Sagital Kraniosinostoz Tanılı Bebeklerde Endoskopik Süturektomi Sonrası Kask Tedavisinin Uzun Süreli Takibi

Amaç: Sagital kraniosinostozlu bebekler endoskopik süturektomi ve kranial kasklar ile tedavi edilir. Kullanılan bu kaskların uzun vadeli etkileri ve kask tedavisinin tamamlanmasından sonra ortaya çıkan etkiler henüz araştırılmamıştır. Bu çalışmanın amacı, kranial kaskın uzun vadeli etkilerini ve kask tedavisinin tamamlanmasından sonra ortaya çıkan etkileri araştırmaktır. Gereç ve Yöntemler: Çalışmaya 14 bebek dahil edildi. Bebekler ameliyat sonrası, kaskın yeniden şekillendirilmesinin tamamlanmasından sonra ve 6 aylık takipte bir 3D lazer sistemi kullanılarak değerlendirildi. Anterior-posterior(AP), medio-lateral (ML) kranial ölçümler, kranial çevre(KÇ), diyagonal ölçümler, sefalik oran(SO) ve kranial kubbe asimetri indeksi(KKAI) değerlendirildi. Bulgular: Bebekler 35±3.4 hafta boyunca yeniden şekillendirme kaskı kullandılar. Ameliyat sonrası ve tamamlama sonuçları incelendiğinde, kranial kask kullanımı sırasında, AP, ML, KÇ ölçümlerinin, SO ve KKAI’nin istatistiksel olarak iyileştiği ve bunun sonucunda kafa şeklinin normalleştiği görülmektedir (p<0.05). Takip sonuçları incelendiğinde kranial şekil simetrisinde bozulma olmadığı ve bebeklerin kraniumlarında simetrinin büyüme devam ederken AP, ML, KÇ ölçümleri ile SO ve KKAI’nin korunduğu (p>0.05) görülmektedir. Sonuç: Bu çalışma, kranial kask tedavisi tamamlandığında, kranial gelişimin normal oranlarda devam ettiğini göstermektedir. Uzun vadede kranial simetride herhangi bir bozulma olmadığı ve kranial kask tedavisi tamamlandıktan sonra tedavinin etkinliğinin devam ettiğini ortaya koymaktadır. Anahtar Sözcükler: Bebek, Çocuk gelişimi, Endoskopi, Kraniosinostoz, Ortez Cihazları

Anahtar Kelimeler:

Bebek, Çocuk gelişimi, Endoskopi, Kraniosinostoz, Ortez Cihazları

The Long Term Follow Up of Helmet Therapy Following Endoscopic Suturectomy For Infants with Sagittal Craniosynostosis

Objective: Infants with sagittal craniosynostosis are treated with endoscopic suturectomy and remodeling helmets. The long term effects and the effects that occur after the completion of remodeling helmet treatment have not been investigated. The purpose of this study is to investigate the long term effects of remodeling helmet and effects that occur after the completion of remodeling helmet treatment. Material and Methods: 14 infants were included in the study. The children were assessed post-op, after the completion of remodeling helmet and at 6 months’ follow-up using a 3D laser acquisition system. The anterior-posterior(AP), medio-lateral(ML) cranial measurements, cranial circumference(CC), diagonal measurements, cephalic ratio(CR) and cranial vault asymmetry index(CVAI) were assessed. Results: The infants used the remodeling helmet for 35±3.4 weeks. When the post-op and completion results are examined, it can be seen that during remodeling helmet usage duration, AP, ML, CC measurements, the CR and CVAI have statistically improved, resulting in normalization of cranial shape (p<0.05). When the follow up results are examined, it can be seen that there was no deterioration in the symmetry of the cranial shape and the AP, ML, CC measurements and the CR and CVAI were preserved (p>0.05) whilst the infants’ craniums continued to grow at a normal rate. Conclusion: The present study shows that when remodeling helmet therapy is completed, cranial development continues at normal rates. There is no deterioration in cranial symmetry in the long term, and the effectiveness of the treatment continues after the remodeling helmet therapy is completed.

Keywords:

Child development, Craniosynostoses, Endoscopy, Infant, Orthotic Devices,

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