Yang Bin, Ni Jian, Li Binghang
Centre of Maxillofacial Surgery and Digital Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100041, People's Republic of China.
Childs Nerv Syst. 2018 May;34(5):947-955. doi: 10.1007/s00381-018-3721-1. Epub 2018 Jan 15.
This study aims to comprehensively evaluate the deformation of the skull base and fronto-temporal soft tissue in the patients with anterior plagiocephaly over 1 year of age by three-dimensional (3D) imaging after fronto-orbital advancement (FOA).
We quantitatively analyzed the surgical results and outcome of FOA performed in 10 patients with anterior plagiocephaly. The measurements of the skull base and fronto-temporal soft tissue were performed based on 3D computed tomography (CT) scan. We assessed symmetry of the skull base and fronto-temporal soft tissue change.
The mean age of patients at FOA was 38.9 months. A significant asymmetry of the skull base was found in all the patients. The growth of the anterior and middle fossae was restricted and the deformation of the fronto-temporal region was marked by soft tissue measurements in different grades. On the follow-up CT images 23.6 months after surgery, there was prominent change (p < 0.05) between the two hemibases (CSO^ ratio) and between the lengths and angles of the anterior and middle cranial hemi-fossae (CX, CSX^, XSM^, XM ratio), especially in grade IIA. Anterior cranial vault asymmetry index obviously decreased to - 1.2 from 12% after surgery (p < 0.05). What's more, ACA^ was also proved to be less after surgical correction (19.91° versus 8.29°, p < 0.01) in grade IIA. The change of fronto-temporal soft tissue was significant such as the frontal angle, the angle of the frontal plane, the fontal-temporal angle, and the angle of the temporal plane in different grades.
The asymmetry of the skull base and the deformation of the fronto-temporal region can be presented by intracranial view at over 1 year of age in different grades. FOA can correct the skeletal malformation of the fronto-temporal region as well as soft tissue and the asymmetry of the skull base was improved after surgical treatment.
本研究旨在通过三维（3D）成像全面评估1岁以上前斜头畸形患者在额眶前移术（FOA）后1年以上颅底和额颞部软组织的变形情况。
我们对10例前斜头畸形患者进行的FOA手术结果和疗效进行了定量分析。基于3D计算机断层扫描（CT）对颅底和额颞部软组织进行测量。我们评估了颅底和额颞部软组织变化的对称性。
FOA手术时患者的平均年龄为38.9个月。所有患者均发现颅底存在明显不对称。前颅窝和中颅窝的生长受限，额颞部区域的变形在不同程度上通过软组织测量得以体现。在术后23.6个月的随访CT图像上，两个半颅底（CSO^比值）以及前颅半窝和中颅半窝的长度与角度（CX、CSX^、XSM^、XM比值）之间存在显著变化（p<0.05），尤其是在IIA级。术后前颅穹窿不对称指数明显从12%降至-1.2（p<0.05）。此外，在IIA级中，手术矫正后ACA^也被证明更小（19.91°对8.29°，p<0.01）。不同程度的额颞部软组织变化显著，如额角、额平面角、额颞角和颞平面角。
1岁以上不同程度的前斜头畸形患者，通过颅内视角可呈现颅底不对称和额颞部区域变形。FOA可矫正额颞部区域的骨骼畸形以及软组织，手术治疗后颅底不对称得到改善。
