Campinas, Brazil From the Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, Brazil.
Plast Reconstr Surg. 2014 Feb;133(2):182e-191e. doi: 10.1097/01.prs.0000437260.31693.75.
Crouzon and Apert syndromes are the most common syndromic forms of craniofacial dysostosis. Apert syndrome has a broad clinical spectrum, including complex craniofacial involvement, as well as limiting deformities of the hands, feet, and other joints that require multiple surgical procedures when compared with Crouzon syndrome, which is generally less severe. The authors hypothesized that the quality of life of Apert syndrome patients is inferior to that of Crouzon syndrome patients.
The quality of life of Apert (n = 8) and Crouzon (n = 12) syndrome patients was assessed using the World Health Organization Quality of Life-100 questionnaire. The Mann-Whitney test was used to compare the quality-of-life scores between Apert and Crouzon patients. Values were considered significant for a confidence interval of 95 percent (p < 0.05).
Apert patients showed an overall higher (score > 60 percent) quality of life in most World Health Organization Quality of Life-100 facets (68 percent) and domains (83.33 percent), with significance (p < 0.05) in three facets (energy and fatigue, mobility, and environment in the home), compared with Crouzon patients.
Contrary to the authors' initial hypothesis, both the highest-functioning Apert patients and the Crouzon patients presented a satisfactory quality of life, demonstrating that these syndromic patients had acquired the necessary repertoire to manage the adverse daily situations of their lives.
颅面骨发育不全的最常见综合征形式是克劳宗(Crouzon)和尖颅-多指(趾)畸形(Apert)综合征。与克劳宗综合征相比,尖颅-多指(趾)畸形综合征具有广泛的临床特征,包括复杂的颅面受累,以及手部、足部和其他关节的限制畸形,这些都需要进行多次手术。作者假设尖颅-多指(趾)畸形综合征患者的生活质量劣于克劳宗综合征患者。
采用世界卫生组织生活质量量表 100 项(World Health Organization Quality of Life-100)评估尖颅-多指(趾)畸形(n = 8)和克劳宗(n = 12)综合征患者的生活质量。采用曼-惠特尼检验比较尖颅-多指(趾)畸形和克劳宗综合征患者的生活质量评分。置信区间为 95%(p < 0.05)时认为差异有统计学意义。
尖颅-多指(趾)畸形患者在大多数世界卫生组织生活质量量表 100 项(68%)和领域(83.33%)中表现出整体较高(评分> 60%)的生活质量,在活力和疲劳、移动性和家庭环境这三个方面具有统计学意义(p < 0.05),与克劳宗综合征患者相比。
与作者最初的假设相反,功能最高的尖颅-多指(趾)畸形患者和克劳宗综合征患者都表现出满意的生活质量,这表明这些综合征患者已经获得了应对日常生活中不利情况的必要技能。