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减轻护理负担:迟发性克鲁宗综合征的多学科管理——病例报告

Reducing the Burden of Care: Multidisciplinary Management of Late-Manifested Crouzon Syndrome-A Case Report.

作者信息

Achterrath Sarah, Kruse Teresa, Neuschulz Julia, Graf Isabelle, Zöller Joachim, Braumann Bert

机构信息

Department of Orthodontics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, North Rhine Westphalia, Germany.

Center for Rare Orofacial and Craniofacial Malformations, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, North Rhine Westphalia, Germany.

出版信息

Children (Basel). 2021 Dec 3;8(12):1122. doi: 10.3390/children8121122.

Abstract

The therapy of patients with Crouzon syndrome involves a multidisciplinary team. In most cases, this therapy is extensive, time-consuming, and exhausting for the patient. This case report illustrates a temporally coordinated therapy plan that succeeds in reducing the burden of care. Showing typical extraoral characteristics of Crouzon syndrome, the patient had a frontal and left-sided crossbite, and impaction of the maxillary canines. Multidisciplinary therapy included the extraction of multiple teeth, midface distraction at Le Fort III level, and alignment of the impacted teeth. Before starting, during, and after completion of the treatment, the patient's oral health-related quality of life was assessed using COHIP-19. The combination of different treatment steps significantly reduced the duration of therapy. The therapy improved not only the patient's oro- and craniofacial function, but also the patient's facial appearance in a short treatment period. The patient's quality of life improved considerably during this time. In the treatment of severe craniofacial anomalies, the highest priority should be given to keeping the burden of care low. All measures should encourage young patients' appropriate psychosocial development despite extensive therapies, ensuring at the same time medically satisfactory treatment results.

摘要

克鲁宗综合征患者的治疗需要多学科团队参与。在大多数情况下,这种治疗对患者来说范围广、耗时且令人疲惫。本病例报告展示了一个时间协调的治疗方案,该方案成功减轻了护理负担。该患者表现出克鲁宗综合征典型的口外特征,存在前牙及左侧反合,上颌尖牙阻生。多学科治疗包括拔除多颗牙齿、在Le Fort III水平进行面中份牵张以及排齐阻生牙。在治疗开始前、治疗期间及治疗完成后,使用COHIP - 19评估患者的口腔健康相关生活质量。不同治疗步骤的组合显著缩短了治疗时间。该治疗不仅改善了患者的口腔及颅面功能,还在短时间内改善了患者的面部外观。在此期间,患者的生活质量有了显著提高。在治疗严重颅面畸形时,应将降低护理负担作为首要任务。尽管治疗范围广泛,但所有措施都应促进年轻患者适当的心理社会发展,同时确保获得医学上令人满意的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4ae/8700770/3b1864618c94/children-08-01122-g001.jpg

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