Raffaini Mirco, Magri Alice Sara, Genitori Lorenzo, Arcuri Francesco
"Facesurgery Center", Parma, Italy.
Service of Pediatric Neurosurgery, Hospital for Sick Children Anna Meyer, Florence, Italy.
J Craniomaxillofac Surg. 2022 Feb;50(2):124-133. doi: 10.1016/j.jcms.2021.11.008. Epub 2021 Nov 26.
Clinical reports regarding the entire surgical sequence in Crouzon syndrome from the neonatal period to the adult age are rare. The purpose of this study is to trace an operative algorithm with a long term follow up in a homogenous group of patients affected by Crouzon syndrome. A retrospective review was conducted for all patients affected by Crouzon syndrome who completed the entire surgical sequence. 7 Crouzon patients (4 females, 3 males) completed the entire surgical sequence at different ages: fronto-orbital advancement (0.9 years), LF III distraction osteogenesis (11.5 years) and orthognathic surgery (18 years). The mean age at the last follow up was 19.3 years; normalization of the face was obtained in all cases with improvement of the respiratory problems. After orthognathic surgery, all patients had stable occlusion. A one-year postoperative CBCT scan revealed almost complete ossification of all osteotomy sites. Frontoorbital advancement and modified Le Fort III distraction osteogenesis are reliable surgical procedures. SARME and conventional orthognathic surgery with reductive genioplasty and fat grafting are performed at the end of the surgical sequence to enhance facial aesthetics.
关于从新生儿期到成年期克鲁宗综合征整个手术流程的临床报告很少。本研究的目的是在一组受克鲁宗综合征影响的同质患者中追踪一种具有长期随访的手术算法。对所有完成整个手术流程的克鲁宗综合征患者进行了回顾性研究。7例克鲁宗综合征患者（4例女性，3例男性）在不同年龄完成了整个手术流程：额眶前移术（0.9岁）、改良Le Fort III型牵引成骨术（11.5岁）和正颌手术（18岁）。最后一次随访时的平均年龄为19.3岁；所有病例面部均恢复正常，呼吸问题得到改善。正颌手术后，所有患者咬合稳定。术后一年的CBCT扫描显示所有截骨部位几乎完全骨化。额眶前移术和改良Le Fort III型牵引成骨术是可靠的手术方法。序列治疗的最后阶段采用骨锚式上颌骨牵张成骨术（SARME）和常规正颌手术联合颏部成形术及脂肪移植术，以改善面部美观。
