Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
J Craniomaxillofac Surg. 2013 Dec;41(8):747-54. doi: 10.1016/j.jcms.2012.12.011. Epub 2013 Feb 4.
Children with unilateral isolated coronal suture synostosis suffer from frontal plagiocephaly. In this retrospective study we analyzed 21 patients who were treated with an identical and standardized surgical technique of fronto-orbital advancement with hypercorrection with an average follow-up of 57.5 months. The median age at surgery was 12.1 months. The median average amount of blood loss during the operation was less than 188 ml. Not a single major complication was observed. According to the classification of Whitaker, 15 patients had a Class 1 outcome, with excellent surgical results. Three patients were defined as Class 2 outcome. One of our patients was Class 3 and two patients were Class 4 because of severe forehead retrusion and temporal hollowing. Re-operation rate was 14.3%. 67% of our patients showed a correction or an improvement of the typical C-shaped deformity in their follow-up examination. Aesthetic outcomes were excellent in 13, good in 5, and poor in 3 of cases, as judged by their families and the craniofacial team. Unilateral coronal synostosis can be successfully treated by fronto-orbital advancement with a low complication rate and an excellent clinical outcome. To minimize the need of re-operations, fronto-orbital advancement should be performed with an overcorrection on the affected side.
患有单侧冠状缝早闭的儿童会出现额部偏头畸形。在这项回顾性研究中，我们分析了 21 名接受相同标准化手术治疗的患者，采用额眶前移术并过度矫正，平均随访 57.5 个月。手术时的中位年龄为 12.1 个月。手术过程中平均失血量小于 188ml。未观察到任何重大并发症。根据 Whitaker 分类，15 名患者的手术结果为 1 级，手术效果极佳。3 名患者被定义为 2 级结果。我们的 1 名患者为 3 级，2 名患者为 4 级，因为额部明显后缩和颞部凹陷。再次手术率为 14.3%。67%的患者在随访检查中出现典型 C 形畸形的矫正或改善。根据患者家属和颅面团队的评估，13 例患者的美容效果为优，5 例为良，3 例为差。单侧冠状缝早闭可以通过额眶前移术成功治疗，并发症发生率低，临床效果极佳。为了尽量减少再次手术的需要，应在受累侧进行过度矫正。
