Almeida Mariana N, Alper David P, Williams Mica C G, Ihnat Jacqueline M H, Parikh Neil, Diluna Michael, Alperovich Michael
Department of Surgery, Division of Plastic Surgery, Yale School of Medicine, New Haven, CT.
J Craniofac Surg. 2023 Oct 1;34(7):1931-1933. doi: 10.1097/SCS.0000000000009697. Epub 2023 Aug 29.
Cranial vault remodeling (CVR) with and without frontal orbital advancement remodels the skull in craniosynostosis. Virtual surgical planning (VSP) for preoperative planning has been previously shown to be effective in CVR. In this study, the authors aimed to evaluate the impact of VSP on operative and perioperative efficiency for craniosynostosis surgery. A retrospective chart review was conducted of patients with craniosynostosis who underwent CVR. Patient demographics, perioperative variables, use of VSP, and complications were obtained. Perioperative variables collected include operative time and length of stay. An independent t test was used to compare variables from patients who had surgery with VSP and patients who did not. Records were available for 126 patients with craniosynostosis who underwent CVR of whom 79 (62.7%) utilized VSP. There was no difference in average age at surgery (9.3±5.7 mo versus 13.2±31.1 mo, P =0.39). Surgeries planned using VSP demonstrated a decreased operative time of 1.3 hours (3.7±1.1 versus 5.0±1.1 h, P <0.001) and a shorter length of stay (3.9±1.3 versus 4.6±1.7 d, P =0.01). There were no differences in complication rates of dehiscence, infection, returns to the operating room, or 30-day readmission. These trends were similar among patients who underwent fronto-orbital advancement in addition to CVR. Virtual surgical planning was associated with decreased operative time and length of stay for patients with craniosynostosis and comparable complication rates. Virtual surgical planning is an effective tool for reducing anesthetic exposure time.
颅骨重塑（CVR）联合或不联合额眶前移可重塑颅缝早闭患者的颅骨。术前规划的虚拟手术规划（VSP）此前已被证明在CVR中有效。在本研究中，作者旨在评估VSP对颅缝早闭手术的手术及围手术期效率的影响。对接受CVR的颅缝早闭患者进行了回顾性病历审查。获取了患者的人口统计学信息、围手术期变量、VSP的使用情况及并发症。收集的围手术期变量包括手术时间和住院时间。采用独立t检验比较接受VSP手术的患者和未接受VSP手术的患者的变量。共有126例接受CVR的颅缝早闭患者的记录可供分析，其中79例（62.7%）使用了VSP。手术时的平均年龄无差异（9.3±5.7个月对13.2±31.1个月，P =0.39）。使用VSP规划的手术显示手术时间减少了1.3小时（3.7±1.1小时对5.0±1.1小时，P <0.001），住院时间缩短（3.9±1.3天对4.6±1.7天，P =0.01）。在裂开、感染、返回手术室或30天再入院的并发症发生率方面无差异。在除CVR外还接受额眶前移的患者中，这些趋势相似。虚拟手术规划与颅缝早闭患者手术时间减少和住院时间缩短以及相当的并发症发生率相关。虚拟手术规划是减少麻醉暴露时间的有效工具。
