临床小儿外科杂志2024，Vol.23Issue(2)：119-124,6.DOI:10.3760/cma.j.cn101785-202311041-004
额眶前移手术对额缝早闭患儿额叶容量及社会情绪改善的效果评价
Improvements of frontal lobe volume and social emotions on metopic synostosis with frontal-orbital ad-vancement
摘要
Abstract
Objective To explore the therapeutic efficacy of frontal orbital advancement on improving so-cial-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 As-sessment(ASQ:SE)was utilized for assessing social-emotional well-being.And cranial magnetic resonance ima-ging(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)°and 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)°and fron-tal 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-emotion-al scores 35(30,40)declined below a threshold and normalized.Conclusions For MS children,frontal orbital ad-vancement may significantly boost frontal volume and effectively improve adverse social-emotional outcomes.关键词
颅缝早闭/额缝早闭/外科手术/额眶前移/治疗结果/社会情绪评估/儿童Key words
Craniosynostoses/Metopic Synostosis/Surgical Procedures,Operative/Frontal-orbital Ad-vancement/Treatment Outcome/Social-emotional Assessment/Child引用本文复制引用
李森,詹琪佳,肖波,蒋文彬,魏民,陈欣..额眶前移手术对额缝早闭患儿额叶容量及社会情绪改善的效果评价[J].临床小儿外科杂志,2024,23(2):119-124,6.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)Science & Technology Innovation Action Plan Project of Shanghai Municipal Science &Technology Commission(20Y11905800) （20Y11905800）
