Menard R M, David D J
Australian Craniofacial Unit, North Adelaide, South Australia.
J Craniofac Surg. 1998 May;9(3):240-6. doi: 10.1097/00001665-199805000-00011.
The accurate diagnosis of unilateral lambdoid synostosis versus deformational occipital plagiocephaly has remained a complex and controversial issue in the field of craniofacial surgery. Over the past 30 years, numerous studies have been published describing the treatment for "lambdoid synostosis," the diagnosis having been ascribed despite radiographically patent sutures and pathology specimens displaying fibrous, nonfused suture lines. Over the past 16 years, 204 patients with unilateral occipital plagiocephaly have been seen at our unit, only 2 of whom (approximately 1%) manifested the clinical, radiographic, and pathological features of true lambdoid synostosis. Radiographically, there was evidence of sutural fusion on plain films and two- and three-dimensional computed tomographic scans. Clinical features included a trapezoid head shape as viewed from the vertex, ipsilateral occipitomastoid bossing, contralateral parietal bossing, and anteroinferior ear displacement. Pathology specimens showed bony sutural fusion. These characteristics are contrasted to those of patients with deformational plagiocephaly and those found in other published studies on occipital plagiocephaly.
在颅面外科领域，准确诊断单侧人字缝早闭与变形性枕部斜头畸形一直是一个复杂且有争议的问题。在过去30年里，已发表了大量研究描述“人字缝早闭”的治疗方法，尽管影像学上缝线是开放的，且病理标本显示缝线为纤维性、未融合状态，但仍作出了该诊断。在过去16年里，我们科室共诊治了204例单侧枕部斜头畸形患者，其中仅有2例（约1%）表现出真正人字缝早闭的临床、影像学和病理特征。影像学上，平片以及二维和三维计算机断层扫描均有缝线融合的证据。临床特征包括从头顶观察呈梯形头型、同侧枕乳突部突出、对侧顶骨突出以及耳向前下移位。病理标本显示骨缝线融合。这些特征与变形性斜头畸形患者的特征以及其他已发表的关于枕部斜头畸形研究中所发现的特征形成对比。
