Li Sen,Zhan Qijia,Xiao Bo,et al.Improvements of frontal lobe volume and social emotions on metopic synostosis with frontal-orbital advancement[J].Journal of Clinical Pediatric Surgery,,():119-124.[doi:10.3760/cma.j.cn101785-202311041-004]
Click Copy

Improvements of frontal lobe volume and social emotions on metopic synostosis with frontal-orbital advancement

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: Number: 2024 02 Page: 119-124 Column: 专题·儿童颅缝早闭的诊治 Date of publication: 2024-02-01
Author(s):
Li Sen1;  Zhan Qijia1;  Xiao Bo2;  Jiang Wenbin1;  Wei Min1;  Chen Xin3
1 Department of Pediatric Neurosurgery, Shanghai Children’s Hospital, Shanghai 200062, China;
2 Department of Pediatric Neurosurgery, Shanghai Children’s Medical Center, Shanghai 200333, China;
3 Ward 6A, Shanghai Children’s Hospital, Shanghai 200062, China
Keywords:
Craniosynostoses; Metopic Synostosis; Surgical Procedures;  Operative; Frontal-orbital Advancement; Treatment Outcome; Social-emotional Assessment; Child
DOI:
10.3760/cma.j.cn101785-202311041-004
Abstract:
Objective To explore the therapeutic efficacy of frontal orbital advancement on improving social-emotional abnormalities and frontal lobe volume in children with metopic synostosis (MS).Methods From January 2017 to October 2021,retrospective review was performed for the relevant clinical data of 15 infants of premature closure of frontal suture managed with frontal orbital advancement.At the timepoints of pre-operation,1-year post-operation and during a final postoperative follow-up period of (52±19) month,Social-Emotional Assessment (ASQ:SE) was utilized for assessing social-emotional well-being.And cranial magnetic resonance imaging (MRI) along with 3D Slicer 5.4.0 software was employed for calculating frontal lobe volume,brain volume and frontal angle.Results Frontal orbital advancement was performed.Preoperative measurements of frontal lobe volume were 106.58(103.38,112.35)cm3,brain volume 528.65(496.57,563.36)cm3,frontal angle 91.3(89.6,93.3)?nd frontal lobe/brain volume 20(20,20)%.At 1-year post-operation,frontal lobe volume was 149.64(145.64,168.85)cm3,brain volume 623.71(587.77,651.87)cm3,frontal angle 109.5(106.4,114.6)?nd frontal lobe/brain volume 24(20,30)%.At the final follow-up,frontal lobe volume was 217.18(208.44,238.42)cm3,brain volume 870.62(786.21,961.88)cm3,frontal angle 116.4(113.4,120.7)° and frontal lobe/brain volume 25(20,30)% with statistical significance (P<0.05).At 1-year post-operation,proportion of frontal lobe growth was significant higher than brain growth ［32(30,30)% vs.15(10,20)%,P<0.05］.At the final follow-up,proportion of frontal lobe growth was significant higher than brain growth ［51(50,50)% vs. 39(30,40)%,P<0.05］.Preoperative social-emotional scores of 85(85,95) were significantly higher than normal threshold.However,at 1-year post-operation,social-emotional scores 50(50,55) dropped markedly.At the final follow-up,all social-emotional scores 35(30,40) declined below a threshold and normalized.Conclusions For MS children,frontal orbital advancement may significantly boost frontal volume and effectively improve adverse social-emotional outcomes.

References:

