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Long-Term Follow-Up on Bone Stability and Complication Rate after Monobloc Advancement in Syndromic Craniosynostosis.

综合征性颅缝早闭整块推进后骨稳定性和并发症发生率的长期随访。

  • 影响因子:1.74
  • DOI:10.1097/PRS.0000000000006646
  • 作者列表:"Raposo-Amaral CE","Denadai R","Zanco GL","Ghizoni E","Raposo-Amaral CA
  • 发表时间:2020-04-01
Abstract

BACKGROUND:Monobloc advancement is a complex procedure used to treat patients with syndromic craniosynostosis. Studies directly addressing the long-term stability of monobloc advancement with distraction osteogenesis are underreported in the literature. The objectives of this study were to assess 5-year midface bone stability following monobloc advancement performed on patients with syndromic craniosynostosis, identify risk factors for relapse, and present strategies for prevention and management of complications. METHODS:An observational retrospective study was performed on consecutive patients with Apert, Crouzon, or Pfeiffer syndrome (n = 23) who underwent monobloc advancement using distraction osteogenesis between 1994 and 2013. A total of 130 lateral cephalograms were used to assess both long-term stability after monobloc advancement with distraction osteogenesis and risk factors for relapse. All serious complications were identified and recorded. The analysis of variance test was used to assess horizontal relapse of the midface and mandibular plane. RESULTS:Cephalometric analysis revealed long-term stability of frontofacial advancement using distraction osteogenesis, regardless of the presence of tested variables. Serious complications arising from monobloc advancement using distraction osteogenesis included cerebrospinal fluid leakage in six patients (26 percent), accompanying meningitis in two patients (8.7 percent), seizures in seven patients (30.4 percent), and impaired visual acuity in one eye of one patient (4.3 percent). CONCLUSION:Frontofacial monobloc advancement with distraction osteogenesis provides long-term midface bone stability. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.

摘要

背景: Monobloc进展是用于治疗综合征性颅缝早闭患者的复杂程序。直接涉及牵张成骨整体推进长期稳定性的研究在文献中报道不足。本研究的目的是评估对综合征性颅缝早闭患者进行整体推进后的 5 年面中部骨稳定性,确定复发的危险因素,并提出预防和处理并发症的策略。 方法: 对 1994 年至 2013 年间接受牵张成骨整体推进术的连续Apert、Crouzon或Pfeiffer综合征患者 (n = 23) 进行了观察性回顾性研究。共使用 130 张头颅侧位片评估牵张成骨整体推进后的长期稳定性和复发风险因素。识别并记录所有严重并发症。采用方差分析检验评估面中部和下颌骨平面的水平复发。 结果: 头影测量分析显示,无论是否存在测试变量,使用牵张成骨的额面部前移的长期稳定性。牵张成骨整体推进引起的严重并发症包括脑脊液漏 6 例 (26%),伴发脑膜炎 2 例 (8.7%),癫痫 7 例 (30.4%),1 例患者单眼视力受损 (4.3%)。 结论: 额面部整体推进伴牵张成骨提供了长期的面中部骨稳定性。 临床问题/证据水平: 治疗性,IV。

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影响因子:0.95
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影响因子:2.43
发表时间:2020-01-15
DOI:10.5435/JAAOS-D-16-00918
作者列表:["Grigoryan G","Korcek L","Eidelman M","Paley D","Nelson S"]

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