鼻根部楔形截骨治疗单侧冠状缝早闭症鼻畸形  

Management of nasal deformity with unicoronal craniosynostosis using the nasal bones were wedge removed

作　　者：於正福 严俊[1] 高庆文[1] 崔杰[1] 陈建兵[1] 季易[1] 邹继军[1] 陈海妮[1] 沈卫民[1] Yu Zhengfu;Yan Jun;Gao Qingwen;Cui Jie;Chen Jianbing;Ji Yi;Zou Jijun;Chen Haini;Shen Weimin(Department of Burn and Plastic Surgery, Children′s Hospital of Nanjing Medical University, Nanjing 210008, China)

机构地区：[1]南京医科大学附属儿童医院烧伤整形科,210008

出　　处：《中华整形外科杂志》2019年第4期386-389,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨单侧冠状缝早闭症斜头畸形出现的鼻畸形的处理方法。方法2015年1月至2017年1月南京医科大学附属儿童医院烧伤整形科治疗5例单侧冠状缝早闭患儿,男1例,女4例,年龄8~14个月,平均10.4个月。在矫正眶额畸形的同时,于鼻骨上做楔形切除截骨,但不做固定。单侧冠状缝早闭症以半侧额骨带蒂骨瓣进行牵张成骨治疗。结果术后额骨延长28~41 mm,平均35.4 mm,延长结束后行头颅CT三维重建,测得颅顶不对称指数为0.8~1.2,平均0.98,趋于正常。出院后佩戴动态颅支具1年。患儿术后随访8~36个月,平均28个月,所有病例外形和鼻畸形均较术前有所改善。结论采用鼻骨楔形切除、额骨牵张成骨术可以较好地矫正6个月以上单侧冠状缝早闭症患儿的鼻畸形。Objective To investigate the treatment of nasal deformity in patients with unicoronal craniosynostosis. Methods In patients over 6 months old, the nasal bones were wedge-removed without fixation. The management of all patients with unicoronal craniosynostosis was distraction osteogenesis of pedicled unilateral frontal bone flap. Results Postoperative extended distance of the frontal bone was 28-41 mm (mean, 35.4 mm). After extension, three-dimensional reconstruction of cranial CT was carried out, which showed that CVAI was 0.8-1.2 (mean, 0.98), tending to normal. After discharge, dynamic cranial braces were put on for 1 year. Postoperatively, the children were followed up for 8-36 months (mean, 28 months). The shape and nasal deformity of all children were improved compared with those before surgery. Conclusions Nasal wedge resection should be used to correct nasal deformity in children over 6 months with unicoronal craniosynostosis.

关 键 词：单侧冠状缝早闭 鼻畸形 骨生成 牵张 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]