Hinojosa J, Esparza J, Muñoz M J
Unit for Craniofacial Surgery, Pediatric Neurosurgery, Hospital 12 de Octubre, Avda. Córdoba s/n, 28041 Madrid, Spain.
Childs Nerv Syst. 2007 Dec;23(12):1421-30. doi: 10.1007/s00381-007-0473-8. Epub 2007 Sep 26.
The development of multidisciplinar units for Craniofacial Surgery has led to better postoperative results and a considerable decrease in morbidity in the treatment of complex craniofacial patients.
Standard correction of craniosynostosis involves calvarial remodeling, often considerable blood losses that need to be replaced and lengthy hospital stay. The use of minimally invasive techniques for the correction of some of these malformations are widespread and allows the surgeon to minimize the incidence of complications by means of a decreased surgical time, blood salvage, and shortening of postoperative hospitalization in comparison to conventional craniofacial techniques.
Simple and milder craniosynostosis are best approached by endoscopy-assisted osteotomies and render the best results. Extended procedures other than simple suturectomies have been described for more severe patients. Different osteotomies resembling standard fronto-orbital have been developed for the correction, and the use of postoperative cranial orthesis may improve the final cosmetic appearance. Thus, endoscopic-assisted procedures differ from the simple strategy of single suture resection that rendered insufficient results in the past, and different approaches can be tailored to solve these cases in patients in the setting of a case-to-case bases.
颅面外科多学科单位的发展已使复杂颅面患者的术后效果更佳，发病率显著降低。
颅缝早闭的标准矫正涉及颅骨重塑，往往会有大量失血需要补充，且住院时间较长。与传统颅面技术相比，使用微创技术矫正其中一些畸形已广泛应用，且能使外科医生通过减少手术时间、血液回收和缩短术后住院时间来降低并发症发生率。
简单且症状较轻的颅缝早闭最好采用内镜辅助截骨术，效果最佳。对于病情较重的患者，已描述了除简单缝线切除术之外的扩展手术。已开发出不同的类似标准额眶截骨术用于矫正，术后使用颅骨矫形器可能会改善最终的美容效果。因此，内镜辅助手术不同于过去效果不佳的单缝切除术这一简单策略，并且可以根据具体情况为患者量身定制不同方法来解决这些病例。
