Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 7JH, UK.
Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 Street, Edmonton, AB T6G 2B7, Canada.
Clin Plast Surg. 2021 Jul;48(3):507-519. doi: 10.1016/j.cps.2021.03.004.
Monobloc and bipartition advancement by external distraction plays a major role in the treatment of syndromic craniosynostosis. They can reverse the associated facial deformity and play a role in the management of ocular exposure, intracranial hypertension, and upper airway obstruction. Facial bipartition distraction corrects the intrinsic facial deformities of Apert syndrome. Both procedures are associated with relatively high complication rates principally related to ascending infection and persistent cerebrospinal fluid leaks. Modern perioperative management has resulted in a significant decline in complications. External distractors allow fine tuning of distraction vectors and improve outcome but are less well tolerated than internal distractors.
单体式和分体式外部牵引在综合征性颅缝早闭的治疗中起着重要作用。它们可以逆转相关的面部畸形，并在眼部暴露、颅内压升高和上呼吸道阻塞的管理中发挥作用。面部分体式牵引可矫正 Apert 综合征的内在面部畸形。这两种手术都与相对较高的并发症发生率有关，主要与上行感染和持续性脑脊液漏有关。现代围手术期管理已导致并发症显著减少。外部牵开器可以精细调整牵开矢量，改善治疗效果，但不如内置牵开器耐受良好。
