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BACKGROUND: The correction of severe blepharoptosis is one of the most challenging surgeries in plastic surgery. This study introduces a novel self-reinforced fixation technique combining the levator complex with conjoint fascial sheath for the correction of severe blepharoptosis and reviews the postoperative results over the preceding 12 years. METHODS: This retrospective review included all patients who underwent self-reinforced fixation with or without conjoint fascial sheath at the authors' center between 2010 and 2022. The clinical data of the two groups were collected and evaluated. RESULTS: All patients were followed up for 6 months to 8 years postoperatively. The mean postoperative MRD1 and LF increased significantly in both groups. Sufficient correction of ptosis was achieved in 32 (65.31%) and 84 (81.56%) eyelids in Groups I and II, respectively. The mean eyelid lagophthalmos was 1.27± 0.91 mm and 0.85 ± 0.89 mm in Groups I and II, respectively. The most common complication was undercorrection of ptosis, which was observed in 14 eyelids (28.57%) and 15 eyelids (14.56%) in Groups I and II, respectively. CONCLUSIONS: The self-reinforced fixation technique was effective in correcting severe congenital ptosis in Chinese patients. The clinical effect was consistent in the long-term follow-up cases, and the recurrence rate was low. Thus, this technique can enhance the strength of the levator muscle and maintain appropriate elasticity of eye closure. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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Cartilage defects are one of the hardest injures to cure, given the limited regenerative ability of cartilage tissues. Moreover, cartilage defects affect an increasing number of people worldwide. Therefore, scientists have attempted to develop effective strategies to repair cartilage defects in recent years. Recent advances in tissue engineering have led to the strategies for inducing cartilage regeneration. Among the emerging strategies, scaffolds are commonly used in cartilage tissue engineering (CTE) as they provide favorable environment for the growth and proliferation of chondrocytes. An ideal scaffolding material should be highly biocompatible. Type I collagen is one such material, which is widely used in CTE. However, type I collagen has poor mechanical properties and stability, which limit its use. Cross-linking is a simple method known to improve degradability, biological and mechanical properties of biomaterials by enhancing chemical and physical interactions between polymers. Cross-linking can be induced through chemical, physical or biological processes. In this review, we present cross-linking methods that can enhance the mechanical strength of type I collagen for CTE and highlight future directions in this field.
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The facial nerve decompression via mastoid is simple and easy to expose the vertical segment of the facial nerve (VFN). The objective of this study was to find out the relationship between the VFN and anatomic landmarks to facilitate prediction of the location of VFN during facial nerve decompression. The different landmarks were cochlear window (CW), oval window (OW), promontorium tympani (PT), and mastoid antrum (MA). Parameters of 140 patients (280 observations) with healthy middle ears were measured on high-resolution spiral multislice computed tomographic multiplanar reconstruction (MPR) images that were parallel to the base plane. The data gained were analyzed by statistical method and were also analyzed with respect to side and gender. The angle between orientation of VFN to the CW of the longest distance and horizontal axis was larger on the left side than that of the right (P < 0.05). Our results may provide more detailed information to predict the location of VFN during facial nerve decompression through mastoid.