Neurochirurgie Pédiatrique Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Université de Lyon, Centre de Reference Craniosténose-Lyon INSERM 1033, 59 Bd Pinel, 69003, Lyon, France.
Department of Medical and Surgical Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy.
Childs Nerv Syst. 2024 Sep;40(9):2825-2828. doi: 10.1007/s00381-024-06551-0. Epub 2024 Jul 23.
This study aims to evaluate the effectiveness of the Piezosurgery® device in endoscopic-assisted correction of trigonocephaly. Trigonocephaly is a type of craniosynostosis characterized by a triangular-shaped forehead due to the premature fusion of the metopic suture. Traditional open cranial vault reconstruction, although common, is invasive and poses risks. The study explores a less invasive alternative using ultrasonic microvibrations for bone cutting, potentially reducing soft tissue damage and improving surgical outcomes.
The Piezosurgery® device was employed in endoscopic trigonocephaly correction surgeries performed on patients under 4 months old at the French Referral Center for Craniosynostosis in Lyon. The technique involves making a small skin incision and performing osteotomies from the anterior fontanel to the glabella. A rigid 0° endoscope provides visibility, and the Piezosurgery® device enables precise bone cutting while preserving the dura mater. Post-surgery, patients were discharged within 3 days and required to wear a remodeling helmet for 6-8 months.
The use of Piezosurgery® device allowed precise osteotomies with minimal soft tissue damage. No dura mater injuries occurred in the patient series. The procedure was efficient, with an average duration of 80 min, and blood loss was minimal, reducing the need for blood transfusions. The endoscopic approach facilitated shorter surgical times and reduced postoperative infection risks. Enhanced visibility during surgery, due to cavitation effects, improved the accuracy of bone cuts. The technique demonstrated promising safety and esthetic outcomes, although it incurred higher costs compared to traditional methods.
Piezosurgery® device provides a safe and effective method for minimally invasive endoscopic correction of trigonocephaly. The device's ability to selectively cut bone while preserving soft tissues offers significant advantages, despite longer surgical times and higher costs. This technique represents a viable alternative to traditional open surgery, promoting better clinical outcomes and reduced recovery times.
本研究旨在评估 Piezosurgery® 设备在经内镜辅助治疗三角头畸形中的有效性。三角头畸形是一种颅缝早闭的类型，表现为额骨呈三角形，由于额骨正中缝过早融合所致。传统的开放式颅盖重建术虽然常见，但具有侵袭性，且存在风险。本研究探索了一种使用超声微振动进行骨切割的微创替代方法，可能减少软组织损伤并改善手术结果。
该研究在法国里昂颅缝早闭治疗中心，对 4 个月以下的患者采用 Piezosurgery® 设备进行内镜下三角头畸形矫正手术。该技术包括在额前囟和眉间之间做一个小的皮肤切口，并进行骨切开术。使用刚性 0°内窥镜提供可视性，Piezosurgery® 设备可在保留硬脑膜的情况下进行精确的骨切割。手术后，患者在 3 天内出院，并需要佩戴塑形头盔 6-8 个月。
Piezosurgery® 设备的使用允许进行精确的骨切开术，同时最大限度地减少软组织损伤。在患者系列中，未发生硬脑膜损伤。该手术过程高效，平均持续 80 分钟，出血量极少，减少了输血的需要。由于气蚀效应，内镜方法有助于缩短手术时间并降低术后感染风险。术中增强的可视性提高了骨切开的准确性。该技术具有良好的安全性和美容效果，但与传统方法相比，成本更高。
Piezosurgery® 设备为微创内镜治疗三角头畸形提供了一种安全有效的方法。该设备选择性切割骨而保留软组织的能力具有显著优势，尽管手术时间更长且成本更高。与传统的开放式手术相比，该技术代表了一种可行的替代方法，可促进更好的临床结果和缩短恢复时间。
