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目的:探讨应用双侧额眶重塑联合颅盖切开松解术治疗单侧冠状缝早闭的效果。方法:2014年4月至2019年5月，上海交通大学医学院附属上海儿童医学中心采用双侧额眶重塑联合颅盖切开松解术治疗20例单侧冠状缝早闭患儿。其中，男8例，女12例；平均手术年龄为10. 5个月，范围为5~23个月；左侧冠状缝早闭8例，右侧冠状缝早闭12例。患儿头颅外观均表现为不同程度的患侧前额及眼眶内陷，眼眶上抬，同时患侧枕部也内陷，整个颅腔小于健侧。分别测量术前、术后1周、末次随访时的前颅顶不对称指数（anterior cranial vault asymmetry index，ACVAI）和颅腔容积进行手术疗效评估。在颅腔容积的比较上，将本研究的20例患儿作为颅缝早闭组，将报道测量的不同年龄正常儿童的颅腔容积数据作为正常对照组。结果:颅缝早闭组患儿术后颅面外观均获得满意效果，无手术死亡病例，无骨瓣坏死、骨瓣移位、脑脊液漏、组织过敏等严重并发症。平均随访时间为19. 9个月，范围为12~40个月。颅缝早闭组患儿术前ACVAI值为（9. 07±3. 55）%，术后1周ACVAI值为（3. 56±3. 42）%，末次随访时为（3. 13±2. 41）%，术后1周较术前明显减小，差异具有统计学意义（n t=4.83，n P<0. 001 ），末次随访时与术后1周相比，差异无统计学意义（n t=0. 66，n P=0. 517）。术前，颅缝早闭组颅腔容积为（1 027.85±112. 25) ml，正常对照组为（1 131. 92±161. 71) ml，颅缝早闭组颅腔容积明显减小，差异具有统计学意义（n t=2. 36，n P＝0. 023）；颅缝早闭组术后1周的颅腔容积为（1 081. 62± 111. 10) ml，较术前明显增加，差异具有统计学意义（n t=8.70，n P<0. 001）；末次随访时为（1 386. 90± 119. 30) ml，正常对照组为（1 438.22±89.28) ml，两组间的差异无统计学意义（n t=1. 54，n P=0. 132）。n 结论:运用双侧额眶重塑联合颅盖切开松解术治疗单侧冠状缝早闭，可获得很好的颅腔容积扩增，随访时接近正常儿童，头颅畸形恢复较好，手术效果良好。“,”Objective:To assess the efficacy of bilateral frontal-orbital reconstruction plus craniotomy for unilateral coronal synostosis.Methods:From April 2014 to May 2019, 20 children with unilateral premature coronal suture closure underwent frontal orbital remodeling plus craniotomy and release. There were 8 boys and 12 girls with an average operative age of 10. 5 (5-23) months. There were premature closure of left coronal suture (n=8) and premature closure of right coronal suture (n=12). Skull appearance showed different degrees of forehead & orbital retraction, orbital elevation and occipital retraction and entire cranial cavity was smaller than unaffected side. Anterior cranialvault asymmetry index (ACVAI) and cranial cavity volume were measured pre-operatively, 1 week postoperatively and during follow-ups for assessing surgical outcomes. Twenty children were selected as craniosynostosis group and cranial cavity volumes of normal children of different ages as normal control group.Results:Postoperative skull surface appearance was satisfactory in skull suture early closure group without operative death, bone flap necrosis, bone flap displacement, cerebrospinal fluid leakage, tissue allergy or other serious complications. The average follow-up period was 19. 9 (12-40) months. In craniosynostosis group, preoperative ACVAI was (9. 07±3. 55) % , postoperative 1-week ACVAI (3. 56±3. 42) % and follow-up time (3. 13±2. 41) %. Postoperative 1-week ACVAI was significantly smaller than that the pre-operation and the difference had statistical significance (n t=4. 83, n P<0. 001) . The difference between follow-up time and postoperative 1-week ACVAI showed no statistical significance (n t=0. 66, n P= 0. 517) . At pre-operation, cranial cavity volume was (1 027. 85±112. 25) ml in craniosynostosis group and (1 131. 92±161. 71) ml in normal control group. Cranial cavity volume decreased markedly in craniosynostosis group and the difference had statistical significance (n t=2. 36, n P=0. 023) ; cranial cavity volume at 1 week post-operation was (1 081.62±111. 10) ml in craniosynostosis group and there was a marked increase. And the difference had statistical significance (n t=8.70, n P<0. 001) ; during follow-ups, it was (1 386. 90±119. 30) ml and (1 438. 22±89. 28) ml in normal control group and inter-group difference showed no statistical significance (n t=1. 54, n P=0. 132) .n Conclusions:Unilateral coronal synostosis may be successfully managed by bilateral fronto-orbital remodeling plus craniotomy. With an excellent postoperative recovery of skull deformity, enlarged intracranial volume and normal follow-ups, the surgical outcome is satisfactory.