Abstract:
(1) Background: Non-syndromic unicoronal craniosynostosis (UCS) is associated with a high prevalence of ocular anomalies. Currently, the etiology of this association remains obscure, however, it is presumed to be primarily attributed to their orbital malformations and/or secondary to craniofacial surgery. We assessed pre-operative ophthalmological examinations of non-syndromic UCS patients and compared them with their postoperative outcomes and long-term follow-up. (2) Methods: A retrospective case series was conducted on medical records of patients with non-syndromic UCS at Sophia Children\'s Hospital, Rotterdam. Ophthalmologic examinations were collected at different time periods: T1 (first visit), T2 (<1 year after cranioplasty), and T3 (long-term follow-up at last visit). The McNemar\'s test was used for statistical analysis. (3) Results: A total of 101 patients were included, for whom examinations were available at T1 and T3. Patients had a mean age of 2.8 years (±2.7) and 9.5 (±4.9) at T1 and T3, respectively. At T1, 52 patients (51.5%) were diagnosed with strabismus, and 61 patients (60.4%) at T3. Vertical strabismus increased significantly from 23 patients (22.8%) at T1 to 36 patients (35.6%) at T3 (p = 0.011). Followed by astigmatism, which increased significantly from 38 (37.6%) at T1 to 59 (58.4%) patients at T3 (p = 0.001). T1 was available in 20 patients prior to fronto-orbital advancement (FOA), therefore, a sub-analysis was conducted on these patients, which was followed shortly after FOA at T2. Prior to FOA, strabismus was present in 11 patients (55.0%) and in 12 patients (60.0%) at T2. After FOA, strabismus worsened in two patients. (4) Conclusions: This study showed the high prevalence of ocular anomalies in patients with non-syndromic UCS before and after cranioplasty and at long-term follow-up. The findings of this study show that ophthalmic and orthoptic examinations are an important part of the optimal treatment of patients with non-syndromic UCS.
摘要:
(1)背景:非综合征性单冠状颅骨融合(UCS)与眼部异常的高患病率相关。目前,这种联系的病因仍然模糊,然而,据推测主要归因于眼眶畸形和/或继发于颅面部手术。我们评估了非综合征性UCS患者的术前眼科检查,并将其与术后结果和长期随访进行比较。(2)方法:对索菲亚儿童医院非综合征性UCS患者的病历进行回顾性研究,鹿特丹.收集不同时间段的眼科检查:T1(首次访问),T2(颅骨修补术后<1年),和T3(最后一次访问的长期随访)。采用McNemar检验进行统计分析。(3)结果:共纳入101例患者,在T1和T3时可以进行检查。患者在T1和T3时的平均年龄分别为2.8岁(±2.7)和9.5岁(±4.9)。T1时,52例患者(51.5%)被诊断为斜视,T3时61例(60.4%)。垂直斜视从T1时的23例(22.8%)显着增加到T3时的36例(35.6%)(p=0.011)。其次是散光,从T1时的38例(37.6%)增加到T3时的59例(58.4%)(p=0.001)。在前眶推进(FOA)之前,有20例患者可获得T1,因此,对这些患者进行了亚分析,在T2的FOA后不久。在FOA之前,在T2时,有11例患者(55.0%)和12例患者(60.0%)存在斜视。在FOA之后,两名患者斜视恶化。(4)结论:本研究显示,非综合征性UCS患者在颅骨成形术前后和长期随访中,眼部异常的患病率很高。这项研究的结果表明,眼科和正交检查是非综合征性UCS患者最佳治疗的重要组成部分。