Shi Lijun, Shen Weimin, Gao Qingwen, Kong Liangliang
Department of Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
J Craniofac Surg. 2019 Oct;30(7):2091-2093. doi: 10.1097/SCS.0000000000005987.
One of the most characteristic features in premature craniosynostosis is fronto-orbital retrusion. The standardized surgical technique of fronto-orbital advancement (FOA) can treat this (some) deformity, such as bilateral coronal synostosis. The purpose of the study is to investigate an available method to assess the postoperative outcome of the craniofacial surgery.
From 2010 to 2015, 6 pediatric patients were taken the FOA in the Department of Burn and Plastic Surgery in the Children's Hospital of Nanjing Medical University. All the patients were performed the computed tomography (CT) scan preoperatively and postoperatively. The CT databases were processed by DICOM files into MIMICS 16.0 software, which were automatically calculated into orbital volume and orbital roof and base surface area. T-test was used to compare measured values before and after surgery. P < 0.05 was considered statistically significant.
The average preoperative orbital volume was 13930.70 mm, and the postoperative was 18578.67917 mm. After operation, the volume of orbital was significantly increased (P < 0.05). The mean area of the orbital roof surface was 753.989025 mm preoperatively, and the postoperative was 1122.074583 mm. The difference was statistically significant (P < 0.05). The average area of the orbital base (S2) was 334.94 ± 91.76 mm. After the FOA, the orbital base was 356.99 ± 114.21 mm. P(S2) = 0.6072 > 0.05, there was no significant statistical difference.
Fronto-orbital advancement can successfully improve morphological orbital deformities in children with premature craniosynostosis, but much less for maxillary. The computer-assisted technique can present a measurement of FOA preoperatively and postoperatively, which make the evaluation intuitive.
额眶后缩是小儿颅缝早闭最典型的特征之一。标准化的额眶前移术（FOA）可治疗此类畸形，如双侧冠状缝早闭。本研究旨在探索一种评估颅面外科手术后疗效的可行方法。
2010年至2015年，南京医科大学附属儿童医院烧伤整形外科对6例患儿实施了额眶前移术。所有患儿在术前和术后均接受了计算机断层扫描（CT）。CT数据库通过DICOM文件导入MIMICS 16.0软件，自动计算眼眶容积、眶顶及眶底表面积。采用t检验比较手术前后的测量值。P<0.05为差异有统计学意义。
术前平均眼眶容积为13930.70mm，术后为18578.67917mm。术后眼眶容积显著增加（P<0.05）。术前眶顶表面积平均为753.989025mm，术后为1122.074583mm。差异有统计学意义（P<0.05）。眶底平均面积（S2）为334.94±91.76mm。额眶前移术后，眶底为356.99±114.21mm。P（S2）=0.6072>0.05，差异无统计学意义。
额眶前移术可成功改善小儿颅缝早闭所致的眼眶形态畸形，但对上颌骨畸形的改善作用较小。计算机辅助技术可对额眶前移术的术前和术后情况进行测量，使评估更为直观。
