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循证医学:非综合征性颅缝早闭

Evidence-Based Medicine: Nonsyndromic Craniosynostosis.

作者信息

Tahiri Youssef, Bartlett Scott P, Gilardino Mirko S

机构信息

Indianapolis, Ind.; Philadelphia, Pa.; and Montreal, Quebec, Canada.

From the Department of Plastic and Reconstructive Surgery at Cedars Sinai Medical Center; the Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, Children's Hospital of Philadelphia; and the Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal Children's Hospital.

出版信息

Plast Reconstr Surg. 2017 Jul;140(1):177e-191e. doi: 10.1097/PRS.0000000000003473.

Abstract

LEARNING OBJECTIVES

After reading this article, the participant should be able to: 1. Understand the craniofacial dysmorphology associated with nonsyndromic craniosynostosis. 2. Understand the functional concerns and preoperative considerations when treating patients with nonsyndromic craniosynostosis. 3. Understand the various treatment options available to address patients with nonsyndromic craniosynostosis. 4. Recognize the current debate with regard to timing and type of surgical intervention, and their impact on patient outcome, for patients with nonsyndromic craniosynostosis.

SUMMARY

Craniosynostosis is a pathologic condition associated with the premature fusion of one or more cranial sutures. When the cranial sutures fuse prematurely, the skull and the growing brain beneath the suture are restricted, leading to a compensatory expansion into regions of the skull that are not affected. Craniosynostosis can occur in isolation (nonsyndromic) or can be associated with other extracranial anomalies. When anomalies outside the skull are present, craniosynostosis is often part of a syndrome and usually involves multiple sutures (syndromic craniosynostosis). This article focuses on nonsyndromic craniosynostosis, and describes the current state of knowledge regarding its diagnosis, surgical management, and outcomes.

摘要

学习目标

阅读本文后,读者应能够:1. 了解与非综合征性颅缝早闭相关的颅面畸形。2. 了解治疗非综合征性颅缝早闭患者时的功能问题及术前注意事项。3. 了解针对非综合征性颅缝早闭患者的各种治疗选择。4. 认识到关于非综合征性颅缝早闭患者手术干预时机和类型的当前争论,以及它们对患者预后的影响。

总结

颅缝早闭是一种与一条或多条颅缝过早融合相关的病理状况。当颅缝过早融合时,颅骨以及缝下正在生长的大脑会受到限制,导致向颅骨未受影响的区域进行代偿性扩张。颅缝早闭可单独发生(非综合征性),也可与其他颅外异常相关。当存在颅骨外异常时,颅缝早闭通常是综合征的一部分,且通常涉及多条缝(综合征性颅缝早闭)。本文聚焦于非综合征性颅缝早闭,并描述了其诊断、手术治疗及预后的当前知识状况。

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