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首页> 外文期刊>Scandinavian journal of plastic and reconstructive surgery and hand surgery >Sagittal synostosis: II. Cranial morphology and growth after the modified pi-plasty.
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Sagittal synostosis: II. Cranial morphology and growth after the modified pi-plasty.

机译：矢状突突：II。改良的pi成形术后的颅骨形态和生长。

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摘要

The aim of this study was to characterise the postoperative cranial growth and morphology after a modified pi-plasty for sagittal synostosis. The shape of the skull of 82 patients with isolated premature synostosis of the sagittal suture (SS group) operated on with a modified pi-plasty was studied longitudinally. Forty-five children with unilateral incomplete cleft lip (UICL), evaluated longitudinally at the ages of 2.4 and 23.2 months were used as controls. A standardised radiocephalometric technique was used for image acquisition. The radiocephalograms were analysed using a modification of a method developed by Kreiborg, which included the digitisation of 89 landmarks of the calvaria, cranial base, and orbit (43 in the lateral and 46 in the frontal projections), the production of mean shape plots for each group, and the intergroup comparison of a series of 78 variables (linear distance between selected landmarks, and angles defined by groups of three landmarks). Paired and unpaired t tests were used to assess the differences between the variables studied. These were accepted as significant for values of p<0.01 and were presented as coloured segments or areas in the respective plots. In a comparative analysis with the mean UICL lateral plots, the mean preoperative lateral plots of the study group (SS) showed that the anterior slope of the forehead was more pronounced and it was also more convex. The vertex area was located more anteriorly and was less convex. The occipital curvature was more prominent. Comparison of the mean frontal plots showed a deficiency in convexity and lateral projection of the upper parietal regions, and the line of maximum skull width was lower. The postoperative mean lateral plots of the study group showed a correction of the exaggerated anterior inclination of the forehead and a reduction of the abnormal occipital convexity. However, there was little change in the vertex region and it remained flatter than in the control group. In the mean frontal plots, the increase in convexity and in the lateral projection of the upper parietal areas led to a shape that was similar to that of the UICL group. The mean (SD) cephalic index changed from 64.9% (1.8%) to 71.4% (3.5%) (p<0.001). The longitudinal comparison between the mean postoperative plots at 3 and 5 years of age showed that there had been little change in cranial shape. In conclusion, after a modified pi-plasty for sagittal synostosis, significant objective changes in cranial shape towards normality were produced. The postoperative profile cranial shape was improved except in the vertex area, which remained flatter than normal. In the frontal projection an almost normal shape was obtained. The postoperative cranial shape obtained at 3 years of age had remained stable at the age of 5 years.
机译：这项研究的目的是表征经改良的pi成形术治疗矢状突触后的颅骨生长和形态。纵向研究了82例经改良的pi成形术进行手术的孤立的矢状缝线早产先天性鼻窦炎患者的颅骨形状（SS组）。分别对年龄为2.4和23.2个月的45例单侧不完全唇裂（UICL）儿童进行纵向评估。使用标准化的放射头测量技术来获取图像。使用Kreiborg开发的一种方法的改进方法对X线头颅图进行了分析，包括对颅底，颅底和眼眶的89个界标（侧面的43个和额部的46个）进行数字化，生成了平均形状图。每个组，以及一系列78个变量的组间比较（选定地标之间的线性距离，以及由三个地标组定义的角度）。配对和非配对t检验用于评估研究变量之间的差异。对于p <0.01的值，这些值被认为是显着的，并在各个图中以彩色段或区域表示。在与平均UICL侧向图的比较分析中，研究组（SS）的术前平均侧向图显示，前额的前斜度更明显，并且也更凸。顶点区域位于更靠前的位置，凸度较小。枕骨弯曲更为突出。平均额线图的比较显示上壁区域的凸度和侧向投影不足，并且最大颅骨宽度线较低。研究组的术后平均侧位图显示了额头过大的前倾的矫正和枕后凸异常的减少。但是，顶点区域几乎没有变化，并且与对照组相比仍保持平坦。在平均额叶图中，上顶区的凸度和侧向投影的增加导致形状类似于UICL组。平均（SD）头指数从64.9％（1.8％）变为71.4％（3.5％）（p <0.001）。在3岁和5岁时的平均术后图之间的纵向比较表明，颅骨形状几乎没有变化。总之，经过改良的pi成形术治疗矢状突突后，颅骨形状向客观正常方向产生了明显的客观变化。术后轮廓颅骨形状得到改善，但在顶点区域除外，该区域仍比正常人平坦。在正面投影中，获得了几乎正常的形状。 3岁时获得的术后颅骨形状在5岁时保持稳定。

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