Gociman Barbu, Blagg Ross, Agko Mouchammed, Goodwin Isak, Kestle John R W, Siddiqi Faizi
From the *Department of Plastic Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah; †Division of Plastic Surgery, University of Southern California, Keck School of Medicine, Los Angeles, California; and ‡Division of Pediatric Neurosurgery, Primary Children's Medical Center, Salt Lake City, Utah.
J Craniofac Surg. 2014 Nov;25(6):2101-4. doi: 10.1097/SCS.0000000000001047.
While metopic synostosis is typically a straightforward clinical diagnosis, there is no standard objective measurement that can be easily used in the preoperative evaluation and in the subsequent postoperative follow-up. Despite the fact that multiple methods have been previously described, they either lack well-defined landmark points, do not specifically address the frontal vault deformity, or are too cumbersome to be used routinely for clinical applications. We describe the metopic angle as an objective and dependable method for evaluation of the frontal vault contour.Using the STARscanner Laser Data Acquisition System, a portable, noninvasive diagnostic modality, the metopic angle was defined. This angle was used to track postoperative changes and was compared with preoperative values in patients who underwent minimally invasive strip craniectomy for metopic synostosis. To further ensure its validity, the angle was also measured in age-matched control subjects.The metopic angle changed from a preoperative value of 104.9 degrees to 111.3 degrees at 3 months (P = 1.59E-06) and to 114.9 at 1 year postoperatively (P = 2.51E-09) in patients who underwent endoscopic-assisted strip craniectomies for metopic synostosis. The resulting postoperative values were comparable to those obtained in age-matched control subjects with normal cranial vaults.The metopic angle measurement is a rapid, noninvasive, reproducible method for objective measurement of both preoperative deformity and postoperative correction of the frontal bone contour in metopic synostosis.
虽然额缝早闭通常是一种简单明了的临床诊断，但在术前评估和术后随访中，没有一种标准的客观测量方法可以轻松使用。尽管此前已经描述了多种方法，但它们要么缺乏明确的标志点，没有专门针对额骨穹窿畸形，要么过于繁琐，无法常规用于临床应用。我们将额缝角描述为一种评估额骨穹窿轮廓的客观可靠方法。使用STARscanner激光数据采集系统（一种便携式非侵入性诊断方式）定义了额缝角。该角度用于跟踪术后变化，并与接受微创条状颅骨切除术治疗额缝早闭的患者的术前值进行比较。为了进一步确保其有效性，还在年龄匹配的对照受试者中测量了该角度。接受内镜辅助条状颅骨切除术治疗额缝早闭的患者，其额缝角从术前的104.9度在术后3个月变为111.3度（P = 1.59E - 06），术后1年变为114.9度（P = 2.51E - 09）。术后得到的值与年龄匹配的正常颅骨穹窿对照受试者的值相当。额缝角测量是一种快速、非侵入性、可重复的方法，用于客观测量额缝早闭患者术前畸形和术后额骨轮廓的矫正情况。
