【作者】 杨斌； 张智勇； 唐晓军； 石蕾； 尹琳； 尹宏宇； E.Arnaud； D.Marchac； D.Renier；

【Author】 The Craniofacial Surgery Division,The Plastic Surgery Hospital,The Chinese Academy of Medical Sciences, Beijing,P.R.China. Yang Bin,Zhang Zhi-yong,Tang Xiao-jun,Shi Lei, Yin Ling,Yin Hong-yu The Craniofacial Surgery Unit,NECKER Hospital, Paris,France Eric Amaud,Daniel Marchac,Dominique Renier

【机构】 中国医学科学院整形外科医院颅面外科； 法国巴黎NECKER医院颅面外科；

【摘要】 目的:介绍单侧冠状缝早闭症——额部斜头畸形的整复手术治疗的改进术式,探讨眶上额桥、额骨瓣、颞顶骨瓣的设计截取及额眶重建的方法。方法:采用额眶前移及颅眶骨重塑术式、顶颞骨瓣替代畸形额骨再造额眶术式整形修复斜头畸形。结果:本组9例患者均获得满意的疗效并未出现严重并发症。所采用的术式能够重建颅骨眼眶形态,解除早闭的颅骨缝对于大脑发育的限制,避免受累颅骨缝再次早闭及颅面畸形复发。采用可吸收板固定,避免出现固定板陷入颅骨的远期并发症,亦不影响患儿颅脑的生长发育。结论:改进的额眶前移及颞顶骨瓣替代额骨的术式可使斜头畸形获得较为满意的颅眶形态。这种手术方法对于颅面骨发育生长、大脑和视觉功能的远期影响尚有待于进一步随访观察。更多还原

【Abstract】 Objective:To introduce modified types of corrective procedures for frontal plagiocephaly(unilateral coronal synostosis).To appraise the surgical technique for reconstructing orbito-frontal form. Methods:The orbito -frontal advancement and calvarial vault remodeling procedure as well as the parieto-temporal osteotomy and frontal replacing procedure were used to correct the calvarial deformities and reconstructive orbito- frontal form.The resorbable plates and microscrews composed of copolymer polyglycolic acid and polylactic acid were used to fixation cranial segment. Results:Eight patients underwent parieto -temporal osteotomy and orbito -frontal replacing procedures.One patient underwent orbito-frontal advancement and calvarial vault remodeling procedure.All patients got satisfactory surgical results including appearance,mental development ,visual function,respiratory function etc.There is no any serious perioperative complication and mortality. Conclusion:The modified parieto-temporal bone segment repositioning procedures are effective methods to correct the deformities and reconstruct the fronto-orbital form,by which the satisfactory craniofacial apperance and function were gained.Long-term follow-up would be needed to observe the long -term effect of the orbito -frontal reconstructive operation to brain and calvarial vault development as well as visual function.更多还原