Zhang Jinwei,Wu Shuihua,Su Jun,et al.Efficacy of simple posterior parieto-occipital osteotomy and remodeling for children with premature closure of cranial suture plus Chiari malformation type Ⅰ[J].Journal of Clinical Pediatric Surgery,2025,(04):368-371.[doi:10.3760/cma.j.cn101785-202312039-012]
单纯后顶枕截骨重塑术在颅缝早闭合并Chiari畸形Ⅰ型患儿治疗中的应用
- Title:
- Efficacy of simple posterior parieto-occipital osteotomy and remodeling for children with premature closure of cranial suture plus Chiari malformation type Ⅰ
- Keywords:
- Craniosynostoses; Arnold-Chiari Malformation; Surgical Procedures; Operative; Osteotomy; Parietal Bone; Osteotomy; Occipital Bone; Treatment Outcome; Child
- 摘要:
- 目的 目前颅缝早闭合并Chiari畸形Ⅰ型 (Chiari malformation type Ⅰ,CM-Ⅰ) 的最佳治疗方式尚未明确,本文旨在初步探讨单纯后顶枕截骨重塑术治疗颅缝早闭合并CM-Ⅰ的临床疗效。方法 回顾性分析2016年1月至2023年12月在中南大学湘雅医学院附属儿童医院(湖南省儿童医院)行单纯后顶枕截骨重塑术的29例颅缝早闭合并CM-Ⅰ患儿临床资料,收集并分析患儿基本情况、诊断、影像学检查结果、术中情况以及临床随访情况。结果 29例中,男11例、女18例,接受手术时平均年龄31.5个月(3~60个月),平均随访时间3.4年(8个月至4年)。均行单纯后顶枕截骨重塑术,其中27例在行单纯后顶枕截骨重塑术后未再出现Chiari畸形进展以及相关临床症状,无一例发生并发症,2例因Chiari畸形进展而于后期行枕骨大孔减压术。结论 单纯后顶枕截骨重塑术治疗颅缝早闭合并CM-Ⅰ患儿安全有效,且能防止Chiari畸形进展。
- Abstract:
- Objective To explore the optimal treatment for premature closure of cranial suture plus Chiari malformation type Ⅰ (CM-Ⅰ) and examine the clinical efficacy of simple posterior parieto-occipital osteotomy and remodeling for premature closure of cranial suture plus CM-Ⅰ.Methods From January 2016 to December 2023,the relevant clinical data were retrospectively reviewed for 29 children with premature closure of cranial suture and CM-Ⅰundergoing simple posterior parieto-occipital osteotomy and remodeling.Results There were 11 boys and 18 girls with a mean operative age of 31.5(3-60) month.Basic profiles,diagnoses,imaging studies,intraoperative findings and clinical follow-ups were recorded during a mean follow-up period of 3.4 years (8 months to 4 years).Twenty-seven cases had no Chiari deformity progression or related clinical symptoms after surgery while two cases underwent reduction of greater occipital foramen at a later stage due to a progression of Chiari deformity.Conclusions Simple posterior parieto-occipital osteotomy and remodeling are efficacious for children with premature closure of cranial suture and CM-Ⅰ.It may prevent the progression of Chiari deformity.
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备注/Memo
收稿日期:2023-12-17。
基金项目:湖南省中医药科研课题(C2024022)
通讯作者:吴水华,Email:292454021@qq.com