- 期刊
Late Cranial Vault Reconstruction for Sagittal Craniosynostosis-A Case Report
晚期顱骨重建治療矢狀裂早期癒合畸形－病例報告
摘要
矢狀裂早期癒合所引發的顱顏畸型較常見於西方白人，很少發生於東方人，外科治療的方法，視病患的年齡及畸形的程度而不同。在多數的情況，顱骨重建手術會在嬰兒一歲以前施行，稱為早期重建(early cranial vault reconstruction)。六個月以下嬰兒，施行條狀顱骨切除術(strip craniectomy)治療效果不錯，六個月以後的嬰兒，因為顱骨畸形已經明顯，簡單的條狀顱骨切除術已無法有效治療，必須以顱骨切碎法(morcellation)，或顱骨造型術(cranial vault reshaping)治療，對於一歲以上之兒童，定義為晚期顱骨重建手術(late cranial vault reconstruction)。因為顱骨變厚變硬，顱骨造型術常常不容易施行，可以選擇做全部或部份顱骨切開術，再做顱骨移植，本篇論文提出一罕見病例報告，並發表一新的手術技術，針對晚期治療輕微前額突出的矢狀裂早期癒合的病人，利用簡單的轉位顱骨移植(transposition cranial bone graft)，成功的達到治療效果並有良好的外觀改善。
關鍵字
無資料並列摘要
Sagittal craniosynostosis is a common congenital craniofacial anomaly in Caucasian. It rarely occurs in Oriental. The methods of surgical intervention vary specifically for each patient depending on the age and the severity of the deformity. In the most circumstances, the cranial vault reconstruction is carried before 1 year of age, so called early reconstruction. Strip craniectomy is often the treatment of choice for children under 6 month-old. Morcellation or cranial vault reshaping is carried for children over 6 month-old, when the disproportional dimensions of the cranial vault have already occurred. For older children (over 1 year of age), the cranial bone reshaping is usually difficult to be achieved because it has become thick and hard. In such situation, total or partial craniotomy with transposition cranial bone graft is performed in the late reconstruction. We report a rare case of sagittal craniosynostosis in our craniofacial center and propose a newly modified technique in transposition cranial bone graft used for the late reconstruction. It is used specifically for the patients with mild frontal prominence. It is simple and improves the aesthetic appearance well.