综合征性颅缝早闭中早期面中部牵引的经面骨钉引导置入：一项回顾性队列研究
Guided insertion of transfacial pin for early midface distraction in syndromic craniosynostosis: a retrospective cohort study.
文献信息
| PMID | 42925786 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Naveen Kumar Jayakumar |
| 作者单位 | Department of Oral and Maxillofacial Surgery, Cleft and Craniofacial Center of Excellence, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India; Pediatric Craniomaxillofacial Surgery, Kanchi Kamakoti Childs Trust Hospital, Nungambakkam, Chennai, India. Electronic address: naveenkumarj@sriramachandra.edu.in. |
| 期刊 | Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery |
| SCI 分区 | Q2 |
| IF | 2.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 综合征性颅缝早闭表现为包括颅底在内的多条颅骨缝过早融合。这可能导致严重的面中部后缩、眼球突出、阻塞性睡眠呼吸暂停和颅内压（ICP）升高。早期行额眶前移或后颅穹窿牵引以降低ICP，而面中部则较晚处理以确保稳定性并减少干预频率。严重的气道和眼部并发症需要早期面中部前移，最好采用牵引。本研究旨在评估在年轻个体中使用引导式经面骨钉固定（GTP）进行早期面中部牵引（EMD）的结局和安全性。方法：对2014年至2024年间由单一外科医生实施的所有经面骨钉固定的面中部牵引手术进行回顾性队列研究。回顾的数据包括人口学资料、骨钉置入所需尝试次数、骨钉置入准确性、与预期路径的偏差、牵引幅度、涉及气道和眼球位置的功能结局以及并发症。结果：14例患者接受了经面骨钉固定的面中部牵引，其中6例使用了3D打印导板。平均年龄为4.3岁。所有患者均有显著的阻塞性睡眠呼吸暂停和眼球突出。无论是否使用导板，C臂X线摄影均作为标准监测辅助手段。12例患者在面中部前移之前已接受过额眶前移。我们在1例患者中遇到涉及经面骨钉的轻微术中并发症。结论：在不使用机器人辅助的中心，使用3D打印导板似乎是置入经面骨钉的一种安全有效的方法。
英文摘要
Syndromic craniosynostosis presents with premature fusion of multiple calvarial sutures including the skull base. This could result in severe mid-face retrusion, exorbitism, obstructive sleep apnea and elevated intracranial pressure (ICP). Fronto-orbital advancement or posterior calvarial vault distraction is performed early to reduce ICP, while the midface is handled later to ensure stability and reduce the frequency of interventions. Severe airway and ocular complications necessitate early midface advancement preferably using distraction. This study aims to assess outcomes and safety of early midface distraction (EMD) using guided transfacial pin fixation (GTP) in young individuals. A retrospective cohort study was conducted of all transfacial pin fixated midface distraction surgeries performed by a single surgeon between 2014 and 2024. Data reviewed included demographics, attempts required for pin insertion, accuracy of pin insertion, deviation from desired path, magnitude of distraction, functional outcome involving airway, globe position and complications. Fourteen patients underwent transfacial pin fixated midface distraction of which 6 involved use of 3D printed guides. The mean age was 4.3 years. All patients had significant obstructive sleep apnea and exorbitism. C-arm radiography was used as a standard monitoring aid irrespective of the use of guides. Twelve patients had undergone fronto-orbital advancement prior to midface advancement. We encountered minor intra-operative complication involving transfacial pin in 1 patient. Use of 3D printed guide appears to be safe and effective method for insertion of transfacial pins in centers which do not employ robotic assistance.