Management of sagittal craniosynostosis: morphological comparison of eight surgical techniques

The aim of this study was to carry out a retrospective multicentre study comparing the morphological outcome of 8 techniques used for the management of sagittal synostosis versus a large cohort of control patients. Computed tomographic (CT) images were obtained from children CT-scanned for non-craniosynostosis related events (n = 241) and SS patients at preoperative and postoperative follow-up stages (n = 101). No significant difference in morphological outcomes was observed between the techniques considered in this study. However, the majority of techniques showed a tendency for relapse. Further, the more invasive procedures at older ages seem to lead to larger intracranial volume compared to less invasive techniques at younger ages. This study can be a first step towards future multicentre studies, comparing surgical results and offering a possibility for objective benchmarking of outcomes between methods and centres.     

青少年拔牙矫治期间对颅面部硬组织结构影响的研究

目的 研究青少年拔牙矫治时颅面部硬组织的影响。方法 选择50例为青少年恒牙He，安氏Ⅰ类患者，25例需拔除四个第一双尖牙治疗，25例无需拔牙治疗，用标准方丝弓技术矫治，共收集到完整病例43例，拔牙20例，非拔牙23例，利用X线头影测量技术，比较拔牙与非拔牙组治疗前后的变化。结果 拔牙矫治与非拔牙矫治组都存在一定的颅面部骨骼的生长，但两者矫治前后改变无明显差别。拔牙矫治明显改变了前牙位置。结论 青少年拔牙矫治期间对颅面部骨骼的改变无影响。     

眶周截骨和皮瓣转移修复放疗后眼眶发育不良畸形

目的　探讨放射治疗所引起的眼眶发育不良的整形外科治疗方法。方法　通过眶周截骨扩大眶腔 ,重建眼眶的骨架结构 ,采用皮瓣移植完成结膜囊的再造和局部凹陷的充填。结果　12例眼眶发育不全患者经手术后均获得满意效果。结论　联合应用眶周截骨前移和皮瓣转移可有效地修复放射治疗所致的眼眶骨组织和软组织的畸形。     

<Emphasis Type="Italic">Susuks</Emphasis> (charm needles) in the craniofacial region

Objectives  We conducted a study to determine the numbers of susuks (charm needles) and their distribution in the craniofacial region of susuk wearers, and the sex, racial affiliation, and age of the wearers. In addition, we sought to determine whether the presence of susuks posed any potential hazard to patients undergoing magnetic resonance imaging (MRI). Methods  We studied various radiographs of 33 susuk wearers (age range, 33–69 years) and investigated the most common sites of insertion in the craniofacial region. A susuk was also suspended inside a 1.5-T MRI machine to determined whether it was attracted by the machine’s magnet. Results  The largest number of susuks that we observed in the craniofacial region was 39 pins, and susuks were particularly numerous in Malay Muslim women. Other sites with susuks were the maxillofacial region (except the temporomandibular region) and the forehead. The susuks showed no ferromagnetic characteristics. Conclusions  As susuks are made from gold, they are generally biocompatible with human tissue and do not cause problems to their wearers. Gold and the other minor metal constituents found in susuks have no ferromagnetic characteristics and therefore pose no hazard to patients undergoing MRI.     

颌骨畸形伴阻塞性睡眠呼吸暂停低通气综合征的牵引成骨治疗

目的　探讨牵引成骨技术在颌骨畸形继发阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapnea hypopneasyndrome,OSAHS)治疗中应用的效果。方法　收集自 1 997年 1 0月～2 0 0 2年 9月共 46例颌骨畸形伴OSAHS少年儿童 ,患者睡眠呼吸障碍经夜间多导睡眠监测证实。年龄从 4～ 1 8岁 ,平均年龄 1 1 4岁 ,其中颞下颌关节强直伴小下颌畸形 32例 ;小下颌畸形患者 9例 ;第一、二鳃弓综合征 2例 ;Crouzon综合征 3例。患者术前常规拍照、摄头颅定位侧位片 ,全景片。每位患者根据畸形情况 ,采取单侧或双侧牵引成骨治疗 ,根据侧位片预测 ,一般牵引到略微反覆盖为准。牵引幅度为 5～ 35mm ,平均牵引幅度 1 8 34mm。比较患者术前后颅颌面形态、呼吸道测量分析、多导睡眠监测结果评价治疗效果。结果　患者术后颌骨畸形明显改善 ,头影测量分析提示上呼吸道狭窄得以显著缓解 ,最小后气道径 ( x±s)由 (5 48± 2 76)mm增加到 (9 97± 2 0 5)mm ,睡眠呼吸暂停低通气指数 (apnea hypopneaindex,AHI, x±s)从术前 (66 31± 1 7 1 5)次 /s降低到 (3 1 6± 1 70 )次 /s,以上结果统计分析表明差异具有非常显著性 (P <0 0 0 1 )。结论　牵引成骨治疗颌骨畸形继发OSAHS患者具有很好的疗效