Jimenez D F, Barone C M, Argamaso R V, Goodrich J T, Shprintzen R J
University of Missouri-Columbia Medical Center 65212.
Cleft Palate Craniofac J. 1994 Mar;31(2):136-41. doi: 10.1597/1545-1569_1994_031_0136_ars_2.3.co_2.
Posterior plagiocephaly historically has been associated with synostosis of the lambdoid suture. The incidence, diagnosis, and modes of treatment for stenosis of the lambdoid suture remain controversial. Commonly, the lambdoid suture is found to be open both on radiographic examination and at the time of surgery. The study reports on nine patients who presented with unilateral posterior plagiocephaly and who were found to have open lambdoid sutures, but a stenosed region of the asterion. The area of involvement included the distal-most lambdoid suture, the parietomastoid, occipitomastoid, and proximal squamosal sutures. Positional molding or torticollis was ruled out in all patients. All the patients showed progressive involvement of the skull base, including anterior shifts of the ipsilateral ear, compensatory ipsilateral frontal bossing and malar protrusion. Stenosis of the asterion was diagnosed with three-dimensional computed tomography scans, corroborated at the time of surgery and confirmed histologically. Surgical correction involved resection of the affected asterion and reconstruction using a bandeau-technique, barrel staves of the occipital bone and bone graft transposition. This approach provided excellent esthetic results in all patients.
从历史上看，后斜头畸形一直与人字缝早闭有关。人字缝狭窄的发病率、诊断和治疗方式仍存在争议。通常，在影像学检查和手术时都发现人字缝是开放的。该研究报告了9例表现为单侧后斜头畸形的患者，这些患者被发现人字缝开放，但星点区域狭窄。受累区域包括最远端的人字缝、顶乳缝、枕乳缝和近端鳞状缝。所有患者均排除了体位塑形或斜颈。所有患者均表现出颅底的进行性受累，包括同侧耳朵向前移位、同侧额部代偿性隆起和颧骨突出。通过三维计算机断层扫描诊断星点狭窄，手术时得到证实，并经组织学确认。手术矫正包括切除受影响的星点，并采用 bandeau 技术、枕骨桶状骨条和骨移植移位进行重建。这种方法在所有患者中都取得了出色的美学效果。
