Blecher J C, Howaldt H P
Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie (Prof. Dr. Dr. H.-P. Howaldt), Justus-Liebig-Universität Gießen, Gießen, Deutschland.
Mund Kiefer Gesichtschir. 1998 May;2(Suppl 1):S81-5. doi: 10.1007/PL00014489.
In all craniofacial deformities the differential diagnosis between synostotic and non-synostotic conditions must be made. While the first group is usually subject to intracranial surgical intervention, the treatment of non-synostotic deformities is the subject of controversial discussion. Often associated with premature birth, restrictive intrauterine environment or torticollis, these conditions, also defined as positional deformations, can lead to severe plagiocephalic head shapes. Dynamic orthotic cranioplasty is a conservative method of treating these deformities in early childhood by means of an individually fabricated orthotic head band. The principle is that dynamic pressure is applied to prominent parts while leaving space for growth in depressed areas. In accordance with this principle, various deformities can be addressed. Through clinical, anthropometric and radiographic evaluation it has been shown that dynamic orthotic cranioplasty can correct positional deformation of the cranial vault, skull base and upper face with no relapse following treatment. It must be emphasised that the method is simple, easy to handle and very effective when treatment starts within the first 6 months of life. Therefore, its potential should be recognised by paediatricians and craniofacial surgeons.
在所有颅面畸形中,必须对骨性融合和非骨性融合情况进行鉴别诊断。虽然第一组情况通常需要进行颅内手术干预,但非骨性融合畸形的治疗一直是有争议的讨论话题。这些情况通常与早产、子宫内环境受限或斜颈有关,也被定义为位置性畸形,可导致严重的斜头畸形头型。动态矫形颅骨成形术是一种在儿童早期通过单独制作的矫形头带来治疗这些畸形的保守方法。其原理是对突出部位施加动态压力,同时在凹陷部位留出生长空间。根据这一原理,可以处理各种畸形。通过临床、人体测量和影像学评估表明,动态矫形颅骨成形术可以矫正颅顶、颅底和上脸的位置性畸形,治疗后不会复发。必须强调的是,该方法简单、易于操作,在出生后前6个月内开始治疗时非常有效。因此,儿科医生和颅面外科医生应该认识到它的潜力。