Ravi Subhashree, AlSaadawi Ghaith, Al Olama Mohammad, Stenger Charl, Mendonca Derek A
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE.
Department of Pediatric Plastic Surgery, Al Jalila Children's Hospital, Dubai, UAE.
Plast Reconstr Surg Glob Open. 2023 Jan 23;11(1):e4788. doi: 10.1097/GOX.0000000000004788. eCollection 2023 Jan.
Isolated frontosphenoidal craniosynostosis is extremely rare, due to which diagnosis can be challenging. All the isolated cases reported have been treated by open surgical technique. We present a unique case report of an infant with an isolated frontosphenoidal synostosis corrected by a novel endoscopic surgical technique. The patient was a 5-month-old boy with worsening abnormal head shape indicating progressive right frontal bossing, left orbital displacement, and right occipital plagiocephaly. Computed tomography scan confirmed the diagnosis of left isolated frontosphenoidal craniosynostosis. Endoscopic-assisted surgical release was done starting with a 2.5-cm incision in the left temple area followed by a 2-cm strip osteotomy to excise the fused frontosphenoidal suture. Custom-made orthotic helmet therapy was started 2-weeks postsurgery, with excellent progress noted in the head shape confirmed by laser scans. The benefits of the endoscopic technique include smaller incision, decreased blood loss and need for blood transfusion, and decreased stay in hospital. This is the first case report showing the application of a novel endoscopic-assisted surgical treatment in an isolated frontosphenoidal craniosynostosis with no complications noted.
孤立性额蝶缝早闭极为罕见,因此诊断具有挑战性。所有已报道的孤立病例均采用开放性手术技术治疗。我们报告了一例独特的病例,一名婴儿的孤立性额蝶缝早闭通过一种新型内镜手术技术得到矫正。该患者为一名5个月大的男孩,头部形状异常恶化,表现为右侧额部逐渐隆起、左侧眼眶移位和右侧枕部斜头畸形。计算机断层扫描证实诊断为左侧孤立性额蝶缝早闭。在内镜辅助下进行手术松解,首先在左侧颞部区域做一个2.5厘米的切口,然后进行2厘米的条状截骨术以切除融合的额蝶缝。术后2周开始定制矫形头盔治疗,激光扫描证实头部形状改善良好。内镜技术的优点包括切口更小、失血量减少和输血需求降低以及住院时间缩短。这是第一例报告显示新型内镜辅助手术治疗在孤立性额蝶缝早闭中的应用且未发现并发症。