<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0376-7892</journal-id>
<journal-title><![CDATA[Cirugía Plástica Ibero-Latinoamericana]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. plást. iberolatinoam.]]></abbrev-journal-title>
<issn>0376-7892</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0376-78922019000200008</article-id>
<article-id pub-id-type="doi">10.4321/s0376-789220190002000008</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Abordaje quirúrgico temprano de la trigonocefalia]]></article-title>
<article-title xml:lang="en"><![CDATA[Early quirurgic management of trigonocephaly]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Andrade Delgado]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gordillo Domínguez]]></surname>
<given-names><![CDATA[Luis Felipe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="Aa"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortiz-Monasterio Todd]]></surname>
<given-names><![CDATA[Iván]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Contreras Mérida]]></surname>
<given-names><![CDATA[Sara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gevara Valmaña]]></surname>
<given-names><![CDATA[Osvaldo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Andrade Delgado]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Prada Madrid]]></surname>
<given-names><![CDATA[José Rolando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="Aa "/>
<xref ref-type="aff" rid="Af5"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General Dr Manuel Gea González División de Cirugía Plástica y Reconstructiva ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Infantil de México Federico Gómez  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="A2a">
<institution><![CDATA[,Hospital Médica Sur  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital General Dr Manuel Gea González  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital General Dr Manuel Gea González Servicio de Cirugía Plástica ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Fundación Universitaria de Ciencias de la Salud  ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="A5a">
<institution><![CDATA[,Hospital Infantil Universitario de San José  ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="A5b">
<institution><![CDATA[,Fundación Santa Fe  ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="A5c">
<institution><![CDATA[,Federación Ibero Latinoamericana de Cirugía Plástica  ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<volume>45</volume>
<numero>2</numero>
<fpage>159</fpage>
<lpage>168</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0376-78922019000200008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0376-78922019000200008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0376-78922019000200008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción y Objetivo La trigonocefalia, originada por la sinostosis prematura de la sutura metópica, en sus formas más graves presenta mayor restricción del crecimiento lateral de los huesos frontales y temporales, afectando a los rebordes supraorbitarios, limitando el crecimiento y condicionando un hipoteleorbitisimo aparente. Los principales problemas de las técnicas quirúrgicas empleadas para su tratamiento son: falta de corrección del defecto, vaciamiento temporal, daño de suturas no afectadas al hacer transposiciones que producen defectos de crecimiento (sinostosis secundarias), sobrecorrección del hipoteleorbitisimo y defectos óseos. El objetivo de este trabajo es presentar nuestra experiencia en una serie de casos tratados de forma temprana con modificaciones propias a las técnicas abiertas propuestas por Dhellemmes en Francia.  Material y método Entre 2010 y 2018 operamos 7 pacientes con trigonocefalia no sindrómica severa, con una media de 7 meses de edad. Todos fueron estudiados con tomografía computerizada de cráneo con reconstrucción ósea en tres dimensiones (TCC-3D) preoperatoria, postoperatoria inmediata y al año de evolución, electroencefalograma, valoración del neurodesarrollo y por Pediatría y Oftalmología. Resecamos la sutura metópica estenosada y efectuamos craneotomías frontales en forma de alas de escarabajo respetando la sutura coronal. Remodelamos la barra frontoorbitaria con injerto óseo para corregir la angulación y la fijamos con un injerto de hueso. Finalmente practicamos osteotomías radiadas en parietal para modificar la restricción del crecimiento de la bóveda.  Resultados Los resultados funcionales y estéticos fueron excelentes, sin defectos de osificación ni vacío de la fosa temporal, ni morbimortalidad, con cicatriz oculta por el cabello. El desarrollo neurocognitivo de los niños tuvo una mejoría notable de la irritabilidad y de la actividad e interacción con los padres.  Conclusiones En trigonocefalia, la cirugía temprana logra la corrección total del defecto en un solo tiempo quirúrgico, obteniendo una remodelación ósea y un crecimiento armónico del cráneo al respetar el crecimiento del sistema suturario. Las modificaciones a la técnica que proponemos evitan el defecto de vaciamiento temporal y permiten no utilizar material de osteosíntesis.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background and objective The premature synostosis of the metopic suture in the most severe forms occurs with a restriction of the lateral growth of frontal and temporal bones, affecting the supraorbital rims, which limits its growth and leads to hypoteleorbitism. The triangular shape of the forehead is accentuated by the compensatory growth of the other structures of the skull. The main problem of the handling techniques are: temporal emptying, lack of defect correction, damage of unaffected sutures while making transpositions that will later produce defects in growth and cranial molding. Our aim is to show our surgical experience operated with the variations of the open technique that was conceived by Dhellemmes in France.  Methods Between 2010 and 2018 we operated 7 patients with trigonocephaly; patients´ average age was 7 months. They were studied with presurgical and post operatory CBT-3D, electroencephalograms, neurodevelopmental assessment and by Pediatry and Ophthalmology. Stenosed metopic suture was resected and frontal craniotomies shaped like beetle wings were performed out without drying the coronal suture, securing them to the fronto-orbital bar with a discreet progress of the side edges. The medial osteotomy of the orbital toolbar was used to reshape it and correct its angulation fixing it with a bone graft and radiated parietal osteotomy to modify the restriction of frontoparietal growth.  Results Functional and aesthetic results were excellent, without ossification defects or vacuum the temporal fossa, morbidity or mortality, with the scar hidden by hair. Children&#8217;s neuropsychological development had a noticeable improvement in irritability, activity and interaction with their rents.  Conclusions In trigonocephaly, early surgery achieves total defect correction in a single procedure and a bone remodeling and harmonic skull growth by respecting the sutures system. Our modifications to the technique avoid the temporary emptying defect and don´t use osteosynthesis material.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Trigonocefalia]]></kwd>
<kwd lng="es"><![CDATA[Craneosinostosis]]></kwd>
<kwd lng="es"><![CDATA[Cirugia Craneofacial]]></kwd>
<kwd lng="en"><![CDATA[Trigonocephaly]]></kwd>
<kwd lng="en"><![CDATA[Craneosynostosis]]></kwd>
<kwd lng="en"><![CDATA[Craneofacial surgery]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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