Udayakumaran Suhas, Krishnadas Arjun, Subash Pramod
Division of Paediatric Neurosurgery and Craniofacial Surgery, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Division of Craniomaxillofacial Surgery, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
J Pediatr Neurosci. 2022 Sep;17(Suppl 1):S29-S43. doi: 10.4103/jpn.JPN_26_22. Epub 2022 Sep 19.
Most complex craniosynostoses are managed the same way as syndromic craniosynostoses (SCs), as these patients often experience similar problems regarding cognition and increased intracranial pressure (ICP). The evaluation and treatment plan for craniosynostoses is complex, and this, additionally, is complicated by the age at presentation. In this article, the authors review the complexity of SCs in the presentation and management. An algorithm is necessary for such multifaceted and multidimensional pathology as craniosynostoses. In most algorithms, posterior calvarial distraction is a consistent early option for complex craniosynostoses presenting early with raised ICP. Addressing the airway early is critical when significant airway issues are there. All other surgical interventions are tailored on the basis of presentation and age.
大多数复杂颅缝早闭的治疗方式与综合征性颅缝早闭(SCs)相同,因为这些患者在认知和颅内压(ICP)升高方面通常会遇到类似问题。颅缝早闭的评估和治疗方案很复杂,此外,还因就诊年龄而变得更加复杂。在本文中,作者回顾了SCs在表现和管理方面的复杂性。对于颅缝早闭这种多方面、多维度的病理情况,需要一种算法。在大多数算法中,对于早期出现ICP升高的复杂颅缝早闭,后颅骨牵张是一个一致的早期选择。当存在严重气道问题时,尽早解决气道问题至关重要。所有其他手术干预都根据表现和年龄进行调整。