CAJ | 학술논문

目的总结额部斜头畸形——单侧冠状缝早闭症的整复手术方法.方法应用浮动额骨瓣原理,采用额眶前移、额顶骨瓣、颞顶骨瓣替代畸形额骨并再造额眶3种术式修复斜头畸形,以可吸收板固定颅骨骨段.结果 2008年1月至2010年12月,于临床应用9例,所有患者均获得满意疗效,未出现严重并发症.术后随访1～2年,颅骨眼眶形态得以重建,解除了早闭的颅骨缝对大脑发育的限制,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,避免出现金属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.结论额眶前移、额顶骨瓣、颞顶骨瓣替代额骨的术式可矫正斜头畸形,获得较为满意的颅眶形态,且这3种手术技术近期效果良好,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.
목적 총결액부사두기형——단측관상봉조폐증적정복수술방법.방법 응용부동액골판원리,채용액광전이、액정골판、섭정골판체대기형액골병재조액광3충술식수복사두기형,이가흡수판고정로골골단.결과 2008년1월지2010년12월,우림상응용9례,소유환자균획득만의료효,미출현엄중병발증.술후수방1～2년,로골안광형태득이중건,해제료조폐적로골봉대대뇌발육적한제,피면수루로골봉재차조폐급로면기형복발.채용가흡수판고정,피면출현금속고정판함입로골적원기병발증,역불영향환인로뇌적생장발육.결론 액광전이、액정골판、섭정골판체대액골적술식가교정사두기형,획득교위만의적로광형태,차저3충수술기술근기효과량호,대우로면골발육생장、대뇌화시각공능적원기영향,상유대우진일보수방관찰.
Objective To sum up three types of plastic procedures for frontal plagiocephaly (unilateral coronal synostosis).Methods Based on the principle of floating forehead,the plagiocephaly was corrected and orbito-frontal reconstruction was performed by orbito-frontal advancement,or temporoparietal osteotomy,or fronto-parietal osteotomy.The absorbable plates and microscrews composed of polylactide polymers,were used to immobilize calvarial segments.Results From January 2008 to December 2010,9 cases of plagiocephaly were treated with satisfactory result and no severe complication.The patients were followed up for 1-2 years with no recurrence of suture fusion and deformity.The brain development was not restricted.The absorbable plates were applied to avoid the metal fixation moving into the cranial bone.Conclusions The three types of plastic procedures,orbito-frontal advancement,or temporo-parietal osteotomy,or fronto-parietal osteotomy,can correct the plagiocephaly with satisfactory orbito-frontal appearance.Long-term follow-up is needed to observe the long-term effect of the orbito-frontal reconstructive operation on mental and calvarial development as well as visual function.