[1] Vergnaud E,Vecchione A,Blanot S,et al.Reducing blood losses and transfusion requirements in craniosynostosis surgery:an endless quest?[J].Anesthesiology,2012,116(3):733-734.DOI:10.1097/ALN.0b013e3182449fc8.
[2] van der Meulen J,van der Hulst R,van Adrichem L,et al.The increase of metopic synostosis:a pan-European observation[J].J Craniofac Surg,2009,20(2):283-286.DOI:10.1097/scs.0b013e31818436be.
[3] Weinzweig J,Kirschner RE,Farley A,et al.Metopic synostosis:defining the temporal sequence of normal suture fusion and differentiating it from synostosis on the basis of computed tomography images[J].Plast Reconstr Surg,2003,112(5):1211-1218.DOI:10.1097/01.PRS.0000080729.28749.A3.
[4] Vu HL,Panchal J,Parker EE,et al.The timing of physiologic closure of the metopic suture:a review of 159 patients using reconstructed 3D CT scans of the craniofacial region[J].J Craniofac Surg,2001,12(6):527-532.DOI:10.1097/00001665-200111000-00005.
[5] Engel M,Thiele OC,Mühling J,et al.Trigonocephaly:results after surgical correction of nonsyndromatic isolated metopic suture synostosis in 54 cases[J].J Craniomaxillofac Surg,2012,40(4):347-353.DOI:10.1016/j.jcms.2011.05.010.
[6] Kelleher MO,Murray DJ,McGillivary A,et al.Behavioral,developmental,and educational problems in children with nonsyndromic trigonocephaly[J].J Neurosurg,2006,105(5 Suppl):382-384.DOI:10.3171/ped.2006.105.5.382.
[7] Sidoti EJJr,Marsh JL,Marty-Grames L,et al.Long-term studies of metopic synostosis:frequency of cognitive impairment and behavioral disturbances[J].Plast Reconstr Surg,1996,97(2):276-281.DOI:10.1097/00006534-199602000-00002.
[8] Kapp-Simon KA,Speltz ML,Cunningham ML,et al.Neurodevelopment of children with single suture craniosynostosis:a review[J].Childs Nerv Syst,2007,23(3):269-281.DOI:10.1007/s00381-006-0251-z.
[9] van der Vlugt JJB,van der Meulen JJNM,Creemers HE,et al.Cognitive and behavioral functioning in 82 patients with trigonocephaly[J].Plast Reconstr Surg,2012,130(4):885-893.DOI:10.1097/PRS.0b013e318262f21f.
[10] Almli CR,Rivkin MJ,McKinstry RC.The NIH MRI study of normal brain development (Objective-2):newborns,infants,toddlers,and preschoolers[J].Neuroimage,2007,35(1):308-325.DOI:10.1016/j.neuroimage.2006.08.058.
[11] 卞晓燕,Squires J,卢红梅,等.年龄与发育进程问卷:社会-情绪(第2版)的中国常模及信度研究[J].中国儿童保健杂志,2021,29(1):23-27,51.DOI:10.11852/zgetbjzz2020-1795.Bian XY,Squires J,Lu HM,et al.Study on the norm and the reliability of the second edition of the ages & stages questionnaires:social-emotional with a Chinese national sample[J].Chin J Child Health Care,2021,29(1):23-27,51.DOI:10.11852/zgetbjzz2020-1795.
[12] Peterson M,Warf BC,Schiff SJ.Normative human brain volume growth[J].J Neurosurg Pediatr,2018,21(5):478-485.DOI:10.3171/2017.10.PEDS17141.
[13] Havlik RJ,Azurin DJ,Bartlett SP,et al.Analysis and treatment of severe trigonocephaly[J].Plast Reconstr Surg,1999,103(2):381-390.DOI:10.1097/00006534-199902000-00004.
[14] Beckett JS,Chadha P,Persing JA,et al.Classification of trigonocephaly in metopic synostosis[J].Plast Reconstr Surg,2012,130(3):442e-447e.DOI:10.1097/PRS.0b013e31825dc244.
[15] Ruiz-Correa S,Starr JR,Lin HJ,et al.New severity indices for quantifying single-suture metopic craniosynostosis[J].Neurosurgery,2008,63(2):318-325.DOI:10.1227/01.NEU.0000316417.06500.DA.
[16] Netherway DJ,Abbott AH,Anderson PJ,et al.Intracranial volume in patients with nonsyndromal craniosynostosis[J].J Neurosurg,2005,103(2 Suppl):137-141.DOI:10.3171/ped.2005.103.2.0137.
[17] Freudlsperger C,Steinmacher S,B?chli H,et al.Metopic synostosis:measuring intracranial volume change following fronto-orbital advancement using three-dimensional photogrammetry[J].J Craniomaxillofac Surg,2015,43(5):593-598.DOI:10.1016/j.jcms.2015.02.017.
[18] Maltese G,Tarnow P,Wikberg E,et al.Intracranial volume before and after surgical treatment for isolated metopic synostosis[J].J Craniofac Surg,2014,25(1):262-266.DOI:10.1097/SCS.0000000000000423.
[19] 颜青,何俊平,高喆,等.评价计算机辅助三维重建下额眶重建术治疗额缝早闭症的早期疗效[J].中华小儿外科杂志,2019,40(10):899-904.DOI:10.3760/cma.j.issn.0253-3006.2019.10.007.Yan Q,He JP,Gao Z,et al.Early clinical efficacy of computer-aided three-dimensional frontal orbital reconstruction for pediatric metopic synostosis[J].Chin J Pediatr Surg,2019,40(10):899-904.DOI:10.3760/cma.j.issn.0253-3006.2019.10.007.
[20] 董留建,齐林.改良额眶前移术对颅缝早闭患儿颅脑生长发育的影响[J].现代诊断与治疗,2020,31(21):3433-3435.Dong LJ,Qi L.Effect of modified fronto-orbital advancement on the growth and development of brain in children with premature closure of cranial suture[J].Mod Diagn Treat,2020,31(21):3433-3435.
[21] 吴水华,梁大中.非综合征性颅缝早闭患儿手术后ASQ-3年龄与发育进程问卷评估结果的相关因素分析[J].临床小儿外科杂志,2023,22(8):762-767.DOI:10.3760/cma.j.cn101785-202304003-012.Wu SH,Liang DZ.Analysis of factors related to ASQ-3 age and developmental process assessment questionnaire in children with nonsyndromic craniosynostosis after surgery[J].J Clin Ped Sur,2023,22(8):762-767.DOI:10.3760/cma.j.cn101785-202304003-012.
[22] 蒋文怡,董晨彬,吴颖,等.颅缝早闭婴幼儿手术治疗前后发育筛查结果分析[J].中华小儿外科杂志,2022,43(10):865-868.DOI:10.3760/cma.j.cn421158-20210918-00453.Jiang WY,Dong CB,Wu Y,et al.Developmental screening results of infants with craniosynostosis before and after operations[J].Chin J Pediatr Surg,2022,43(10):865-868.DOI:10.3760/cma.j.cn421158-20210918-00453.
[23] Kapp-Simon KA,Figueroa A,Jocher CA,et al.Longitudinal assessment of mental development in infants with nonsyndromic craniosynostosis with and without cranial release and reconstruction[J].Plast Reconstr Surg,1993,92(5):831-839.DOI:10.1097/00006534-199392050-00008.

Memo

收稿日期:2023-11-27。
基金项目:上海市科学技术委员会"科技创新行动计划"项目(20Y11905800)
通讯作者:陈欣,Email:chenxin@shchildren.com.cn

Last Update: 1900-01-01