Castro-Govea Yanko, Vela-Martinez Amin, Treviño-Garcia Luis Alberto
Plastic Surgery Service, Hospital Universitario "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.
Arch Plast Surg. 2018 Mar;45(2):128-134. doi: 10.5999/aps.2017.00997. Epub 2018 Mar 15.
Non-syndromic craniosynostosis causes craniofacial asymmetry and may persist after cranioplasty. These postoperative asymmetries are primarily depressions. In some cases, patients may be subjected to pranks and harassment by their peers, affecting their psychosocial development. We propose lipoinjection enriched with adipose stem cells (ASCs) to treat the sequelae of craniosynostosis in the fronto-orbital and temporal complex in cranioplasty patients, with the goal of improving the appearance of the upper third of the face.
Twelve children (four boys and eight girls) between 4 and 8 years of age (mean age, 6 years) in the postoperative period after treatment for plagiocephaly, brachycephaly, and trigonocephaly were included, with a follow-up period of 1 to 18 months. Fat tissue was obtained from the lower abdomen, and ASCs were isolated using the Yoshimura technique. Lipoinjection was performed using several mini-approaches to ensure adequate distribution.
Two different scales were used to evaluate the aesthetic outcomes. At 6 months, three plastic surgeons independent of the study classified the results using a Likert scale. The patients' parents categorized the results using a visual analog scale at 6, 9, and 18 months. R esults were favorable on both scales, as the patients' facial appearance improved and they reported increased happiness and self-esteem due to their remodeled facial appearance.
We suggest that lipoinjection enriched with ASCs is a good alternative for correcting asymmetry of the fronto-orbital and temporal contour in patients with sequelae of craniosynostosis. This treatment will help boost patients' self-esteem starting at an early age.
非综合征性颅缝早闭会导致颅面不对称，且在颅骨成形术后可能持续存在。这些术后不对称主要表现为凹陷。在某些情况下，患者可能会受到同伴的恶作剧和骚扰，影响其心理社会发展。我们提出采用富含脂肪干细胞（ASC）的脂肪注射来治疗颅骨成形术患者额眶和颞部复合体的颅缝早闭后遗症，目的是改善面部上三分之一的外观。
纳入12名4至8岁（平均年龄6岁）的儿童（4名男孩和8名女孩），他们在接受斜头畸形、短头畸形和三角头畸形治疗后的术后阶段，随访期为1至18个月。从下腹部获取脂肪组织，并使用吉村技术分离ASC。采用多种微创方法进行脂肪注射，以确保充分分布。
使用两种不同的量表评估美学效果。在6个月时，3名独立于该研究的整形外科医生使用李克特量表对结果进行分类。患者的父母在6个月、9个月和18个月时使用视觉模拟量表对结果进行分类。两个量表的结果均良好，因为患者的面部外观得到改善，并且他们报告由于面部外观重塑而幸福感和自尊心增强。
我们认为，富含ASC的脂肪注射是纠正颅缝早闭后遗症患者额眶和颞部轮廓不对称的一种良好选择。这种治疗将有助于从小就增强患者的自尊心。
