Gociman Barbu, Marengo Jason, Ying Jian, Kestle John R W, Siddiqi Faizi
Department of Plastic Surgery, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA.
J Craniofac Surg. 2012 May;23(3):825-8. doi: 10.1097/SCS.0b013e31824dbcd5.
The most common approaches used today for the correction of sagittal synostosis involve large craniectomies and extensive cranial vault remodeling. Although these techniques ultimately yield very good cosmetic results, they have significant drawbacks. They are lengthy, expensive, associated with significant blood loss, universally require transfusions, and often result in prolonged hospitalization.We present here our 5-year experience with correction of sagittal synostosis using the recently described minimally invasive strip craniectomy followed by postoperative cranial vault helmet molding. During this period, we treated a total of 97 children with nonsyndromic single-suture synostosis. The first 46 of 67 children treated for sagittal synostosis had at least 1 year of postoperative follow-up and were included in the analysis. There were 33 boys and 13 girls. Patients' mean age at surgery was 3.1 months, and the mean weight was 6.1 kg. The mean operative time was 75 minutes. The estimated blood loss during the procedure was 56 mL. Eight patients received blood transfusions during surgery (17.4%) and 3 patients received after surgery (6.5%). There were no significant postoperative complications. The mean hospitalization was 2.2 days. Excellent aesthetic outcomes were noted in all patients. The change in cranial index from a preoperative value of 0.7 to 0.8 postoperatively was virtually stabilized 3 months after the surgical intervention. Significantly better correction rates were observed in the youngest patients.Because of its excellent attributes, minimally invasive strip craniectomy followed by postoperative helmet molding is likely to become the preferred treatment modality for the correction of sagittal synostosis.
目前用于矫正矢状缝早闭的最常见方法包括大型颅骨切除术和广泛的颅盖重塑。尽管这些技术最终能产生非常好的美容效果，但它们有显著的缺点。手术时间长、费用高、失血量大，普遍需要输血，且常常导致住院时间延长。我们在此介绍我们采用最近描述的微创条状颅骨切除术并术后进行颅盖头盔塑形来矫正矢状缝早闭的5年经验。在此期间，我们共治疗了97例非综合征性单缝早闭患儿。接受矢状缝早闭治疗的67例患儿中的前46例有至少1年的术后随访，并纳入分析。其中有33名男孩和13名女孩。患者手术时的平均年龄为3.1个月，平均体重为6.1千克。平均手术时间为75分钟。术中估计失血量为56毫升。8例患者在手术期间接受了输血（17.4%），3例患者在术后接受了输血（6.5%）。术后无明显并发症。平均住院时间为2.2天。所有患者均获得了极佳的美学效果。颅骨指数从术前的0.7术后变为0.8，在手术干预后3个月基本稳定。最年幼的患者观察到明显更好的矫正率。由于其出色的特性，微创条状颅骨切除术并术后头盔塑形可能会成为矫正矢状缝早闭的首选治疗方式。
