目标:在过去的几十年里,关于矢状面滑膜的理想治疗方法一直存在很多争论。这项研究的目的是比较围手术期,人体测量学,以及对孤立矢状面滑膜的开放和内镜治疗之间的美容结果的主观评估。
方法:在他们的常规术后随访中,本研究招募了患有矢状位颅骨融合的儿科患者,接受数字化颅骨测量和标准化摄影,以客观和主观评估围手术期结局.头颅指数的年龄归一化z评分,头围,euryon-euryon直径(Eu-Eu),计算每位患者的glabella-opsthocranion直径(G-Op)。教员外科医生,外科学员,护士,并要求外行人使用5点Likert量表对颅面外观的正常性进行评分。比较内窥镜矫正治疗的患者和开放修复治疗的患者的预后。
结果:本研究共纳入50例患者。31人接受了开放手术矫正,19人接受了内镜治疗.内镜修复术的手术时间明显减少,失血,输血率,和住院时间比那些开放修复(p<0.001)。在头围的z评分方面,组间没有显着差异(p=0.22),头颅指数(p=0.25),或Eu-Eu(p=0.38)。内镜治疗与显著降低的G-Op相关(p=0.009)。此外,当校正年龄时,内窥镜治疗的头部形状的平均主观评分较高,性别,和种族(p=0.02)。
结论:研究结果表明,接受内窥镜治疗的患者可能在颅骨形态和外观方面总体上更正常,尽管这些结果受到可靠性差的限制。
In the last several decades, there has been much debate regarding the ideal treatment for sagittal synostosis. The purpose of this study was to compare perioperative, anthropometric, and subjective assessments of cosmetic outcomes between open and endoscopic management of isolated sagittal synostosis.
At their routine postoperative follow-up, pediatric patients with sagittal craniosynostosis were recruited to undergo digital cranial measurement and standardized photography for objective and subjective assessments of perioperative outcomes. Age-normalized z-scores for cephalic index, head circumference, euryon-euryon diameter (Eu-Eu), and glabella-opisthocranion diameter (G-Op) were calculated for each patient. Faculty surgeons, surgical trainees, nurses, and laypersons were asked to rate the normalcy of craniofacial appearances using a 5-point Likert scale. Outcomes were compared between patients treated with endoscopic correction and those treated with open repair.
A total of 50 patients were included in the study. Thirty-one had undergone open surgical correction, and 19 had undergone endoscopic treatment. Endoscopic repair involved significantly lower operative time, blood loss, transfusion rate, and hospital length of stay than those with open repair (p < 0.001). There was no significant difference between groups in terms of z-scores for head circumference (p = 0.22), cephalic index (p = 0.25), or Eu-Eu (p = 0.38). Endoscopic treatment was associated with a significantly lower G-Op (p = 0.009). Additionally, the average subjective rating of head shape was higher for endoscopic treatment when corrected for age, gender, and ethnicity (p = 0.02).
The study findings suggest that patients who are treated endoscopically may have an overall more normal appearance in skull morphology and cosmesis, although these results are limited by poor reliability.