Masserano Benjamin, Woo Albert S, Skolnick Gary B, Naidoo Sybill D, Proctor Mark R, Smyth Matthew D, Patel Kamlesh B
1 Division of Plastic and Reconstructive Surgery, Washington University in St Louis, St Louis, MO, USA.
2 Department of Neurosurgery, Children's Hospital Boston/Harvard Medical School, Boston, MA, USA.
Cleft Palate Craniofac J. 2018 Mar;55(3):423-429. doi: 10.1177/1055665617739000. Epub 2017 Dec 14.
To compare postoperative temporal expansion in patients treated with fronto-orbital advancement or endoscopy-assisted craniectomy with cranial orthotic therapy.
This is a retrospective, multicenter cohort study of patients with unilateral coronal craniosynostosis (UCS).
Computed tomographic (CT) scans were drawn from UCS patients treated at Boston Children's Hospital or St Louis Children's Hospital.
The study included 56 patients with UCS after fronto-orbital advancement (n = 32) or endoscopic repair (n = 24) and 10 age-matched controls.
Fronto-orbital advancement entails a craniotomy of the frontal bone and superior orbital rim followed by reshaping and forward advancement. Endoscopic repair is the release of the synostotic suture and guidance of further growth of the cranium using a molding orthotic.
Measures included posterior temporal width, anterior temporal width, orbital width, and anterior cranial fossa area taken preoperatively and 1 year postoperatively. Linear regression was performed to assess 1 year postoperative improvement in symmetry; covariates included preoperative symmetry and type of surgery.
Both treatments showed improvement in orbital width and anterior cranial fossa area symmetry 1 year postoperatively ( P < .001), but no significant improvement in posterior or anterior temporal width symmetry. Linear regression revealed no difference between the 2 procedures in any of the 4 measurements (.096 ≤ P ≤ .898).
Fronto-orbital advancement and endoscopic repair show equivalent outcomes 1 year postoperatively in all 3 width measurements and anterior cranial fossa area. Neither procedure produced significant improvement in temporal width.
比较接受额眶前移术或内镜辅助颅骨切除术并结合颅骨矫形治疗的患者术后颞部扩张情况。
这是一项针对单侧冠状缝早闭（UCS）患者的回顾性多中心队列研究。
计算机断层扫描（CT）扫描数据来自于在波士顿儿童医院或圣路易斯儿童医院接受治疗的UCS患者。
该研究纳入了56例接受额眶前移术（n = 32）或内镜修复术（n = 24）的UCS患者以及10例年龄匹配的对照者。
额眶前移术包括对额骨和眶上缘进行开颅手术，随后进行重塑和向前推进。内镜修复是松解骨缝并使用塑形矫形器引导颅骨进一步生长。
测量指标包括术前及术后1年的颞部后宽度、颞部前宽度、眶宽度和前颅窝面积。进行线性回归以评估术后1年对称性的改善情况；协变量包括术前对称性和手术类型。
两种治疗方法术后1年眶宽度和前颅窝面积对称性均有改善（P <.001），但颞部后宽度或前宽度对称性无显著改善。线性回归显示，在4项测量中的任何一项中，两种手术方法之间均无差异（.096≤P≤.898）。
额眶前移术和内镜修复术在术后1年的所有3项宽度测量指标和前颅窝面积方面显示出等效的结果。两种手术方法均未使颞部宽度有显著改善。
