全拱顶重建术治疗非综合征矢状突综合征患者颅骨体积和头位指数的回顾性研究

IF 0.9 4区医学 Q4 CLINICAL NEUROLOGY

Pediatric Neurosurgery Pub Date : 2022-05-16 DOI:10.1159/000525114

Maximilian Götzinger, M. Verius, R. Eder, I. Laimer, M. Rasse

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引用次数: 1

摘要

背景：颅骨缝线过早融合会影响颅骨发育并导致头部畸形。未经治疗的颅缝闭合可出现颅内压升高和大脑生长受限。手术治疗旨在实现接近平均值的颅骨形状的即时和持久矫正，并通过增加颅内容积（ICV）或在ICV已经低于标准的情况下使其正常化来防止或释放可能增加的颅内压。本研究旨在评估全颅骨重建对非综合征性矢状缝合症患者颅骨发育的影响。材料和方法：研究人群包括19名男性和5名女性患者，他们患有孤立性非综合征矢状缝合。在手术过程中，临时固定的预弯金属板为所需的颅骨膨胀、高度增加和缩短提供了术中参考。使用ImageJ软件程序在计算机断层扫描数据集上测量术前和术后ICV和头部指数，并将其相互比较和与标准数据进行比较。结果：男性患者术前平均ICV为863.3 cm³。术后平均ICV增加243.5 cm³（p＜0.001），ICV进一步增大（p＜001）。平均CI从术前的71.0%变为术后的75.4%（p=0.002），在随访中下降不显著（p=0.546）。女性人群术前平均ICV为804.9 cm³。术后，平均ICV增加了211.1cm³（p=0.043），在随访中也增加了（p=0.043术后即刻的ICV增加。

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Retrospective Investigation of Cranial Volume and Cephalic Index in Patients with Nonsyndromic Sagittal Synostosis Operated by Total Vault Remodeling

Background: Premature fusion of cranial sutures affects skull development and leads to head deformity. Intracranial pressure increase and brain growth restriction can occur in untreated craniosynostosis. Operative treatment aims to achieve an immediate and long-lasting correction of skull shape that is close to the average and to prevent or release possible increased intracranial pressure by increasing the intracranial volume (ICV) or normalizing the ICV if it is already below the standards. This study was designed to evaluate the effect of a total calvarial reconstruction on skull development in patients with nonsyndromic sagittal synostosis. Material and Methods: The study population included 19 male and 5 female patients with isolated nonsyndromic sagittal suture synostosis. During the operation, temporarily fixed prebent metal plates provided an intraoperative reference for the desired cranial expansion gain of height and shortening. Preoperative and postoperative ICVs and cephalic indices were measured on computed tomography datasets using the software program ImageJ and were compared with one another and with normative data. Results: The male population presented with a preoperative mean ICV of 863.3 cm³. A postoperative mean ICV increase of 243.5 cm³ (p < 0.001) and a further ICV enlargement (p < 0.001) was measured. The mean CI changed from 71.0% preoperatively to 75.4% postoperatively (p = 0.002) and decreased insignificantly in the follow-up (p = 0.546). The female population had a preoperative mean ICV of 804.9 cm³. Postoperatively, the mean ICV increased by 211.1 cm³ (p = 0.043) and also increased in the follow-up (p = 0.043). Their mean CI values increased from 66.5% preoperatively to 72.8% (p = 0.043) postoperatively and decreased insignificantly in the follow-up (p = 0.345). Conclusion: This method of total vault remodeling provides reliable ICV increase and improvement in length and width of skull proportions beyond the immediate postoperative period together with an ICV increase.

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来源期刊

Pediatric Neurosurgery 医学-临床神经学

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Articles in ''Pediatric Neurosurgery'' strives to publish new information and observations in pediatric neurosurgery and the allied fields of neurology, neuroradiology and neuropathology as they relate to the etiology of neurologic diseases and the operative care of affected patients. In addition to experimental and clinical studies, the journal presents critical reviews which provide the reader with an update on selected topics as well as case histories and reports on advances in methodology and technique. This thought-provoking focus encourages dissemination of information from neurosurgeons and neuroscientists around the world that will be of interest to clinicians and researchers concerned with pediatric, congenital, and developmental diseases of the nervous system.