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3D打印引导手术治疗单冠状缝颅缝早闭眼眶畸形

3D printing guided surgery in the treatment of unicoronal craniosynostosis orbital dysmorphology.

作者信息

Elbanoby Tarek M, Elbatawy Amr M, Aly Gaber M, Sharafuddin Mohab Abdulkafy, Abdelfattah Usama A

机构信息

Department of Plastic Surgery, Al-Azhar University, 1st Elmokhiam Eldaem St., Madinat Nasr, Cairo, Egypt.

出版信息

Oral Maxillofac Surg. 2020 Dec;24(4):423-429. doi: 10.1007/s10006-020-00863-6. Epub 2020 Jun 26.

Abstract

PURPOSE

The purpose of our study was to improve the minor asymmetries of fronto-orbital advancement (FOA) by introducing a simple model to guide the FOA in unicoronal synostosis which may help saving time and cost.

METHODS

A retrospective analysis of 16 consecutive patients with unicoronal synostosis corrected by FOA guided by a guide model. Patients with syndromic craniosynostosis or associated craniofacial anomalies were excluded from the analysis. In all cases, 3D mirror image models were used for guiding unilateral fronto-orbital advancement. Demographic, perioperative, and follow-up data were collected for comparison. Cranial and orbital volumes were documented preoperatively and postoperatively and compared with the non-synostotic side. The postsurgical appearance of the face was documented photographically and then evaluated and scored using the Whitaker scoring system.

RESULTS

The study included nine males and seven females. The mean age of the patients at the time of the operation was 20.4 months. The mean follow-up duration was 36 months. Mean operative time was 170 min, mean anesthetic time was 230 min, mean blood loss was 50-80 ml, and the average hospital stay was 4.4 days. No relapse that required surgical correction was reported. There were improvements in the orbital indices and volume to be near equal to the normal side. Excellent to good results were obtained in all patients according to the Whitaker classification system.

CONCLUSION

Residual deformity after FOA mandates another tool to optimize the results. Our study introduced a simple, easy, and applicable method to guide the FOA with lesser asymmetries.

摘要

目的

我们研究的目的是通过引入一个简单模型来指导单冠状缝早闭的额眶前移术(FOA),以改善其轻微不对称性,这可能有助于节省时间和成本。

方法

对16例在引导模型指导下接受FOA矫正的单冠状缝早闭患者进行回顾性分析。综合征性颅缝早闭或相关颅面畸形患者被排除在分析之外。在所有病例中,使用三维镜像模型指导单侧额眶前移。收集人口统计学、围手术期和随访数据进行比较。术前和术后记录颅骨和眼眶体积,并与未患缝早闭的一侧进行比较。对面部术后外观进行拍照记录,然后使用惠特克评分系统进行评估和评分。

结果

该研究包括9名男性和7名女性。患者手术时的平均年龄为20.4个月。平均随访时间为36个月。平均手术时间为170分钟,平均麻醉时间为230分钟,平均失血量为50 - 80毫升,平均住院时间为4.4天。未报告需要手术矫正的复发情况。眼眶指数和体积得到改善,接近正常侧。根据惠特克分类系统,所有患者均获得了优至良的结果。

结论

FOA术后的残余畸形需要另一种工具来优化结果。我们的研究引入了一种简单、易行且适用的方法来指导FOA,减少不对称性。

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