From The Craniofacial Center; the Department of Research, Medical City Dallas Hospital; and the Department of Surgery, Texas Tech University Health Sciences Center of El Paso.
Plast Reconstr Surg. 2018 Sep;142(3):334e-341e. doi: 10.1097/PRS.0000000000004649.
Following correction of anterior sutural fusions, long-term forehead irregularities may arise. Based on the premise that frontal reconstructions using a seamless construct might produce better long-term aesthetic results, the supraorbital bandeau was abandoned for a single-piece frontal reconstruction. The purpose of this review was to compare outcomes and complications between children who underwent reconstruction with the traditional supraorbital bandeau and those who underwent reconstruction with a single bony segment.
A retrospective sequential chart review was performed of all children undergoing anterior sutural fusion repairs to compare supraorbital bandeau to single-segment reconstructions. Length of surgery, blood loss, hospital stay, and complications were assessed. Aesthetic outcomes and reoperation rates were also examined.
Over 10 years, 199 patients with anterior sutural fusions underwent correction: 124 with a single-piece frontal reconstruction and 75 with traditional supraorbital bandeaus. Outcome analyses revealed no significant differences between techniques with respect to blood loss, surgical times, complication rates, and hospital length of stay. A preliminary analysis suggested lower reoperation rates (0 percent versus 2.7 percent) and more favorable aesthetic rankings for those treated with a single segment, although the follow-up for this group was significantly shorter compared with those treated with a supraorbital bandeau (16 months versus 43 months).
Abandoning the traditional supraorbital bandeau for a simplified single-segment frontal reconstruction has the potential to result in improved forehead aesthetics, although longer term evaluations are needed. This review suggests that this technical variation does not appear to be associated with longer surgical times, increased blood loss, or higher complication rates.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
在前缝线融合矫正后，可能会长期出现前额不规则的情况。基于使用无缝结构进行前额重建可能会产生更好的长期美学效果的前提，我们放弃了眶上带用于单一额骨重建。本回顾的目的是比较使用传统眶上带和单一骨段进行重建的儿童的结果和并发症。
对所有接受前缝线融合修复的儿童进行回顾性连续图表回顾，比较眶上带和单段重建。评估手术时间、失血量、住院时间和并发症。还检查了美学效果和再次手术率。
在 10 多年的时间里，有 199 例前缝线融合患者接受了矫正：124 例采用单段额骨重建，75 例采用传统眶上带。结果分析显示，两种技术在失血量、手术时间、并发症发生率和住院时间方面无显著差异。初步分析表明，单次手术的再手术率（0%比 2.7%）和更有利的美学评分较低，尽管该组的随访时间明显短于眶上带组（16 个月比 43 个月）。
放弃传统的眶上带，采用简化的单段额骨重建，有可能改善前额的美学效果，尽管需要更长期的评估。本回顾表明，这种技术变化似乎不会导致手术时间延长、失血量增加或并发症发生率增加。
临床问题/证据水平：治疗，III。
