目的:本研究旨在评估Piezheoscage®装置在内窥镜辅助矫正三角头畸形中的有效性。三角头颅是一种颅骨融合症,其特征是由于异位缝线的过早融合而形成三角形的前额。传统的开颅穹顶重建,虽然普通,是侵入性的,存在风险。该研究探索了一种使用超声微振动进行骨切割的侵入性较小的替代方法,有可能减少软组织损伤并改善手术结果。
方法:在位于里昂的法国颅骨融合转诊中心对4个月以下的患者进行的内窥镜下头颅矫正手术中,采用了Piezhoc®装置。该技术包括做一个小的皮肤切口,并从前font门到glabella进行截骨术。刚性0°内窥镜提供可见性,和压电外科®设备能够精确切割骨头,同时保留硬脑膜。手术后,患者在3天内出院,需佩戴重塑头盔6~8个月.
结果:使用Piezography®装置可以进行精确的截骨术,同时软组织损伤最小。患者系列中没有发生硬脑膜损伤。程序很有效,平均持续时间为80分钟,失血很少,减少输血的需要。内镜方法可缩短手术时间并降低术后感染风险。手术期间的能见度增强,由于空化效应,提高了骨切割的准确性。该技术展示了有希望的安全性和美学效果,尽管与传统方法相比,它产生了更高的成本。
结论:压电外科®装置为微创内窥镜矫正三角头畸形提供了一种安全有效的方法。该装置在保留软组织的同时选择性切割骨骼的能力具有显著的优势,尽管手术时间较长,费用较高。这种技术代表了传统开放手术的可行替代方案,促进更好的临床结果和减少恢复时间。
OBJECTIVE: This study aims to evaluate the effectiveness of the Piezosurgery® device in endoscopic-assisted correction of
trigonocephaly.
Trigonocephaly is a type of craniosynostosis characterized by a triangular-shaped forehead due to the premature fusion of the metopic suture. Traditional open cranial vault reconstruction, although common, is invasive and poses risks. The study explores a less invasive alternative using ultrasonic microvibrations for bone cutting, potentially reducing soft tissue damage and improving surgical outcomes.
METHODS: The Piezosurgery® device was employed in endoscopic
trigonocephaly correction surgeries performed on patients under 4 months old at the French Referral Center for Craniosynostosis in Lyon. The technique involves making a small skin incision and performing osteotomies from the anterior fontanel to the glabella. A rigid 0° endoscope provides visibility, and the Piezosurgery® device enables precise bone cutting while preserving the dura mater. Post-surgery, patients were discharged within 3 days and required to wear a remodeling helmet for 6-8 months.
RESULTS: The use of Piezosurgery® device allowed precise osteotomies with minimal soft tissue damage. No dura mater injuries occurred in the patient series. The procedure was efficient, with an average duration of 80 min, and blood loss was minimal, reducing the need for blood transfusions. The endoscopic approach facilitated shorter surgical times and reduced postoperative infection risks. Enhanced visibility during surgery, due to cavitation effects, improved the accuracy of bone cuts. The technique demonstrated promising safety and esthetic outcomes, although it incurred higher costs compared to traditional methods.
CONCLUSIONS: Piezosurgery® device provides a safe and effective method for minimally invasive endoscopic correction of
trigonocephaly. The device\'s ability to selectively cut bone while preserving soft tissues offers significant advantages, despite longer surgical times and higher costs. This technique represents a viable alternative to traditional open surgery, promoting better clinical outcomes and reduced recovery times.