Raposo-Amaral Cassio Eduardo, Denadai Rafael, Ghizoni Enrico, Raposo-Amaral Cesar Augusto
From the *Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil; and †Division of Pediatric Neurosurgery, Department of Neurology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
Ann Plast Surg. 2017 Apr;78(4):421-427. doi: 10.1097/SAP.0000000000000915.
Although craniofacial bone correction is the essential step in hypertelorbitism correction, the final result depends on the management of soft tissue deformities. The purpose of this study was to review our surgical strategies for soft tissue reconstruction in hypertelorbitism correction.
A retrospective study was performed of consecutive patients with hypertelorbitism, undergoing hypertelorbitism correction between 2007 and 2014. All aspects related to the craniofacial surgical procedures (number and type of procedures, outcomes, and complications) were verified through medical records, clinical photographs, and interviews with all patients. The surgical results were classified based on a previously published outcome grading scale I-IV on the need for additional surgery.
The present study included 16 patients diagnosed with Crouzon syndrome (n = 2), Apert syndrome (n = 1), encephalocele (n = 1), frontonasal dysplasia (n = 2), craniofrontonasal dysplasia (n = 5), Tessier number 10 type (n = 1), and Tessier number 0 to 14 type (n = 4).The number and types (local flaps, medial canthopexy, Converse scalping flap, and/or the K stitch technique) of surgeries performed varied according to the facial soft tissue deformities of each patient. The overall rate of surgical results ranked according to the need for additional surgery was 1.56 ± 0.51 (between categories I and II).
As hypertelorbitism has been associated with a variety of congenital deformities, plastic surgeons who deal with these patients should have a broad surgical armamentarium tailored to each individual presentation.
尽管颅面骨矫正术是矫正眶距增宽症的关键步骤，但最终效果取决于软组织畸形的处理。本研究的目的是回顾我们在矫正眶距增宽症时进行软组织重建的手术策略。
对2007年至2014年间连续接受眶距增宽症矫正术的患者进行回顾性研究。通过病历、临床照片以及与所有患者的访谈，核实与颅面外科手术相关的所有方面（手术的数量和类型、结果及并发症）。根据先前发表的结局分级量表I-IV，依据是否需要额外手术对手术结果进行分类。
本研究纳入了16例诊断为克鲁宗综合征（n = 2）、阿佩尔综合征（n = 1）、脑膨出（n = 1）、额鼻发育不良（n = 2）、颅额鼻发育不良（n = 5）、泰西埃10型（n = 1）和泰西埃0至14型（n = 4）的患者。所施行手术的数量和类型（局部皮瓣、内眦固定术、康弗斯头皮瓣和/或K缝线技术）因每位患者的面部软组织畸形情况而异。根据是否需要额外手术分类的手术结果总体评分是1.56 ± 0.51（介于I类和II类之间）。
由于眶距增宽症与多种先天性畸形相关，处理这些患者的整形外科医生应具备针对每种个体表现的广泛手术方法。
