Marchac D, Renier D
World J Surg. 1989 Jul-Aug;13(4):358-65. doi: 10.1007/BF01660748.
Craniosynostosis affects approximately one infant out of one thousand. Increase of intracranial pressure and risks of functional problems are more frequent than previously thought, especially in single-suture synostosis. Frontocranial remodeling will correct both functional and esthetic consequences of craniosynostosis. The best time for surgery is the first year of life, 2-3 months of age for the brachycephalies, and 6-9 months of age for the other craniosynostoses. Not only does growth not deteriorate after forehead remodeling, but the adjacent orbitonasal areas improve with time. In Crouzon's disease and Apert's syndrome, early frontal advancement does not prevent the midface retrusion, and a radical frontofacial advancement may be occasionally indicated in very severe cases. Frontocranial remodeling is also indicated in children presenting with sequelae of classical neurosurgical treatment or those who have had no treatment.
颅缝早闭影响约千分之一的婴儿。颅内压升高和功能问题的风险比以前认为的更常见,尤其是在单缝早闭中。额颅重塑将纠正颅缝早闭的功能和美学后果。手术的最佳时间是生命的第一年,短头畸形为2至3个月大,其他颅缝早闭为6至9个月大。前额重塑后不仅生长不会恶化,而且相邻的眶鼻区域会随着时间改善。在克鲁宗病和阿佩尔综合征中,早期额部前移并不能防止中面部后缩,在非常严重的情况下偶尔可能需要进行根治性的面中部前移。对于有经典神经外科治疗后遗症的儿童或未接受治疗的儿童,也建议进行额颅重塑。