Cardim Vera Lúcia N, Peres Geórgia M C, Silva Alessandra Dos S
From the Hospital Beneficência Portuguesa de São Paulo, Sâo Paulo, Brazil.
Plast Reconstr Surg Glob Open. 2023 Aug 16;11(8):e5208. doi: 10.1097/GOX.0000000000005208. eCollection 2023 Aug.
In primary craniosynostosis, the premature fusion of one or more sutures prevents the perpendicular expansion of brain tissue (primary defect). Providing space for the brain to expand, the compensatory growth of unaffected sutures causes progressive skull deformation (secondary defect). Understanding the need to treat the osteogenic matrix responsible for the cranial vault's shape was essential to develop a novel surgical concept known as dynamic osteotomy. It uses springs to activate stenotic sutures and trigger dura-mater distension while flexibilizing compensatory osseous defects via helicoid osteotomy (nautilus technique), allowing for efficient bone expansion and remodeling in craniosynostosis.
This case series describes patients with craniosynostosis treated with dynamic osteotomy utilizing structural transformation inductors such as springs and helicoid osteotomy (nautilus technique), operated on between July 2004 and January 2020 at a single center in Brazil.
Dynamic osteotomy longitudinally achieved stable osseous remodeling during growth period while maintaining good vitality and continuity of the osteotomized cranial vault.
Dynamic osteotomy utilizing springs and nautilus technique, alone or in combination, is a successful treatment of craniosynostosis regardless of patient's age.
在原发性颅缝早闭中，一条或多条缝线的过早融合会阻止脑组织垂直扩张（原发性缺陷）。为大脑扩张提供空间，未受影响缝线的代偿性生长会导致颅骨逐渐变形（继发性缺陷）。认识到治疗负责颅穹窿形状的成骨基质的必要性对于开发一种称为动态截骨术的新型手术概念至关重要。它使用弹簧激活狭窄缝线并引发硬脑膜扩张，同时通过螺旋截骨术（鹦鹉螺技术）使代偿性骨缺损变得柔韧，从而在颅缝早闭中实现有效的骨扩张和重塑。
本病例系列描述了2004年7月至2020年1月期间在巴西一个中心接受动态截骨术治疗的颅缝早闭患者，该手术使用了弹簧和螺旋截骨术（鹦鹉螺技术）等结构转换诱导器。
动态截骨术在生长期纵向实现了稳定的骨重塑，同时保持了截骨后颅穹窿的良好活力和连续性。
无论患者年龄如何，单独或联合使用弹簧和鹦鹉螺技术的动态截骨术都是治疗颅缝早闭的成功方法。
