Chieffe Doug, Naffaa Lena, Doumit Gaby
*University of Vermont College of Medicine, Burlington, VT †American University of Beirut Medical Center, Hamra, Beirut, Lebanon ‡Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada.
J Craniofac Surg. 2017 Jan;28(1):51-55. doi: 10.1097/SCS.0000000000003184.
Squamosal suture synostosis has received little attention, potentially due to its rare nature. The authors present here a clinical report of isolated unilateral squamosal suture synostosis and a literature review, which produced 6 articles describing 33 patients of squamosal synostosis.Of the reported patients, 15 were associated with a craniofacial syndrome, 10 were nonsyndromic, and 8 were not specified. The cranial morphology varied greatly and only 1 patient was consistent with the morphology predicted by Virchow law-decreased vertical growth with compensatory ipsilateral longitudinal growth (manifesting as occipital and possibly frontal zygomatic bulging). Additional suture synostoses were observed in 36.3% of nonsyndromic and 80% of syndromic patients, suggesting that either squamosal synostosis may have an effect on other sutures, or more likely, only the most severe patients are recognized and reported.Surgical and nonsurgical interventions have found limited utility due to the subtle nature of the cranial defects and a lack of increased intracranial pressure, with a conservative follow-up course being the preferred treatment.
鳞状缝早闭受到的关注较少,可能是由于其罕见性。本文作者报告了一例孤立性单侧鳞状缝早闭的临床病例并进行文献综述,共检索到6篇描述33例鳞状缝早闭患者的文章。在报告的患者中,15例与颅面综合征相关,10例为非综合征性,8例未明确说明。颅骨形态差异很大,只有1例患者符合魏尔啸定律预测的形态——垂直生长减少并伴有同侧代偿性纵向生长(表现为枕部及可能的额颧部膨隆)。在36.3%的非综合征性患者和80%的综合征性患者中观察到了额外的缝早闭,这表明要么鳞状缝早闭可能对其他缝线有影响,要么更有可能的是,只有最严重的患者才被识别和报告。由于颅骨缺损不明显且颅内压没有升高,手术和非手术干预的效用有限,保守的随访观察是首选的治疗方法。