Miri Sara, Mittermiller Paul, Buchanan Edward P, Khosla Rohit K
*Division of Plastic and Reconstructive Surgery, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California †Pediatric Plastic Surgery, Texas Children's Clinical Care Center, Baylor College of Medicine, Houston, Texas.
J Craniofac Surg. 2015 May;26(3):655-7. doi: 10.1097/SCS.0000000000001436.
Unilateral coronal synostosis (UCS) often causes notable facial twist in affected patients. This condition occurs when the midface deviates toward the synostotic side, and the lower face deviates away from the synostotic side. The exact underlying mechanism for this phenomenon remains unclear. It has been proposed that premature fusion of facial sutures may play a role in the formation of facial twist. The purpose of this study was to determine whether asymmetrical facial suture fusion is present in patients with UCS.
A single-center retrospective study was designed. Our study group consisted of 23 patients with a confirmed diagnosis of isolated UCS. Our control group consisted of 17 age-matched patients with deformational plagiocephaly and 11 normocephalic control subjects. The computed tomography scans of the faces were examined for the presence of facial suture fusions on both synostotic and nonsynostotic sides. All results with P < 0.05 were considered statistically significant.
We found an increased incidence of fusion of the frontomaxillary, nasofrontal, and nasomaxillary sutures on the side of synostosis in UCS when compared with the nonsynostotic side and when compared with patients with deformational plagiocephaly or normocephalic patients.
Asymmetrical premature fusion of facial sutures can potentially be contributing to the facial twist that is seen in patients with UCS.
单侧冠状缝早闭（UCS）常导致患侧患者出现明显的面部扭曲。当中面部向缝早闭侧偏斜，而下面部远离缝早闭侧时，就会出现这种情况。这种现象的确切潜在机制尚不清楚。有人提出面部缝线过早融合可能在面部扭曲的形成中起作用。本研究的目的是确定UCS患者是否存在不对称的面部缝线融合。
设计了一项单中心回顾性研究。我们的研究组由23例确诊为孤立性UCS的患者组成。我们的对照组由17例年龄匹配的变形性斜头畸形患者和11例头部正常的对照受试者组成。检查面部计算机断层扫描，以确定缝早闭侧和非缝早闭侧是否存在面部缝线融合。所有P<0.05的结果均被认为具有统计学意义。
我们发现，与非缝早闭侧相比，以及与变形性斜头畸形患者或头部正常患者相比，UCS患者缝早闭侧的额上颌缝、鼻额缝和鼻上颌缝融合发生率增加。
面部缝线的不对称过早融合可能是导致UCS患者面部扭曲的原因。
