全颅骨切开成形矫正早期矢状缝早闭头颅畸形.docVIP

全颅骨切开成形矫正早期矢状缝早闭头颅畸形[摘要]目的：探讨矢状缝早闭舟状头畸形的早期手术治疗方法。 方法：患儿采取改良的俯卧位，通过头皮冠状切口显露从眉间至枕骨大孔后唇的整个颅盖，切开颅骨分离双侧额骨和双侧顶-枕部骨块。对额骨和枕骨进行放射状切开、塑形纠正前后部隆突畸形；切除部分额、顶骨块缩短头颅前后径；在颞、顶骨下部采用“木桶板”样截骨以及放射状切开、塑形两侧顶骨纠正头颅狭窄畸形。结果：手术后4例舟状头畸形明显改善，外形良好，无严重并发症。术后随访3～10月，头颅外形维持良好，畸形无复发。结论：包括双侧额、顶、枕、颞全颅骨切开重新塑形的手术方法能够有效地矫正婴幼儿矢状缝早闭舟状头畸形。 [关键词]矢状缝早闭；舟状头畸形；颅骨切开术；婴幼儿 [中图分类号]R782.2 [文献标识码]A [文章编号]1008-6455（2009）01-0035-03 Early management of sagittal synostosis with craniotomies and skull reshaping BO Bin1,John Persing2 (1.Department of Oral and Maxillofacial Surgery,Stomatological College, Fourth Military Medical University,Xi’an 710032,Shaanxi,China; 2. Section of Plastic Surgery, Yale University School of Medicine, New Haven, USA) Abstract:ObjectiveTo discuss the early surgical treament of scaphocephaly deformity in sagittal synostosis.MethodsThe patients were placed in the modified prone position. Supraperiosteal dissection was performed extending from the glabella anteriorly to the posterior lip of the foramen magnum posteriorly. Craniotomies were performed to separate the bifrontal and biparietal-occipital frangments. The bifrontal and occipital frangments were reshaped after placement of radial osteotomies to correct the frotal and occipital prominence. Shortening of the anteroposterior length of the skull was accomplished by resecting a portion of the frontal and parietal bones at the midline. The narrowing of the skull was addressed by the “barrel stave” osteotomies of the low temporal and parietal regions and reshaping of lateral pieces of parietal bones.ResultsScaphocephaly deformities of four patients were corrected. There were no complications happened in these patients. The post-operation results were kept well for 3～10 months follow-up.ConclusionsCraniotomies and skull reshaping were proved to be effective to correct scaphocephaly deformity in sagittal synostosis. Key words: sagittal synostosis; scaphocephaly deformity; craniotomy; infant 颅缝早闭系颅穹窿部一个或多个颅缝过早发生骨性融合，颅缝下的颅骨及脑组