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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La serie que se presenta consta de 45 ni&#241;os operados de plagiocefalia anterior&#46; El estudio preoperatorio incluy&#243; en todos los casos fotograf&#237;as en tres posiciones&#44; Rx&#46; de cr&#225;neo y tomograf&#237;a computarizada &#40;TC&#41;&#46; Se practic&#243; adem&#225;s TC tridimensional &#40;TC tri-D&#41; en 20 ni&#241;os&#46; En 6 casos no fue posible demostrar la existencia de craneosinostosis en el estudio preoperatorio&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La edad media de los ni&#241;os en la primera intervenci&#243;n fue de 14 meses y el tiempo medio de seguimiento postoperatorio fue de 47&#46;5 meses&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se han utilizado tres t&#233;cnicas quir&#250;rgicas diferentes&#58; el adelantamiento cantal lateral &#40;5 casos&#41;&#44; el avance orbitario unilateral con &#8220;ra&#237;l temporal&#8221; &#40;12 casos&#41; y el avance orbitario bilateral &#40;28 ni&#241;os&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los resultados fueron excelentes en 33 pacientes &#40;33&#47;45&#41;&#44; mientras que 8 ni&#241;os necesitaron revisiones quir&#250;rgicas con procedimientos quir&#250;rgicos menores&#46; En relaci&#243;n con las t&#233;cnicas quir&#250;rgicas empleadas&#44; los resultados obtenidos fueron mejores en los casos que se operaron con el avance orbitario bilateral&#46; Por otra parte recomendamos practicar osteotom&#237;as de la pir&#225;mide nasal cuando se trate de ni&#241;os mayores con gran desviaci&#243;n del eje nasal asociada a severa deformaci&#243;n del complejo nasoetmoidal y de la base craneal en el TC&#46;</p>"
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        "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">An operative series of 45 patients with anterior synostotic plagiocephaly is analyzed&#46; In six children it was not posible to elicite synostosis of the cranial sutures on skull x&#46; ray films and three-dimentional CT scan&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Primary procedures were performed at an average age of 14 months with an average postoperative follow-up of 47&#46;5 months&#46; Children were operated either by lateral canthal advancement &#40;5 cases&#41;&#44; unilateral orbital advancement with &#8220;tongue-in-groove&#8221; &#40;12 cases&#41; or bilateral orbital advancement &#40;28 cases&#41;&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Excellent results were obtained in 33 patients &#40;33&#47;45&#41; and eight children required secondary minor revisions&#46; Among the three differents surgical techniques&#44; the results achieved by the bilateral approach were considered better than those with the use of unilateral techniques&#46; Osteotomies of the nasal bones are recommended in older children with a severe nasal desviation associated to dislocation of the nasoetmoidal complex and the skull base showed on CT scan&#46;</p>"
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Vol. 9. Núm. 2.
Páginas 115-122 (enero 1998)
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Vol. 9. Núm. 2.
Páginas 115-122 (enero 1998)
La plagiocefalia anterior de origen craneosinostótico. Diagnóstico diferencial, tratamiento quirúrgico y resultados. Análisis de 45 casos
Anterior synostotic plagiocephaly. Differential diagnosis, surgical treatment and results. An analysis of 45 cases
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4127
J. Esparza, Mª.J. Muñoz, J. Hinojosa, A. Romance, J. Morera
Servicio de Neurocirugía Pedriátrica y Unidad de Cirugía Craneofacial. Hospital Infantil “12 de Octubre”. Madrid
A. Muñoz*, J. Gómez**
* Servicios de Neurorradiología. Hospital Infantil “12 de Octubre”. Madrid
** Servicios de Anestesia. Hospital Infantil “12 de Octubre”. Madrid
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La serie que se presenta consta de 45 niños operados de plagiocefalia anterior. El estudio preoperatorio incluyó en todos los casos fotografías en tres posiciones, Rx. de cráneo y tomografía computarizada (TC). Se practicó además TC tridimensional (TC tri-D) en 20 niños. En 6 casos no fue posible demostrar la existencia de craneosinostosis en el estudio preoperatorio.

La edad media de los niños en la primera intervención fue de 14 meses y el tiempo medio de seguimiento postoperatorio fue de 47.5 meses.

Se han utilizado tres técnicas quirúrgicas diferentes: el adelantamiento cantal lateral (5 casos), el avance orbitario unilateral con “raíl temporal” (12 casos) y el avance orbitario bilateral (28 niños).

Los resultados fueron excelentes en 33 pacientes (33/45), mientras que 8 niños necesitaron revisiones quirúrgicas con procedimientos quirúrgicos menores. En relación con las técnicas quirúrgicas empleadas, los resultados obtenidos fueron mejores en los casos que se operaron con el avance orbitario bilateral. Por otra parte recomendamos practicar osteotomías de la pirámide nasal cuando se trate de niños mayores con gran desviación del eje nasal asociada a severa deformación del complejo nasoetmoidal y de la base craneal en el TC.

Palabras clave:
Craniosinostosis
Plagiocefalia
Sinostosis coronal unilateral
Base craneal
Técnica quirúrgica
Summary

An operative series of 45 patients with anterior synostotic plagiocephaly is analyzed. In six children it was not posible to elicite synostosis of the cranial sutures on skull x. ray films and three-dimentional CT scan.

Primary procedures were performed at an average age of 14 months with an average postoperative follow-up of 47.5 months. Children were operated either by lateral canthal advancement (5 cases), unilateral orbital advancement with “tongue-in-groove” (12 cases) or bilateral orbital advancement (28 cases).

Excellent results were obtained in 33 patients (33/45) and eight children required secondary minor revisions. Among the three differents surgical techniques, the results achieved by the bilateral approach were considered better than those with the use of unilateral techniques. Osteotomies of the nasal bones are recommended in older children with a severe nasal desviation associated to dislocation of the nasoetmoidal complex and the skull base showed on CT scan.

Key words:
Craniosynostosis
Plagiocephaly
Unilateral coronal synostosis
Skull base
Surgical technique

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