Department of Plastic and Reconstructive Surgery, The Catholic University of Korea-College of Medicine, St. Mary's Hospital, 62 Yeouido-Dong, Yeoungdeungpo-Gu, Seoul 150-713, Republic of Korea.
J Plast Reconstr Aesthet Surg. 2010 Nov;63(11):1787-93. doi: 10.1016/j.bjps.2009.11.006. Epub 2010 Jan 8.
Sagittal synostosis is the most common type of non-syndromic craniosynostosis with fusion of the sagittal suture. Various techniques have been introduced for the treatment of this irregular calvarial deformity. However, since these methods were not suitable for patients who were aged over 1 year when they were diagnosed with sagittal synostosis, a new approach should be undertaken.
Between 2001 and 2005, five patients who were diagnosed with sagittal synostosis, after the age of 1 year, were treated with subtotal cranial vault remodelling. The procedure consisted of right-angled Z-osteotomies in the frontal and parieto-occipital bones, a shortening of the sagittal strut, and barrel-stave osteotomies in the temporal bone. They were undertaken to expand bitemporal diameter and to shorten anteroposterior diameter.
Cranial index increased from 68.2 to 77.8 immediately after surgery and to 78.4 post-surgery 36 months. Cranial morphologies were satisfactory during follow-up. The main advantage of the procedure is the easy control of fixation angle according to the surgeon's preference. There were no major complications including infections or relapses.
The treatment goal of sagittal synostosis is to eliminate factors that may impede brain development by assuring an adequate cranial cavity and to maintain an aesthetically acceptable cranial morphology. We obtained functionally and aesthetically favourable results by right-angled Z-osteotomies. Further, our one-staged procedure is safe, especially in patients over the age of 1 year.
矢状缝早闭是最常见的非综合征性颅缝早闭类型，表现为矢状缝融合。为了治疗这种不规则的颅骨畸形，已经引入了各种技术。然而，由于这些方法不适合在诊断为矢状缝早闭后 1 岁以上的患者中使用，因此需要采用新的方法。
2001 年至 2005 年间，对 5 例 1 岁以后诊断为矢状缝早闭的患者采用部分颅盖重塑术进行治疗。手术包括额骨和顶枕骨的直角 Z 形截骨、矢状骨突缩短和颞骨桶状截骨，旨在扩大双侧颞径并缩短前后径。
术后即刻，头颅指数从 68.2 增加到 77.8，术后 36 个月增加到 78.4。随访期间，头颅形态满意。该手术的主要优点是根据术者的喜好，易于控制固定角度。无感染或复发等重大并发症。
矢状缝早闭的治疗目标是通过确保足够的颅腔来消除可能阻碍大脑发育的因素，并保持美观可接受的头颅形态。我们通过直角 Z 形截骨获得了功能和美观上的良好效果。此外，我们的一步手术是安全的，特别是对于 1 岁以上的患者。
