Dunaway David J, Britto Johnathan A, Abela Christopher, Evans Robert D, Jeelani N U Owase
Craniofacial Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1 3JH, UK.
Childs Nerv Syst. 2012 Sep;28(9):1571-6. doi: 10.1007/s00381-012-1804-y. Epub 2012 Aug 8.
The purpose of this study was to document the early and late complications associated with frontofacial distraction.
A systematic review of the literature on complications in craniofacial surgery and a review of records of patients undergoing frontofacial distraction at Great Ormond Street Hospital for Children over a 10-year period were conducted.
Complications arising from frontofacial advancement are common. Mortality rates varied between 0 and 4.5 %. There has been a general decline in reported mortality rates with time, and the most recent series report mortalities of less than 1 %. The incidence of significant blood loss (greater than one blood volume) in patients undergoing monobloc osteotomy varied between 5.3 and 9.1 %. CSF leaks following monobloc distraction are common (incidence, 2-20 %). Most of these leaks settle spontaneously. The incidence of frontal bone flap necrosis requiring debridement and a subsequent cranioplasty varied between 3 and 20 %.
The functional and aesthetic benefits of frontofacial distraction are well documented, but these advantages are associated with a significant complication rate. The potential benefits of frontofacial distraction need to be carefully weighed against the potential complications when deciding to recommend surgery.
本研究的目的是记录额面牵张成骨术相关的早期和晚期并发症。
对颅面外科手术并发症的文献进行系统综述，并回顾了大奥蒙德街儿童医院10年间接受额面牵张成骨术患者的病历。
额面前移引起的并发症很常见。死亡率在0%至4.5%之间。随着时间的推移，报告的死亡率总体呈下降趋势，最近的系列报道死亡率低于1%。接受整块截骨术的患者中，严重失血（超过一个血容量）的发生率在5.3%至9.1%之间。整块牵张成骨术后脑脊液漏很常见（发生率为2%至20%）。这些漏液大多会自行停止。需要清创及后续颅骨成形术的额骨瓣坏死发生率在3%至20%之间。
额面牵张成骨术在功能和美学方面的益处已有充分记录，但这些优势伴随着较高的并发症发生率。在决定推荐手术时，需要仔细权衡额面牵张成骨术的潜在益处与潜在并发症。
