Abstract：
Endoscopic mini-invasive treatment for sporadic trigonocephaly is becoming a widely accepted surgical treatment. In most centers this treatment is performed in association with postoperative helmeting. The aim of the present study was to review and report the authors\' 11-year experience of endoscope-assisted metopic suturectomy for treatment of 62 trigonocephaly patients without helmet use.
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.
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.
摘要：
目的：内镜微创治疗散发性头端头端畸形正在成为一种被广泛接受的外科治疗方法。在大多数中心，这种治疗与术后头盔一起进行。本研究的目的是回顾并报告作者在内窥镜辅助下进行的近11年的经验，该经验用于治疗62例未使用头盔的三头体患者。
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。
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。
