摘要目的 用三维数字化技术对颅缝早闭症的颅底畸形程度定量化分析,通过长期随访探讨改良额眶前移术治疗效果.方法 选取2010年1月至2016年2月就诊的10例颅缝早闭症患儿,年龄1.0～6.5岁,平均随访时间23.6个月(12～48个月),均采用改良额眶前移术;进行术前及随访时颅底形态学测量.结果 术前患侧颅前窝测量指标(CSX(-)、CX、SX)以及颅中窝测量指标(XSM(-)、S-Pt、XM、SM)均较健侧好转,差异有统计学意义(P＜0.05);双侧颅后窝测量指标(MSO(-),MO)差异无统计学意义(P＞0.05).经过改良的额眶前移术后长期随访发现,颅前窝及颅后窝对称率较术前得到明显改善,随访时前颅对称指数及颅前窝偏斜角较术前差异有统计学意义(P＜0.05).结论 颅底存在偏斜不对称畸形患儿,经过改良额眶前移术后,长期随访结果显示,颅前窝及颅中窝偏斜畸形得到缓解,额颞部畸形得到有效改善.

abstractsObjective To investigate the deformity of cranial base in patients with craniosynostosis and to evaluate the effect of modified fronto-orbital advancement (FOA) for craniosynostosis using three-dimensional digital technology.Methods From January 2010 to December 2016,10 cases of craniosynostosis were included in the study.All patients underwent modified FOA,we quantitatively analysed the pre-operative deformity and the surgical outcome of FOA performed in ten patients with craniosynostosis.The measurements of skull base were performed based on 3D computed tomography (CT) scan.We assessed the symmetry of skull base and the deflection of anterior cranial fossa.Results The mean patients' age at FOAs was 3.2 years.A significant asymmetry of skull base was found in all patients.The growth of anterior and middle fossae was restricted.On the follow-up CT images 23.6 months after surgery,there was prominent change (P＜0.05) between the two hemibases (CSO(-)ratio) and between the lengths and angles of anterior and middle cranial hemi-fossae (CX,CSX(-),XSM(-) ratio).Anterior cranial vault asymmetry index obviously decreased from 12.4％ to 1.05％ before surgery (P＜0.05).In addition,anterior cranial vault deflection angle proved to also be less after surgical correction (20.33°±9.19° versus 13.13°±5.28°,P＜0.05).Conclusions The asymmetry of skull base can be presented by intracranial view at over 1 year of age.FOA can correct the skeletal malformation of frontotemporal region and the asymmetry of skull base is improved after surgical treatment.