Svalina Anja, Serlo Willy, Sinikumpu Juha-Jaakko, Salokorpi Niina
Research Unit of Clinical Medicine, Oulu University Hospital and University of Oulu, Oulu, Finland.
Medical Research Center, Oulu University Hospital, Oulu, Finland.
Childs Nerv Syst. 2024 Dec;40(12):3983-3991. doi: 10.1007/s00381-024-06519-0. Epub 2024 Jun 28.
The purpose of this study was to evaluate the surgical complications of patients treated for nonsyndromic sagittal craniosynostosis and the necessity for reoperations due to craniocerebral disproportion.
The patient cohort of this study consisted of patients (N = 82) who were treated in the Oulu University Hospital using the open vault cranioplasty with a modified H-technique between the years 2008 to 2022. There were 69 males (84.1%) and 13 females (15.9%). The mean age at the primary operation was 6.1 months. Mean follow-up time was 9.0 years.
There were no major complications related to the procedures. Two patients (2.4%) had a minor dural lesion. There were no postoperative wound infections. Of the 82 patients, seven patients with primary craniosynostosis (13.0%) developed symptomatic craniocerebral disproportion requiring reoperation to increase intracranial volume. In all these patients, invasive intracranial pressure (ICP) monitoring was performed prior to decision-making. In the majority of cases, the aesthetical outcome was considered good or excellent.
The operative method used was feasible and safe. Thirteen percent of patients who were followed over 5 years required major surgery due to development of craniocerebral disproportion later in life.
本研究旨在评估非综合征性矢状缝早闭患者的手术并发症以及因颅腔比例失调而进行再次手术的必要性。
本研究的患者队列包括2008年至2022年间在奥卢大学医院采用改良H技术进行开放性颅骨成形术治疗的患者(N = 82)。其中男性69例(84.1%),女性13例(15.9%)。初次手术时的平均年龄为6.1个月。平均随访时间为9.0年。
手术过程中未出现重大并发症。2例患者(2.4%)出现轻微硬脑膜损伤。无术后伤口感染。在82例患者中,7例原发性颅缝早闭患者(13.0%)出现有症状的颅腔比例失调,需要再次手术以增加颅内容量。在所有这些患者中,决策前均进行了有创颅内压(ICP)监测。在大多数情况下,美学效果被认为良好或极佳。
所采用的手术方法可行且安全。在随访超过5年的患者中,13%的患者因后期出现颅腔比例失调而需要进行大手术。