Raposo-Amaral Cassio Eduardo, Denadai Rafael, Ghizoni Enrico, Buzzo Celso Luiz, Raposo-Amaral Cesar Augusto
From the *Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital; and †Pediatric Neurosurgical Division, Department of Neurology, School of Medical Sciences, UNICAMP, Campinas, São Paulo, Brazil.
J Craniofac Surg. 2015 Jan;26(1):141-6. doi: 10.1097/SCS.0000000000001400.
The premature fusion of unilateral coronal suture can cause a significant asymmetry of the craniofacial skeleton, with an oblique deviation of the cranial base that negatively impacts soft tissue facial symmetry. The purpose of this study was to assess facial symmetry obtained in patients with unilateral coronal synostosis (UCS) surgically treated by 2 different techniques. We hypothesized that nasal deviation should not be addressed in a primary surgical correction of UCS.
Consecutive UCS patients were enrolled in a prospective study and randomly divided into 2 groups. In group 1, the patients underwent total frontal reconstruction and transferring of onlay bone grafts to the recessive superior orbital rim (n = 7), and in group 2, the patients underwent total frontal reconstruction and unilateral fronto-orbital advancement (n = 5). Computerized photogrammetric analysis measured vertical and horizontal axis of the nose and the orbital globe in the preoperative and postoperative periods. Intragroup and intergroup comparisons were performed.
Intragroup preoperative and postoperative comparisons showed a significant (all P < 0.05) reduction of the nasal axis and the orbital-globe axis in the postoperative period in the 2 groups. Intergroup comparisons showed no significant difference (all P > 0.05).
Facial symmetry was achieved in the patients with UCS who underwent surgery regardless of surgical approach evaluated here. Our data showed a significant improvement in nasal and orbital-globe deviation, leading us to question the necessity of primary nasal correction in these patients.
单侧冠状缝过早融合可导致颅面骨骼明显不对称，颅底出现斜向偏移，对面部软组织对称性产生负面影响。本研究的目的是评估采用两种不同技术手术治疗的单侧冠状缝早闭（UCS）患者的面部对称性。我们假设在UCS的初次手术矫正中不应处理鼻偏问题。
连续的UCS患者纳入一项前瞻性研究，并随机分为两组。第1组患者接受全额重建并将嵌体骨移植转移至隐性眶上缘（n = 7），第2组患者接受全额重建和单侧额眶前移术（n = 5）。计算机摄影测量术前和术后鼻子及眶眼球的垂直和水平轴。进行组内和组间比较。
组内术前和术后比较显示，两组术后鼻轴和眶眼球轴均显著降低（所有P < 0.05）。组间比较无显著差异（所有P > 0.05）。
无论采用此处评估的何种手术方法，接受手术的UCS患者均实现了面部对称。我们的数据显示鼻和眶眼球偏移有显著改善，这使我们质疑这些患者初次鼻矫正的必要性。
