Das Paramita, Lacey Martin, Guillaume Daniel J
University of Chicago, School of Medicine, Chicago, Illinois, United States.
Department of Plastic Surgery, Health Partners Specialty Center, St. Paul, Minnesota, United States.
J Neurol Surg B Skull Base. 2021 Jul;82(Suppl 3):e300-e305. doi: 10.1055/s-0039-3401998. Epub 2020 Jan 24.
Congenital frontoethmoidal encephaloceles are associated with a shallow sloping forehead. We (1) sought to determine if early repair reverses abnormal forehead slope, and (2) assessed a modification of the fetal profile (FP) line to assess results. Study of two cases. Newborns with frontoethmoidal encephaloceles repaired prior to the age of 4 months with cranial base bone grafting. Forehead slope was assessed using a modification of the FP line, defined as the line that passes through the anterior border of the mandible and nasion, on pre and postoperative magnetic resonance imaging (MRI) in the midsagittal plane. A modified FP (mFP) line anterior to the forehead was " - ", while a posterior (normal) mFP line was " + ." The largest distance from the mFP line to the forehead was measured. Both infants underwent bifrontal craniotomy, excision of encephalocele, and repair of cribriform plate defect using full-thickness autologous parietal bone before the age of 4 months. Preoperatively, the mFP line was -20.6 mm in case 1, and -9.8 mm in case 2. In both cases, follow-up MRI showed excellent reversal of forehead slope and normal calvarium development. The mFP line improved to +7.4 (age = 16 months) in case 1, and +7.6 (age = 11 months) in case 2. The parietal bone donor site ossified completely within 3 months in both cases. Early repair with bone grafting can promote normal frontal bone development and improve forehead slope. The mFP line is a useful method to measure degree of forehead slope.
先天性额筛部脑膨出与前额斜坡浅有关。我们（1）试图确定早期修复是否能逆转异常的前额斜坡，以及（2）评估一种改良的胎儿轮廓（FP）线以评估结果。
两例病例研究。
4个月龄前采用颅底骨移植修复额筛部脑膨出的新生儿。
在前额斜坡评估中，使用改良的FP线，其定义为在矢状面的术前和术后磁共振成像（MRI）上穿过下颌骨前缘和鼻根的线。前额前方的改良FP（mFP）线为“-”，而后方（正常）的mFP线为“+”。测量从mFP线到前额的最大距离。
两名婴儿均在4个月龄前接受了双额开颅术、脑膨出切除术，并使用全层自体顶骨修复筛板缺损。术前，病例1的mFP线为-20.6毫米，病例2为-9.8毫米。在这两个病例中，随访MRI显示前额斜坡得到了极好的逆转，颅骨发育正常。病例1的mFP线在16个月龄时改善为+7.4，病例2在11个月龄时改善为+7.6。两例病例的顶骨供骨部位均在3个月内完全骨化。
早期骨移植修复可促进额骨正常发育并改善前额斜坡。mFP线是测量前额斜坡程度的一种有用方法。
