Murphy Blake D, Ajabshir Navid, Altman Nolan, Wolfe S Anthony, Perlyn Chad
*University Health Network, University of Toronto, Toronto, ON, Canada †Mount Sinai Medical Center ‡Division of Diagnostic Radiology, Miami Children's Health System, Nicklaus Children's Hospital §Division of Plastic Surgery, Nicklaus Children's Hospital ||Division of Plastic Surgery, Florida International University College of Medicine, Miami, FL.
J Craniofac Surg. 2017 Jul;28(5):1179-1184. doi: 10.1097/SCS.0000000000003603.
Squamosal suture craniosynostosis is thought to be a relatively rare entity. In the authors' experience, it is underreported in imaging examinations and the existing literature. The authors sought to determine the incidence of squamosal synostosis, whether it is increasing in frequency, and its relationship with synostosis of the major calvarial sutures.Patients undergoing computed tomography imaging for suspected craniosynostosis over a 15-year period were reviewed by a plastic surgeon and pediatric neuroradiologist. Patients with synostosis of the squamosal sutures were identified and involvement of additional sutures, gender, and the presence of a known syndromic diagnosis were recorded. Patients greater than 4 years of age or those with prior craniofacial surgery were excluded.One hundred twenty-five patients met inclusion criteria, 26 of whom had squamosal suture synostosis (26/125, 20.8%). Squamosal synostosis was found in isolation in 3 patients (3/26, 11.5%), with 1 additional major suture in 10 patients (10/26, 38.5%), and ≥2 major sutures in 13 patients (13/26, 50%). Squamosal synostosis was more common in patients with a syndromic diagnosis (11/26 syndromic, 15/99 nonsyndromic, P < 0.001). Eleven of 26 patients with squamosal synostosis were identified in the radiology report (42.3%).Craniosynostosis of the squamosal suture is much more common than previously reported and can contribute to abnormal head shape in isolation, or in combination with major sutures. Squamosal suture synostosis is underdiagnosed clinically and radiologically, although insufficient evidence exists to determine if its true incidence is increasing.
鳞状缝早闭被认为是一种相对罕见的病症。根据作者的经验，在影像学检查和现有文献中，其报告不足。作者试图确定鳞状缝早闭的发病率、其频率是否在增加以及它与主要颅骨缝早闭的关系。
对15年间因疑似颅缝早闭而接受计算机断层扫描成像的患者进行了整形外科医生和儿科神经放射科医生的评估。确定了患有鳞状缝早闭的患者，并记录了其他缝线的受累情况、性别以及已知综合征诊断的存在情况。排除了4岁以上的患者或之前接受过颅面手术的患者。
125名患者符合纳入标准，其中26名患有鳞状缝早闭（26/125，20.8%）。孤立性鳞状缝早闭在3名患者中发现（3/26，11.5%），10名患者有1条额外的主要缝线（10/26，38.5%），13名患者有≥2条主要缝线（13/26，50%）。鳞状缝早闭在患有综合征诊断的患者中更常见（综合征患者11/26，非综合征患者15/99，P<0.001）。26名患有鳞状缝早闭的患者中有11名在放射学报告中被识别（42.3%）。
鳞状缝早闭比之前报道的更为常见，可单独或与主要缝线一起导致头部形状异常。鳞状缝早闭在临床和放射学上诊断不足，尽管没有足够的证据确定其真实发病率是否在增加。
