Madaree Anil
Department of Plastic and Reconstructive Surgery, Inkosi Albert Luthuli Central Hospital, Nelson R Mandela School of Medicine, University of Kwazulu Natal, Durban, South Africa.
J Craniofac Surg. 2018 Jan;29(1):126-129. doi: 10.1097/SCS.0000000000004123.
In craniofacial surgery, a wide spectrum of pathological conditions are usually treated. The aetiology of these could be congenital, traumatic, infective, post-tumor resection, postradiation, autoimmune, iatrogenic, or other miscellaneous conditions. The surgical approach for the procedures is usually via a coronal incision. In a large proportion of the patients, the frontal bone is removed to obtain intracranial access. The frontal bone is then replaced either in its original form or in a remodeled state. In congenital conditions the supraorbital bar and frontal bone is often also removed, remodeled, and replaced. One of the common late sequelae following craniofacial surgery is contour irregularities of the frontal region. These irregularities can vary in their extent. They are invariably palpable and often visible. Surgeons have attempted various methods to improve the contour irregularities. Despite these measures contour irregularities can still ensue. In the authors' unit, the authors have been using acellular dermal matrix in an attempt to diminish the contour irregularities in the frontal region following craniofacial reconstruction for craniosynostosis. This has been used in 35 patients undergoing craniosynostosis correction. Of the 35 patients, 12 were for plagiocephaly, 7 for brachycephaly, 10 for scaphocephaly, 4 for trigonocephaly, and 2 for combined coronal and metopic synostosis. The age of the patients ranged from 5 months to 12 years (mean 20.5 months). There were 21 males and 14 females. The follow-up ranged from 10 to 48 months (mean 23 months).
在颅面外科手术中，通常会治疗各种各样的病理状况。其病因可能是先天性、创伤性、感染性、肿瘤切除术后、放疗后、自身免疫性、医源性或其他杂类情况。这些手术的入路通常是通过冠状切口。在很大一部分患者中，会切除额骨以获得颅内入路。然后将额骨以其原始形态或重塑状态进行复位。在先天性疾病中，眶上缘和额骨通常也会被切除、重塑并复位。颅面外科手术后常见的晚期后遗症之一是额部轮廓不规则。这些不规则的程度各不相同。它们总是可以触摸到，而且常常可见。外科医生尝试了各种方法来改善轮廓不规则的情况。尽管采取了这些措施，轮廓不规则情况仍可能出现。在作者所在的科室，作者一直在使用脱细胞真皮基质，试图减少颅缝早闭颅面重建术后额部的轮廓不规则。这已用于35例接受颅缝早闭矫正的患者。在这35例患者中，12例为斜头畸形，7例为短头畸形，10例为舟状头畸形，4例为三角头畸形，2例为冠状缝和额缝联合早闭。患者年龄从5个月至12岁不等（平均20.5个月）。男性21例，女性14例。随访时间为10至48个月（平均23个月）。
