Sharma Ramesh Kumar
Department of Plastic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Plast Surg. 2013 Jan;46(1):18-27. doi: 10.4103/0970-0358.113702.
Craniosynostosis is a premature pathologic fusion of one or more cranial vault sutures that leads to abnormal shape of the skull. The fused sutures lead to restricted growth in some areas and compensatory bossing in other areas. The head may assume different shapes depending upon the site and timing of the abnormally fused suture. The exact cause of this suture pathology is still unknown, but the local dura, cranial base and the fibroblast growth factors seem to influence this. The diagnosis rests on clinical examination and confirmation is generally on the computed tomography scan. The need for surgery is both for cosmetic and functional reasons. Many cases may be associated with raised intracranial pressure with its attendant deleterious effects on vision and brain. The aim of treatment is to increase the cranial volume and reshape the skull. The surgery can be safely undertaken around 9-12 months in most of the cases. The conventional management is through an open surgical approach; although, some centres have claimed impressive results with limited endoscopic techniques in selected cases. The review article deals with the aetiopathogenesis, clinical presentations and management of the common varieties of craniosynostoses seen in the Indian scenario.
颅缝早闭是指一个或多个颅顶骨缝过早地发生病理性融合,导致颅骨形状异常。融合的骨缝会导致某些区域生长受限,而其他区域则出现代偿性隆起。根据异常融合骨缝的部位和时间不同,头部可能呈现出不同的形状。这种骨缝病理的确切原因尚不清楚,但局部硬脑膜、颅底和成纤维细胞生长因子似乎对其有影响。诊断依靠临床检查,通常通过计算机断层扫描来确诊。手术治疗既有美容方面的需求,也有功能方面的原因。许多病例可能伴有颅内压升高,随之对视功能和脑功能产生有害影响。治疗的目的是增加颅腔容积并重塑颅骨。大多数情况下,手术可在9至12个月左右安全进行。传统的治疗方法是采用开放手术入路;不过,一些中心声称在某些特定病例中,有限的内镜技术也取得了令人瞩目的效果。这篇综述文章探讨了印度常见的颅缝早闭类型的病因发病机制、临床表现及治疗方法。