Department of Neurosurgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
J Craniofac Surg. 2021;32(1):218-223. doi: 10.1097/SCS.0000000000006977.
To study the effect of total cranial reconstruction for sagittal synostosis (scaphocephaly) deformity in Chinese children.
A retrospective analysis was performed involving 23 children with isolated non-syndromic sagittal synostosis who were treated by total calvarial vault remodeling after 1 year of age from May 2015 to June 2019 in the Department of Neurosurgery, Children's Hospital of Nanjing Medical University. The authors reconstruct patients' pre- and post-operative cranial thin-section CT scan images and those of the control group. The cephalic index (traditional, normative), intracranial volume, horizontal point of maximum width (H-PMW), vertical point of maximum width (V-PMW), frontal to head height ratio and occipital to head height ratio data were analyzed using a paired t test or Wilcoxon signed-rank test.
Twenty-three patients met the inclusion criteria, including 19 males and 4 females. The ratio of males to females was 4.7:1. All patients underwent total cranial reconstruction. The average age was 26.52 months (13-48 months), the average operation time was 214.13 minutes (150-265 minutes), and the average amount of suspended erythrocytes was 200 ml (100-400 ml). The cranial morphology of all patients improved significantly after the operation. The traditional cephalic index (pre-operative: 0.70 (0.04); post-operative: 0.78 (0.02)) and normative cephalic index (pre-operative: 0.68 (0.03); post-operative: 0.77 (0.02)) were significantly increased (P < 0.0001). The mean horizontal point of maximum width improved from 0.54 to 0.56 (P = 0.0043), the mean vertical point of maximum width decreased from 0.59 to 0.54 (P = 0.0006), the frontal height decreased from 0.89 to 0.77 (P < 0.0001), and the occipital height improved from 0.78 to 0.88 (P < 0.0001). The intracranial volume increased from 1287.35 to 1426.90 cm3 (P < 0.0001). All of the children had a good skull shape and no recurrence of deformity.
Total calvarial reconstruction can effectively correct scaphocephaly in Chinese children, expand cranial volume, reduce cranial height, shorten fronto-occipital diameters and enlarge biparietal diameters.
研究中国人颅骨重建术治疗矢状缝早闭（舟状头畸形）的效果。
回顾性分析 2015 年 5 月至 2019 年 6 月南京医科大学附属儿童医院神经外科对 23 例单纯性非综合征性矢状缝早闭患儿在 1 岁后采用全颅盖重建术治疗的病例。对患者术前、术后头颅薄层 CT 扫描图像及对照组图像进行重建。采用配对 t 检验或 Wilcoxon 符号秩检验对传统颅指数（传统、正常）、颅内体积、最大水平宽度点（H-PMW）、最大垂直宽度点（V-PMW）、额高与头高比、枕高与头高比进行分析。
23 例患者符合纳入标准，其中男 19 例，女 4 例，男女比例为 4.7:1。所有患者均行全颅重建术，平均年龄 26.52 个月（13-48 个月），平均手术时间 214.13 分钟（150-265 分钟），平均悬浮红细胞量 200 ml（100-400 ml）。所有患者术后颅骨形态均明显改善，传统颅指数（术前：0.70（0.04）；术后：0.78（0.02））和正常颅指数（术前：0.68（0.03）；术后：0.77（0.02））均显著升高（P<0.0001）。最大水平宽度均值从 0.54 增加到 0.56（P=0.0043），最大垂直宽度均值从 0.59 减少到 0.54（P=0.0006），额高从 0.89 减少到 0.77（P<0.0001），枕高从 0.78 增加到 0.88（P<0.0001）。颅内体积从 1287.35 cm3 增加到 1426.90 cm3（P<0.0001）。所有患儿颅骨形态良好，无畸形复发。
全颅盖重建术可有效矫正中国儿童的舟状头畸形，扩大颅腔容积，降低颅高，缩短额枕径，扩大双顶径。
