For this retrospective study, clinical data of 62 consecutive pediatric patients (age 3-8 months) were obtained from the data bank of the \"Anna Meyer\" Children Hospital. These patients had been diagnosed with trigonocephaly (type II and III) and undergone surgery performed with a mini-invasive endoscopic technique during the period from January 2011 to January 2022. No helmet was used postoperatively in these patients, and they were evaluated through craniometric measurements, pre-/postoperative photographs, and parents\' impressions, as well as thorough clinical examinations during follow-up appointments.
The mean patient follow-up period was 6 ± 1.3 years. The female/male ratio was 1:2; 52% of the patients presented with type II trigonocephaly and the remaining patients with type III. The mean age at surgery was 153 ± 44 days (5 ± 1.5 months, range 3-8 months). In 92% of the patients the surgical outcome was defined as good to excellent. However, 4 patients presented with an unsatisfactory outcome, including 1 patient with a CSF collection requiring surgical repair 2 months after the first surgery and 1 patient who developed infection of the surgical wound and needed a second surgery. In the latter patient the outcome was evaluated as satisfactory, and no sequelae regarding the infection were encountered during follow-up.
According to the authors\' experience, endoscopic metopic suturectomy alone, without the use of a helmet, is a valid surgical option for trigonocephaly treatment, and its application can be considered in patients of older age groups (up to 8 months). Thus, in the right patient selection context, this technique represents the treatment of choice.
方法:对于这项回顾性研究,我们从"AnnaMeyer"儿童医院的数据库获得了62例连续儿科患者(年龄3~8个月)的临床数据.在2011年1月至2022年1月期间,这些患者已被诊断出患有三角头颅症(II型和III型),并接受了使用微创内窥镜技术进行的手术。这些患者术后没有使用头盔,通过颅骨测量对它们进行评估,术前/术后照片,和父母的印象,以及随访期间的全面临床检查。
结果:患者平均随访期为6±1.3年。男女比例为1:2;52%的患者患有II型三头畸形,其余患者患有III型。手术的平均年龄为153±44天(5±1.5个月,范围3-8个月)。在92%的患者中,手术结果被定义为好到优。然而,4名患者表现出不满意的结果,其中包括1例首次手术后2个月需要手术修复的CSF收集患者和1例发生手术伤口感染并需要进行第二次手术的患者。在后者患者中,结果被评估为令人满意,随访期间未出现感染后遗症。
结论:根据作者的经验,单纯内镜下异位尿道切除术,不使用头盔,是一种有效的手术治疗方法,它的应用可以考虑在老年组的患者(长达8个月)。因此,在正确的患者选择背景下,这种技术代表了治疗的选择。