RESUMO
Apert Syndrome, also called acrocephalosyndactylia type 1, is characterized by craniostenosis with early fusion of sutures of the vault and/or cranial base, associated to mid-face hypoplasia, symmetric syndactylia of the hands and feet and other systemic malformations. CNS malformations and intracranial hypertension are frequently observed in these patients. Early surgical treatment aims to minimize the deleterious effects of intracranial hypertension. Fronto-orbital advancement, the usual surgical technique, increases the intracranial Volume and improves the disposition of encephalic structures previously deformed by a short skull. This study analyzes CNS alterations revealed by magnetic resonance in 18 patients presenting Apert Syndrome, and the conformational alterations in the encephalic structures after surgical treatment. The patients' age in February 2001 ranged from 14 to 322 Months (m=107). Image study included brain magnetic resonance showing ventricular enlargement in five cases (27.8%), corpus callosum hypoplasia in five cases (27.8%), septum pellucidum hypoplasia in five cases (27.8%), cavum vergae in two cases (11.1%) and, arachnoid cyst in the posterior fossa in two cases (11.1%). Absence of CNS alterations was noted in 44.4% of cases. A corpus callosum morphologic index was established by dividing its height by its length, which revealed values that ranged from 0.4409 to 1.0237. The values of this index were correlated to the occurrence or absence of surgical treatment (p=0.012; t=2.83). Data analysis allowed the conclusion that the corpus callosum morphologic measure quantified the conformational alterations of the cerebral structures determined by the surgical treatment.
Assuntos
Acrocefalossindactilia/complicações , Acrocefalossindactilia/cirurgia , Adolescente , Adulto , Encefalopatias/complicações , Encefalopatias/cirurgia , Sistema Nervoso Central/anormalidades , Sistema Nervoso Central/diagnóstico por imagem , Criança , Pré-Escolar , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Conformação Molecular , Radiografia , Resultado do TratamentoRESUMO
This case required anteroposterior traction of the maxilla. Once none of the traditional methods could be used because of the lack of support in the chin and in the frontal region. Thus, we opted to use a cervical collar.
Assuntos
Maxila/lesões , Traumatismos Maxilofaciais/cirurgia , Tração/instrumentação , Adulto , Desenho de Equipamento , Humanos , Imobilização , Masculino , PescoçoRESUMO
We present our clinical experience in cranioplasty with autograft as follows: conchal cartilage for losses up to 2 cm2, outer table grafts for defects up to 100 cm2, and, for larger defects still, split rib grafts, which may be combined with outer table grafts. We conclude that autograft is superior to alloplastic material in cranioplasty.
