Denis D, Genitori L, Bolufer A, Lena G, Saracco J B, Choux M
Département d'Ophtalmologie, Centre Hospitalo-universitaire de la Timone, Marseille, France.
Childs Nerv Syst. 1994 May;10(4):210-6. doi: 10.1007/BF00301156.
Plagiocephaly, which is caused by premature closure of one of the coronal sutures, leads to fronto-orbital asymmetry. The aim of this work was to study the repercussions of orbital deformation on the visual system. Twenty-one patients presenting with plagiocephaly at birth and operated on by the same craniofacial technique (bilateral approach with translation and advancement of the entire involved orbits) were included in the study. All of the patients were examined by clinical anthropometry with three-dimensional reconstruction and underwent complete eye examination by the same observer. Follow-up after craniofacial surgery ranged from 15 months to 4 years. In the last few years, three-dimensional reconstruction has shown that the anatomic region affected by the deformation is the frontozygomatic region and has thus made it possible to advance to another theory on the origins of ocular problems. The severe effect of orbital anomalies on the development of the visual system (binocular vision, strabismus with amblyopia, refractive errors) has been emphasized in the literature. The present study shows that the scheduling of reconstructive surgery is fundamental and must not exceed 6 months, given the immaturity of the visual system up until this time. This means that the ophthalmologist must be able to recognize the various craniostenoses in order to schedule reconstructive surgery as soon as possible. Cooperation between the neurosurgeon and the ophthalmologist is of paramount importance if the pathogenic effects of this bone deformation are to be stopped and proper visual development preserved.
斜头畸形是由冠状缝之一过早闭合引起的，会导致额眶不对称。这项研究的目的是探讨眼眶变形对视觉系统的影响。本研究纳入了21例出生时即患有斜头畸形且采用相同颅面技术（双侧入路，对整个受累眼眶进行平移和前移）进行手术的患者。所有患者均通过三维重建的临床人体测量学进行检查，并由同一名观察者进行全面的眼部检查。颅面手术后的随访时间为15个月至4年。在过去几年中，三维重建显示受变形影响的解剖区域是额颧区域，从而有可能提出另一种关于眼部问题起源的理论。文献中强调了眼眶异常对视觉系统发育（双眼视觉、斜视伴弱视、屈光不正）的严重影响。本研究表明，鉴于此时视觉系统尚未成熟，重建手术的时机至关重要，且不得超过6个月。这意味着眼科医生必须能够识别各种颅缝早闭，以便尽快安排重建手术。如果要阻止这种骨骼变形的致病作用并保留正常的视觉发育，神经外科医生和眼科医生之间的合作至关重要。
