方面具有有限但明确的潜力。该手术在处理舟状头畸形的颅面外科医生的手术方法中仍占有一席之地。
