METHODS: The patient cohort of this study consisted of patients (N = 82) who were treated in the Oulu University Hospital using the open vault cranioplasty with a modified H-technique between the years 2008 to 2022. There were 69 males (84.1%) and 13 females (15.9%). The mean age at the primary operation was 6.1 months. Mean follow-up time was 9.0 years.
RESULTS: There were no major complications related to the procedures. Two patients (2.4%) had a minor dural lesion. There were no postoperative wound infections. Of the 82 patients, seven patients with primary craniosynostosis (13.0%) developed symptomatic craniocerebral disproportion requiring reoperation to increase intracranial volume. In all these patients, invasive intracranial pressure (ICP) monitoring was performed prior to decision-making. In the majority of cases, the aesthetical outcome was considered good or excellent.
CONCLUSIONS: The operative method used was feasible and safe. Thirteen percent of patients who were followed over 5 years required major surgery due to development of craniocerebral disproportion later in life.
方法:本研究的患者队列包括2008年至2022年间在奥卢大学医院使用改良H技术进行开放穹窿颅骨成形术的患者(N=82)。男性69例(84.1%),女性13例(15.9%)。初次手术的平均年龄为6.1个月。平均随访时间为9.0年。
结果:没有与手术相关的主要并发症。两名患者(2.4%)有轻微的硬脑膜病变。术后无伤口感染。在82名患者中,7例原发性颅骨融合症患者(13.0%)出现症状性颅脑比例失调,需要再次手术以增加颅内容量.在所有这些患者中,在决策前进行有创颅内压(ICP)监测.在大多数情况下,美学结果被认为是好的或极好的。
结论:所采用的手术方法是可行和安全的。在5年以上的随访患者中,有13%的患者需要进行大手术,原因是在以后的生活中发生了颅脑比例失调。