Le Minh-Bao, Patel Kamlesh, Skolnick Gary, Naidoo Sybill, Smyth Matthew, Kane Alex, Woo Albert S
From the *Division of Plastic and Reconstructive Surgery, Department of Surgery, and †Department of Neurosurgery, Washington University School of Medicine, St Louis, Missouri; and ‡Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
J Craniofac Surg. 2014 Mar;25(2):573-6. doi: 10.1097/SCS.0000000000000613.
Sagittal synostosis has been successfully managed with numerous surgical techniques. Nevertheless, few data on long-term outcomes exist to justify use of one surgical technique over another. In this study, we compared children with surgically corrected sagittal synostosis to their age-matched control subjects to assess the longevity of their corrections. Furthermore, the outcomes of open repairs were compared with endoscopic repairs.Following institutional review board approval, three-dimensional photographs of patients who underwent surgical reconstruction for nonsyndromic sagittal synostosis were analyzed to determine biparietal and anterior-posterior diameter, circumference, cephalic index, cranial vault volume, cranial height, and forehead inclination. Thirteen patients who had undergone open repair, including 6 total cranial vault and 7 modified-pi reconstructions, and 6 patients who had undergone endoscopic strip craniectomy with barrel-stave osteotomies and postoperative helmeting were compared with nonsynostotic age-matched control subjects. Mean follow-up was 97.5 months after open and 48.9 months after endoscopic repair. Student t tests were used for analysis. In the second arm of this study, 33 patients who had undergone endoscopic repair were compared with the 13 patients who had undergone open repair; mean follow-up was 24.8 months after endoscopic repair. Linear regression models were used to adjust for age and sex.After comparing three-dimensional photographs of children who were more than 3 years postoperative from surgical correction for sagittal synostosis with their age-matched control subjects, no statistically significant differences were found in any of the measured parameters. In addition, no differences were detected between open reconstruction versus endoscopic repair, suggesting equivalence in final results for both procedures.
矢状缝早闭已通过多种手术技术成功治疗。然而，关于长期预后的数据很少，无法证明使用一种手术技术优于另一种。在本研究中，我们将接受手术矫正矢状缝早闭的儿童与其年龄匹配的对照受试者进行比较，以评估其矫正的持久性。此外，还比较了开放修复与内镜修复的结果。经机构审查委员会批准，对接受非综合征性矢状缝早闭手术重建的患者的三维照片进行分析，以确定双顶径、前后径、头围、头指数、颅腔容积、颅高和额头倾斜度。将13例接受开放修复的患者（包括6例全颅腔修复和7例改良π形重建）和6例接受内镜下条带颅骨切除术加桶状骨切开术并术后佩戴头盔的患者与年龄匹配的非缝早闭对照受试者进行比较。开放修复后的平均随访时间为97.5个月，内镜修复后的平均随访时间为48.9个月。采用学生t检验进行分析。在本研究的第二部分，将33例接受内镜修复的患者与13例接受开放修复的患者进行比较；内镜修复后的平均随访时间为24.8个月。使用线性回归模型对年龄和性别进行调整。在将矢状缝早闭手术矫正术后3年以上的儿童的三维照片与其年龄匹配的对照受试者进行比较后，在任何测量参数中均未发现统计学上的显著差异。此外，开放重建与内镜修复之间未检测到差异，表明两种手术的最终结果相当。
