Sandhaus Henya, Johnson Matthew D
Department of Otolaryngology, Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA.
Curr Opin Otolaryngol Head Neck Surg. 2021 Aug 1;29(4):304-313. doi: 10.1097/MOO.0000000000000724.
Craniosynostosis, a condition of premature cranial suture fusion, can have significantly detrimental effects on development and growth due to sequelae of increased intracranial hypertension (ICP), exophthalmos, and upper airway obstruction. Evolving surgical treatments now include distraction osteogenesis (DO) due to its many benefits relative to standard cranial vault remodeling procedures. This article provides an overview and update of different surgical applications of DO for patients with craniosynostosis.
DO has been utilized successfully for single and multisuture craniosynostosis with or without midface hypoplasia to increase intracranial volume, decrease ICP and improve aesthetics. It has been applied in single suture synostosis, posterior vault DO, fronto-orbital advancement, monobloc DO and Le Fort III DO. DO has been applied through modification of traditional surgical procedures with success in maintaining goals of surgery while reducing risk.
DO is still a relatively new and evolving surgical technique for patients with syndromic and nonsyndromic craniosynostosis. With promising benefits, consideration for each procedure should be weighed until longer-term data is available.
颅缝早闭是一种颅骨缝线过早融合的病症,由于颅内高压(ICP)升高、眼球突出和上呼吸道梗阻等后遗症,可对发育和生长产生显著不利影响。由于相对于标准的颅盖重塑手术具有诸多益处,目前不断发展的手术治疗方法包括牵张成骨术(DO)。本文概述并更新了DO在颅缝早闭患者中的不同手术应用。
DO已成功应用于单缝和多缝颅缝早闭,无论有无面中部发育不全,以增加颅内体积、降低ICP并改善美观。它已应用于单缝颅缝早闭、后颅盖DO、额眶前移、整块DO和Le Fort III DO。DO已通过对传统手术程序的改良得以应用,成功地在降低风险的同时维持了手术目标。
对于患有综合征性和非综合征性颅缝早闭的患者,DO仍然是一种相对较新且不断发展的手术技术。鉴于其有前景的益处,在获得长期数据之前,应权衡对每种手术的考量。