Resnick Cory M, Salcines Alfonso, Hughes Christopher D, Padwa Bonnie L, Mulliken John B
Harvard School of Dental Medicine.
Harvard Medical School.
J Craniofac Surg. 2019 Mar/Apr;30(2):358-362. doi: 10.1097/SCS.0000000000005027.
Patients with syndromic craniosynostosis exhibit exorbitism due to supraorbital and midfacial retrusion. This study documented the change in sagittal orbital-globe relationship following Le Fort III midfacial advancement.
This retrospective case series comprised patients with syndromic craniosynostosis who underwent midfacial distraction from 1997 to 2016. Changes in sagittal globe position in relation to the orbital rims were measured by pre- and postoperative direct anthropometry, computed tomographic scans, or both methods. Descriptive statistics were calculated; significance was set at P < 0.05.
Anthropometry showed a significant increase from superior orbital rim-to-corneal apex (os-acor) (4.1 ± 4.0 mm, P < 0.001) and from inferior orbital rim-to-corneal apex (oi-acor) (4.5 ± 5.3 mm, P < 0.001). The lateral orbital rim to the corneal apex (ol-acor) dimension did not change significantly. Computed tomography measurements confirmed retropositioned globes relative to the anterior border of the orbital cavity (2.5 ± 6.4 mm, P = 0.036). The 2 analytic methods yielded statistically similar results.
The globes move posteriorly a mean of 2.5 to 4.5 mm following Le Fort III midfacial distraction in patients with syndromic craniosynostosis. This finding is useful in attaining euophthalmos when planning and executing this procedure.
综合征性颅缝早闭患者由于眶上和中面部后缩而表现出眼球突出。本研究记录了Le Fort III型中面部前移术后矢状位眶-眼球关系的变化。
本回顾性病例系列包括1997年至2016年接受中面部牵张成骨术的综合征性颅缝早闭患者。通过术前和术后直接人体测量、计算机断层扫描或两种方法测量眼球相对于眶缘的矢状位位置变化。计算描述性统计数据；显著性设定为P<0.05。
人体测量显示，眶上缘至角膜顶点（os-acor）显著增加（4.1±4.0mm，P<0.001），眶下缘至角膜顶点（oi-acor）显著增加（4.5±5.3mm，P<0.001）。眶外侧缘至角膜顶点（ol-acor）尺寸无显著变化。计算机断层扫描测量证实眼球相对于眶腔前缘后移（2.5±6.4mm，P=0.036）。两种分析方法得出的结果在统计学上相似。
综合征性颅缝早闭患者在接受Le Fort III型中面部牵张成骨术后，眼球平均向后移动2.5至4.5mm。这一发现对于在计划和实施该手术时实现眼球正常位置具有重要意义。
