McCarthy J G, Karp N S, LaTrenta G S, Thorne C H
Institute of Reconstructive Plastic Surgery, New York University Medical Center, NY.
Plast Reconstr Surg. 1990 Dec;86(6):1078-84. doi: 10.1097/00006534-199012000-00005.
The frontal sinuses make an important contribution to normal forehead and glabellar contour. This study was designed to test our clinical impression that early fronto-orbital ("frontal bone") advancement could have an adverse effect on frontal sinus development and consequently on forehead aesthetics. A retrospective study was conducted on 11 patients who had undergone fronto-orbital advancement and also had a long period of follow-up at the Institute of Reconstructive Plastic Surgery at New York University. The longitudinal cephalometric data were compared with unoperated controls. With one exception, no patient who underwent bilateral fronto-orbital advancement developed a frontal sinus, and all such patients had a flattened brow contour when compared with unoperated patients, of whom 82 percent developed at least one frontal sinus. Of the three patients who underwent unilateral fronto-orbital advancement for plagiocephaly (flattened forehead), two developed a frontal sinus but only on the unoperated side and one developed bilateral frontal sinuses. The two patients with unilateral frontal sinus development had a particularly obvious deformity resulting from normal glabellar projection on the unoperated side and a flattened contour on the operated side. Fronto-orbital advancement affects forehead aesthetics and should be performed only in infant patients with moderate to severe deformities. patients with plagiocephaly whose deformity is sufficiently severe to warrant surgery should preferably undergo bilateral fronto-orbital advancement (by the technique described) rather than unilateral advancement in order to avoid the brow asymmetry that results from unilateral frontal sinus development.
额窦对正常的额头和眉间轮廓有重要作用。本研究旨在验证我们的临床印象，即早期额眶（“额骨”）前移可能对额窦发育产生不利影响，进而影响额头美观。对11例接受额眶前移手术且在纽约大学整形重建外科长期随访的患者进行了一项回顾性研究。将纵向头影测量数据与未手术的对照组进行比较。除1例例外，所有接受双侧额眶前移手术的患者均未发育出额窦，与未手术患者相比，所有此类患者的眉轮廓均变平，未手术患者中有82%至少发育出一个额窦。在3例因斜头畸形（额头扁平）接受单侧额眶前移手术的患者中，2例仅在未手术侧发育出额窦，1例双侧发育出额窦。2例单侧额窦发育的患者存在特别明显的畸形，表现为未手术侧眉间正常突出，手术侧轮廓扁平。额眶前移会影响额头美观，应仅在患有中度至重度畸形的婴儿患者中进行。对于斜头畸形患者，若其畸形严重到需要手术，最好进行双侧额眶前移（采用所述技术）而非单侧前移，以避免因单侧额窦发育导致的眉不对称。
