Marchac D, Renier D
Ann Plast Surg. 1985 Jan;14(1):43-54. doi: 10.1097/00000637-198501000-00009.
An evaluation of 220 cases of frontocranial remodeling for craniosynostosis is reported. The follow-up period was 10 years for children, 7 years for infants. The principles of the craniofacial techniques described in 1974 [4] and 1978 [3] were not modified; only variations were added. The floating forehead [5] concept has also remained basically unchanged. Intracranial pressure recordings have been used continually to help evaluate borderline indications and to assess results [9]. Our results show that 14% of cases of craniosynostosis affecting only one suture, usually considered as merely aesthetic problems, in fact were accompanied by increased intracranial pressure. The postoperative recordings have shown a return to normal pressures. Growth has not deteriorated the initially satisfactory results at the level of the forehead. At the midface level, improvement has been observed after surgery, especially for plagiocephalics. Their orbitonasal asymmetry has nearly completely disappeared. Patients with bilateral faciocraniosynostosis show an improvement of midface development compared with non-operated patients, but in severe cases an inverted bite still develops and further facial osteotomies remain necessary. The Apert's patients remain the most difficult to improve.
本文报告了220例颅缝早闭的额颅重塑手术病例评估情况。儿童随访期为10年，婴儿为7年。1974年[4]和1978年[3]所描述的颅面技术原则未作修改，只是增加了一些变化。浮动前额[5]的概念也基本保持不变。持续使用颅内压记录来辅助评估临界适应症并评估手术效果[9]。我们的结果表明，仅累及一条缝的颅缝早闭病例中有14%，通常被认为只是美观问题，实际上伴有颅内压升高。术后记录显示颅内压恢复正常。前额部位的生长并未使最初满意的手术效果恶化。在中面部水平，术后观察到有改善，尤其是对于斜头畸形患者。他们的眶鼻不对称几乎完全消失。与未手术患者相比，双侧面颅缝早闭患者的中面部发育有所改善，但在严重病例中仍会出现反咬合，仍需进一步进行面部截骨手术。Apert综合征患者仍然是最难改善的。
