Abstract：
Endoscopic strip craniectomy for metopic craniosynostosis relies on rapid growth and postoperative helmeting for correction. Endoscopic repair is generally performed before patients reach 4 months of age, and outcomes in older patients have yet to be quantified. Here, the authors examined a cohort of patients treated with endoscopic repair before or after 4 months of age to determine aesthetic outcomes of delayed repairs.
Data from eligible patients were retrospectively assessed and aggregated in a dedicated metopic synostosis database. Inclusion criteria were radiographically confirmed metopic synostosis and endoscopic treatment. Patients were dichotomized into two groups: those younger than 4 months and those 4 months or older at the time of repair. The frontal width and interfrontal divergence angle (IFDA) were measured on reconstructed CT images. These measurements, alongside operative time, estimated blood loss, and transfusion rates, were compared between groups using the Student t-test or chi-square test.
The study population comprised 28 patients treated before 4 months of age and 8 patients treated at 4-6 months of age. Patient sex and perioperative complications did not differ by age group. Older age at repair was not significantly associated with 1-year postoperative IFDA (140° ± 4.2° vs 142° ± 5.0°, p = 0.28) or frontal width (84 ± 5.2 vs 83 ± 4.4 mm, p = 0.47).
One-year postoperative IFDA and frontal width do not differ significantly between patients treated before and after 4 months of age. Further study with longer follow-up is necessary to confirm the longevity of these results at skeletal maturity.
Data from eligible patients were retrospectively assessed and aggregated in a dedicated metopic synostosis database. Inclusion criteria were radiographically confirmed metopic synostosis and endoscopic treatment. Patients were dichotomized into two groups: those younger than 4 months and those 4 months or older at the time of repair. The frontal width and interfrontal divergence angle (IFDA) were measured on reconstructed CT images. These measurements, alongside operative time, estimated blood loss, and transfusion rates, were compared between groups using the Student t-test or chi-square test.
The study population comprised 28 patients treated before 4 months of age and 8 patients treated at 4-6 months of age. Patient sex and perioperative complications did not differ by age group. Older age at repair was not significantly associated with 1-year postoperative IFDA (140° ± 4.2° vs 142° ± 5.0°, p = 0.28) or frontal width (84 ± 5.2 vs 83 ± 4.4 mm, p = 0.47).
One-year postoperative IFDA and frontal width do not differ significantly between patients treated before and after 4 months of age. Further study with longer follow-up is necessary to confirm the longevity of these results at skeletal maturity.
摘要：
目的：内镜下带状颅骨切除术治疗异位颅骨前突依赖于快速生长和术后头盔矫正。内镜修复术通常在患者达到4个月之前进行，老年患者的结局尚未量化。这里,作者研究了一组在4月龄之前或之后接受内镜修复治疗的患者,以确定延迟修复的美学结局.
方法：对来自符合条件的患者的数据进行回顾性评估，并将其汇总在一个专门的异位骨膜数据库中。纳入标准为放射学证实的异位骨性和内窥镜治疗。将患者分为两组：小于4个月的患者和修复时4个月或更大的患者。在重建的CT图像上测量额叶宽度和额叶间发散角（IFDA）。这些测量，除了手术时间，估计失血量,输血率，组间比较采用学生t检验或卡方检验。
结果：研究人群包括28名4月龄前接受治疗的患者和8名4-6月龄接受治疗的患者。患者性别和围手术期并发症因年龄组而异。修复年龄与术后1年IFDA无显著相关(140°±4.2°vs142°±5.0°,p=0.28）或正面宽度（84±5.2vs83±4.4mm，p=0.47）。
结论：在4月龄之前和之后接受治疗的患者之间，术后一年的IFDA和额叶宽度没有显著差异。需要进行更长时间的随访进一步研究，以确认这些结果在骨骼成熟时的寿命。
方法：对来自符合条件的患者的数据进行回顾性评估，并将其汇总在一个专门的异位骨膜数据库中。纳入标准为放射学证实的异位骨性和内窥镜治疗。将患者分为两组：小于4个月的患者和修复时4个月或更大的患者。在重建的CT图像上测量额叶宽度和额叶间发散角（IFDA）。这些测量，除了手术时间，估计失血量,输血率，组间比较采用学生t检验或卡方检验。
结果：研究人群包括28名4月龄前接受治疗的患者和8名4-6月龄接受治疗的患者。患者性别和围手术期并发症因年龄组而异。修复年龄与术后1年IFDA无显著相关(140°±4.2°vs142°±5.0°,p=0.28）或正面宽度（84±5.2vs83±4.4mm，p=0.47）。
结论：在4月龄之前和之后接受治疗的患者之间，术后一年的IFDA和额叶宽度没有显著差异。需要进行更长时间的随访进一步研究，以确认这些结果在骨骼成熟时的寿命。
