We performed a literature search in the electronic database of PubMed, CENTRAL, Cochrane, and Ovid Medline guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement for studies evaluating ophthalmic manifestations of unilateral coronal synostosis.
Unilateral coronal synostosis, also called unicoronal synostosis, may be mistaken for deformational plagiocephaly, an asymmetric skull flattening common in newborns. Characteristic facial features, however, distinguish the two. Ophthalmic manifestations of unilateral coronal synostosis include a \"harlequin deformity\", anisometropic astigmatism, strabismus, amblyopia, and significant orbital asymmetry. The astigmatism is greater on the side opposite the fused coronal suture. Optic neuropathy is uncommon unless unilateral coronal synostosis accompanies more complex multi-suture craniosynostosis. In many cases, surgical intervention is recommended; without intervention, skull asymmetry and ophthalmic disorders tend to worsen with time. Unilateral coronal synostosis can be managed by early endoscopic stripping of the fused suture and helmeting through a year of age or by fronto-orbital-advancement at approximately 1 year of age. Several studies have demonstrated that anisometropic astigmatism, amblyopia, and severity of strabismus are significantly lower after earlier intervention with endoscopic strip craniectomy and helmeting compared to treatment by fronto-orbital-advancement. It remains unknown whether the earlier timing or the nature of the procedure is responsible for the improved outcomes. As endoscopic strip craniectomy can only be performed in the first few months of life, early recognition of the facial, orbital, eyelid, and ophthalmic characteristics by consultant ophthalmologists enables expeditious referral and optimized ophthalmic outcomes.
Timely identification of craniofacial and ophthalmic manifestations of infants with unilateral coronal synostosis is important. Early recognition and prompt endoscopic treatment appears to optimize ocular outcomes.
■我们在PubMed的电子数据库中进行了文献检索,中部,科克伦,和OvidMedline以首选报告项目为指导,用于评估单侧冠状突的眼科表现的系统评价和荟萃分析声明。
■单侧冠状突,也被称为单冠状突,可能会被误认为是变形性斜头畸形,新生儿常见的不对称头骨变平。特征性的面部特征,然而,区分两者。单侧冠状突的眼科表现包括“丑角畸形”,屈光参差散光,斜视,弱视,和显著的轨道不对称性。与融合的冠状缝合线相对的一侧的散光更大。视神经病变并不常见,除非单侧冠状滑膜并伴有更复杂的多缝线颅骨滑膜。在许多情况下,建议进行手术干预;没有干预,颅骨不对称和眼科疾病往往随着时间的推移而恶化。单侧冠状突可以通过早期内窥镜剥离融合的缝合线和在1岁左右的头盔或通过大约1岁的前眶推进来管理。一些研究表明,屈光参差散光,弱视,与前眶前移治疗相比,采用内镜下带状颅骨切除术和头盔术进行早期干预后,斜视的严重程度显着降低。尚不清楚早期的时机或程序的性质是否对改善的结果负责。由于内镜下带状骨瓣切除术只能在生命的最初几个月进行,早期识别面部,轨道,眼睑,眼科医生顾问的眼科特征可以快速转诊和优化眼科结果。
■及时识别单侧冠状突畸形婴儿的颅面和眼科表现很重要。早期识别和及时的内窥镜治疗似乎可以优化眼部结果。