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Goldenhar 综合征:当前观点。

Goldenhar syndrome: current perspectives.

机构信息

Craniomaxillofacial and Oncological Surgery Clinic, Medical University of Lodz, 22 Kopcinskiego St, 90-153, Lodz, Poland.

Department of Dentistry, Medical University of Lodz, Lodz, Poland.

出版信息

World J Pediatr. 2017 Oct;13(5):405-415. doi: 10.1007/s12519-017-0048-z. Epub 2017 Jun 15.

Abstract

BACKGROUND

Progress in medical branches that has taken place since the first child with Goldenhare syndrome (GS) had been described in 1952 by Maurice Goldenhar, facilitated better understanding of this congenital defect. It also gave new perspectives and the opportunity to achieve satisfactory treatment results, mainly due to development of surgical techniques.

DATA SOURCES

Based on the literature and own experience, we discussed the phenotype of presentation of GS, ethiopathogenesis, genetic counselling and treatment with particular emphasis on surgery correction of hemifacial microsomia.

RESULTS

The spectrum of GS abnormalities ranges from mild to severe ones and include patients with barely noticeable facial asymmetry to very pronounced facial defect with more or less severe abnormalities of internal organs and/or skeleton. It is characterized most commonly by impaired development of eyes, ears, lips, tongue, palate, mandible, maxilla, zygomatic and orbital structures and deformations of the teeth structures. Ethiopathogenesis is multifactorial and dependent on genetic and environmental factors but there are still many unknowns about the syndrome which should be revealed.

CONCLUSIONS

Patients with GS due to a large variety of abnormalities and different severity of symptoms pose a challenge for clinicians. All of this necessitate an individual approach to each single patient and involvement a team of specialists in treatment planning. It is a complex, long-lasting, multidisciplinary process and should be divided into stages, according to patient's age, as well as the extent and severity of observed abnormalities. Neonatologists and pediatricians are involved in care of these patients from the onset.

摘要

背景

自 1952 年 Maurice Goldenhar 首次描述 Goldenhar 综合征(GS)患儿以来,医学分支的进展促进了对这种先天性缺陷的更好理解。这也为治疗提供了新的视角和机会,主要得益于手术技术的发展,从而取得了令人满意的治疗效果。

资料来源

根据文献和自身经验,我们讨论了 GS 的表型、发病机制、遗传咨询以及治疗方法,特别强调了对面侧偏颌畸形的手术矫正。

结果

GS 异常的范围从轻度到重度不等,包括面部不对称几乎察觉不到的患者到面部缺陷非常明显,伴有或多或少严重的内部器官和/或骨骼异常。其特征通常是眼睛、耳朵、嘴唇、舌头、 palate、下颌骨、上颌骨、颧骨和眼眶结构发育不良以及牙齿结构畸形。发病机制是多因素的,取决于遗传和环境因素,但对于该综合征仍有许多未知之处,需要进一步揭示。

结论

GS 患者由于存在多种异常和不同严重程度的症状,给临床医生带来了挑战。这一切都需要对每位患者进行个体化治疗,并涉及到治疗计划的专家团队。这是一个复杂的、长期的、多学科的过程,应根据患者的年龄以及观察到的异常程度和严重程度分为不同阶段。新生儿科医生和儿科医生从一开始就参与到这些患者的护理中。

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