Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium.
J Neurosurg Pediatr. 2023 Sep 22;32(6):692-700. doi: 10.3171/2023.7.PEDS23126. Print 2023 Dec 1.
Surgical techniques to correct scaphocephaly often rely on the implantation of foreign material and/or postoperative helmet therapy and possibly result in minimal correction of frontal bossing. Moreover, foreign material and helmet therapy are associated with extra medical care and financial costs. Frontal bossing is perceived as a prominent, disfiguring feature of scaphocephaly. Herein, authors present the results of a total cranial vault remodeling technique that corrects scaphocephaly features without relying on foreign material or postoperative helmet therapy. It includes frontal release and pterional decompression, which aim to correct frontal bossing.
All patients who had been operated on for isolated scaphocephaly at a single institution between January 2011 and December 2020 were included in this retrospective review. Operation time, transfusion volume, hospital stay, complications, cephalic index (CI), and bossing angle (BA) were analyzed.
Sixty-five patients with nonsyndromic scaphocephaly were included in this analysis. Imaging to calculate the CI and BA preoperatively, immediately postoperatively, and 1 year postoperatively was available in 22 and 20 patients, respectively. The mean CI increased from 69.2% preoperatively to 74.6% postoperatively and 75.5% 1 year postoperatively. The mean BA decreased from 114.5° preoperatively to 111.6° postoperatively and 108.9° 1 year postoperatively. The mean operating time was 2 hours 4 minutes, and the median blood transfusion volume was 100 ml. There were no major complications or reoperations.
The described total cranial vault remodeling technique is a safe procedure that mitigates total treatment burden, as no helmet therapy or implantation of foreign material is needed. It is effective in correcting CI and results in significant frontal bossing correction. The latter is attributed to a distinctive feature of the technique: frontal release and pterional decompression.
矫正舟状头畸形的手术技术通常依赖于植入异物和/或术后头盔治疗，并且可能导致额骨突出的最小矫正。此外，异物和头盔治疗与额外的医疗护理和经济成本有关。额骨突出被认为是舟状头畸形的一个突出的、毁容的特征。在此，作者介绍了一种无需依赖异物或术后头盔治疗即可矫正舟状头畸形特征的全颅穹窿重塑技术。它包括额部松解和翼点减压，旨在矫正额骨突出。
本回顾性研究纳入了 2011 年 1 月至 2020 年 12 月期间在一家机构接受单纯性舟状头畸形手术的所有患者。分析手术时间、输血量、住院时间、并发症、头颅指数（CI）和突角（BA）。
本分析纳入了 65 例非综合征性舟状头畸形患者。22 例和 20 例患者分别有术前和术后即刻计算 CI 和 BA 的影像学资料。CI 从术前的 69.2%增加到术后的 74.6%和 1 年后的 75.5%。BA 从术前的 114.5°减少到术后的 111.6°和 1 年后的 108.9°。平均手术时间为 2 小时 4 分钟，中位输血量为 100ml。无重大并发症或再次手术。
所描述的全颅穹窿重塑技术是一种安全的手术，减轻了整体治疗负担，因为不需要头盔治疗或植入异物。它在矫正 CI 方面非常有效，并且导致明显的额骨突出矫正。后者归因于该技术的一个独特特征：额部松解和翼点减压。
