单块术与Le Fort III手术治疗颅缝早闭的结局与并发症：文献综述
Outcomes and Complications of Monobloc Versus Le Fort III Procedures for Treating Craniosynostosis: A Literature Review.
文献信息
| PMID | 42903286 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Bassem Chamma |
| 作者单位 | From the Department of Surgery, Wayne State University School of Medicine, Detroit, MI. |
| 期刊 | Plastic and reconstructive surgery. Global open |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 颅缝早闭是一种先天性疾病，导致颅骨多块骨骼过早融合，引起头部和面部结构畸形。治疗颅缝早闭最常进行的两种手术包括单块术和Le Fort III手术。本文献综述比较单块术与Le Fort III手术治疗颅缝早闭的功能和解剖结局及并发症。
方法： 通过PubMed检索评估单块术和Le Fort手术后结局的研究。从每项研究中提取关于解剖变化、眼部、气道和神经系统后遗症以及各种感染性或美学并发症的数据。
结果： 共纳入63篇文章进行分析。单块术病例的中面部前移平均长度（14.28 mm；98.8%的患者采用牵张成骨）显著高于Le Fort III病例（12.26 mm；63%的患者采用牵张成骨）（P = 0.002）。两种手术在阻塞性睡眠呼吸暂停改善率方面相似。观察到脑脊液漏（单块术373例患者中69例；Le Fort III 448例患者中15例）（P ≤ 0.001）、癫痫发作（单块术373例手术患者中8例）和脑膜炎（单块术和Le Fort III患者分别为373例中9例和448例中2例）（P = 0.01）。
结论： 总之，本综述表明单块术和Le Fort III手术均能有效实现颌面部前移并矫正颅缝早闭，其中单块术的平均前移量显著更大。未来研究应进一步探讨美学和阻塞性睡眠呼吸暂停结局的比较。
英文摘要
BACKGROUND: Craniosynostosis is a congenital disorder resulting in the early fusion of several bones in the skull, causing a deformity of the head and facial structures. The 2 most commonly performed surgical procedures to treat craniosynostosis include the monobloc and Le Fort III procedures. This literature review compares the functional and anatomical outcomes and complications between the monobloc and Le Fort III procedures for treating craniosynostosis.
METHODS: A PubMed search was conducted to identify studies assessing the outcomes following monobloc and Le Fort procedures. Data on anatomical changes, ophthalmic, airway, and neurological sequelae, as well as miscellaneous infectious or aesthetic complications were extracted from each study.
RESULTS: A total of 63 articles were included for analysis. The average length of midface advancement across distraction and nondistraction procedures was significantly higher in the monobloc cases (14.28 mm; 98.8% of patients with distraction) compared with Le Fort III cases (12.26 mm; 63% of patients with distraction) (P = 0.002). Both procedures exhibited similar rates of obstructive sleep apnea improvement. Cerebrospinal fluid leakage (69 of 373 monobloc patients; 15 of 448 Le Fort III patients) (P ≤ 0.001), seizures (8 of 373 monobloc surgery patients), and meningitis (9 of 373 and 2 of 448, monobloc and Le Fort III patients respectively) (P = 0.01) were observed.
CONCLUSIONS: In summary, this review demonstrates that both the monobloc and Le Fort III procedures are effective in producing maxillofacial advancement and correcting craniosynostosis, with the monobloc procedure demonstrating significantly greater average advancement. Future research should investigate the comparison of aesthetic and obstructive sleep apnea outcomes further.