Chaisrisawadisuk Sarut, Phakdeewisetkul Kantapat, Sirichatchai Kanin, Hammam Elie, Prasad Vani, Moore Mark H
Cleft and Craniofacial SA, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University.
J Craniofac Surg. 2025;36(1):162-166. doi: 10.1097/SCS.0000000000010508. Epub 2024 Aug 12.
Cranial vault remodeling (CVR) is a common procedure for correcting sagittal craniosynostosis. Some approaches leave significant craniectomy defects. The authors investigated the reosteogenesis in different cranial defect areas after CVR. A cross-sectional study was conducted in nonsyndromic sagittal craniosynostosis. Available early postoperative computed tomography (CT) scans were analyzed. The segmentation of three-dimensional reconstructed images was performed. Different cranial defect areas, including coronal, vertex, and occipital regions, were further investigated using an automated three-dimensional analysis software for reosteogenesis percentage. Forty-four CT scans were included. The average age at CVR was 8.8 months. The median time of postoperative CT scans was 6.1 weeks. The median bone reformation percentage of the entire cranial defect was 56.7%. Given the similar postoperative CT timing, the median bone reformation at the coronal, vertex, and occipital areas demonstrated 44.21%, 41.13%, and 77.75%, respectively ( P < 0.001). In the simultaneously removed coronal and lambdoid sutures, there were 45% with coronal and lambdoid sutures reformation, followed by lambdoid suture reformation alone, no suture reformation and coronal reformation alone in 35%, 20%, and 0%, respectively ( P = 0.013). There was no coronal reformation in the removed coronal suture group. However, 40% demonstrated lambdoid suture reformation after the isolated lambdoid suture removal. The occipital region has the highest reosteogenesis compared with the other cranial defects after CVR in nonsyndromic sagittal craniosynostosis. Within the removed previous patent sutures, the lambdoid suture reformation showed a higher rate than the coronal suture.
颅骨重塑（CVR）是矫正矢状缝早闭的常见手术。一些方法会留下明显的颅骨切除缺损。作者研究了CVR后不同颅骨缺损区域的再骨化情况。对非综合征性矢状缝早闭患者进行了一项横断面研究。分析了可用的术后早期计算机断层扫描（CT）图像。进行了三维重建图像的分割。使用自动三维分析软件进一步研究了不同的颅骨缺损区域，包括冠状、头顶和枕部区域的再骨化百分比。纳入了44份CT扫描图像。CVR时的平均年龄为8.8个月。术后CT扫描的中位时间为6.1周。整个颅骨缺损的中位骨重塑百分比为56.7%。考虑到术后CT扫描时间相似，冠状、头顶和枕部区域的中位骨重塑分别为44.21%、41.13%和77.75%（P<0.001）。在同时切除冠状缝和人字缝的病例中，冠状缝和人字缝均重塑的占45%，其次是仅人字缝重塑，分别有35%、20%和0%未出现缝重塑和仅冠状缝重塑（P = 0.013）。在切除冠状缝组中未出现冠状缝重塑。然而，在单独切除人字缝后，40%的患者出现了人字缝重塑。在非综合征性矢状缝早闭患者CVR后，与其他颅骨缺损相比，枕部区域的再骨化程度最高。在先前已闭合的缝线切除病例中，人字缝重塑的发生率高于冠状缝。
