Abstract：
BACKGROUND: Craniofacial asymmetry associated with unicoronal synostosis (UCS) may persist into the teenage years despite surgery in infancy. This study evaluated outcomes following a nasal monobloc procedure by mobilizing a united nasomaxillary and bilateral medial orbital segment of bone (nasal monobloc) to perform corrective translational and rotational movement for secondary correction of residual nasal-orbital asymmetry associated with UCS.
METHODS: A retrospective review of all UCS patients treated with nasal monobloc at our institution was performed. Demographic information was recorded, and pre- and postoperative 2D imaging was used for morphometric outcome analysis. Outcomes and complications were tabulated.
RESULTS: The study included 14 patients (5 males, 9 females; mean age 14.6 years; range 9.6 to 22.5 years; mean follow-up 70.6 months range 12 to 132 months). Ancillary procedures (scar revision, forehead/orbital contouring, MEDPOR® augmentation) were performed in all patients at the time of the nasal monobloc. One patient underwent a repeat procedure 6 years later following technique modification. Additionally, another patient experienced late overgrowth of the frontal sinus with forehead asymmetry. The morphometric analysis demonstrated significant (p < 0.05) pre-op to post-op improvements in naso-orbital asymmetry, as demonstrated by horizontal orbital aperture ratio (0.88 vs 0.99), midline to exocanthion ratio (0.91 vs 0.98), orbital index ratio (1.15 vs 1.01), and midline discrepancy (7.1 degrees vs 2.7 degrees).
CONCLUSIONS: Nasal monobloc osteotomy provides a reasonable surgical treatment to improve both the nasal and orbital asymmetries associated with unicoronal synostosis, including frontal nasal deviation, basal nasal deviation, and orbital aperture asymmetry. It is important to note that confounding anatomic variables such as globe dystopia, strabismus, and scleral show may affect the perception of orbital symmetry.
METHODS: A retrospective review of all UCS patients treated with nasal monobloc at our institution was performed. Demographic information was recorded, and pre- and postoperative 2D imaging was used for morphometric outcome analysis. Outcomes and complications were tabulated.
RESULTS: The study included 14 patients (5 males, 9 females; mean age 14.6 years; range 9.6 to 22.5 years; mean follow-up 70.6 months range 12 to 132 months). Ancillary procedures (scar revision, forehead/orbital contouring, MEDPOR® augmentation) were performed in all patients at the time of the nasal monobloc. One patient underwent a repeat procedure 6 years later following technique modification. Additionally, another patient experienced late overgrowth of the frontal sinus with forehead asymmetry. The morphometric analysis demonstrated significant (p < 0.05) pre-op to post-op improvements in naso-orbital asymmetry, as demonstrated by horizontal orbital aperture ratio (0.88 vs 0.99), midline to exocanthion ratio (0.91 vs 0.98), orbital index ratio (1.15 vs 1.01), and midline discrepancy (7.1 degrees vs 2.7 degrees).
CONCLUSIONS: Nasal monobloc osteotomy provides a reasonable surgical treatment to improve both the nasal and orbital asymmetries associated with unicoronal synostosis, including frontal nasal deviation, basal nasal deviation, and orbital aperture asymmetry. It is important to note that confounding anatomic variables such as globe dystopia, strabismus, and scleral show may affect the perception of orbital symmetry.
摘要：
背景：尽管在婴儿期进行了手术，但与单冠状骨滑膜（UCS）相关的颅面不对称可能持续到青少年时期。这项研究通过动员联合的鼻腋窝和双侧内侧眼眶段（鼻单块）进行矫正平移和旋转运动，以对与UCS相关的残留鼻眶不对称性进行二次矫正，从而评估了鼻单块手术后的结果。
方法：对在我们机构接受鼻单支治疗的所有UCS患者进行了回顾性回顾。记录了人口统计信息，术前和术后2D成像用于形态计量学结果分析。结果和并发症列表。
结果：该研究包括14名患者（5名男性，9名女性；平均年龄14.6岁；范围为9.6至22.5岁；平均随访70.6个月，范围为12至132个月）。辅助手术(疤痕翻修,前额/眼眶轮廓，MEDPOR®增强）在所有患者进行鼻单块时进行。一名患者在技术修改后6年后接受了重复手术。此外,另一名患者出现前额不对称的额窦晚期过度生长。形态测量分析显示术前到术后鼻眶不对称性的显著改善(p<0.05),如水平轨道孔径比（0.88vs0.99）所示，中线与外生比（0.91对0.98），轨道指数比（1.15对1.01），和中线差异（7.1度对2.7度）。
结论：经鼻单骨截骨术提供了一种合理的手术治疗方法，可以改善与单冠状滑脱相关的鼻和眼眶不对称性，包括额部鼻弯,基础鼻曲，和轨道孔径不对称。重要的是要注意，混杂的解剖变量，如全球反乌托邦，斜视,巩膜显示可能会影响对眼眶对称性的感知。
方法：对在我们机构接受鼻单支治疗的所有UCS患者进行了回顾性回顾。记录了人口统计信息，术前和术后2D成像用于形态计量学结果分析。结果和并发症列表。
结果：该研究包括14名患者（5名男性，9名女性；平均年龄14.6岁；范围为9.6至22.5岁；平均随访70.6个月，范围为12至132个月）。辅助手术(疤痕翻修,前额/眼眶轮廓，MEDPOR®增强）在所有患者进行鼻单块时进行。一名患者在技术修改后6年后接受了重复手术。此外,另一名患者出现前额不对称的额窦晚期过度生长。形态测量分析显示术前到术后鼻眶不对称性的显著改善(p<0.05),如水平轨道孔径比（0.88vs0.99）所示，中线与外生比（0.91对0.98），轨道指数比（1.15对1.01），和中线差异（7.1度对2.7度）。
结论：经鼻单骨截骨术提供了一种合理的手术治疗方法，可以改善与单冠状滑脱相关的鼻和眼眶不对称性，包括额部鼻弯,基础鼻曲，和轨道孔径不对称。重要的是要注意，混杂的解剖变量，如全球反乌托邦，斜视,巩膜显示可能会影响对眼眶对称性的感知。
