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Objective:To evaluate the aesthetic outcome of the pretarsal orbicularis-tarsus fixation technique in incisional double eyelid blepharoplasty.Methods:Postoperative results were evaluated from 798 patients who underwent the orbicularis-tarsus fixation blepharoplasty from January 2015 to December 2018. Based on an incisional maneuver, soft tissue was carefully removed to expose the superior edge of tarsus, then the pretarsal orbicularis oculi muscle was anchored on the tarsus. For skin closure, both skin margins, a small bite of subcutaneous tissue and the pretarsal fascia were interruptedly sutured to enhance cicatricial adhesion.Results:All patients successfully underwent double eyelidplasty using this modified technique. The follow-up period ranged from two to forty-six months, with a mean period of twenty months. Ninety-six percent of the patients were satisfied with postoperative outcomes. Twenty-two cases of palpebral fold asymmetry and ten cases of unsatisfactory fold formation near the inner canthus were encountered. However, all the defects had been well improved by minor revisions. No supratarsal crease drooping or disappearing, suture spitting out, scar hypertrophy or crease depression were observed postoperatively.Conclusions:The orbicularis-tarsus fixation method is a reliable technique for double eyelid plasty. It enables high feasibility and long-lasting result, with lower risk of postoperative complications.
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Birth defects is one of the most important problems of human society. External birth defect is one of the major research fields of plastic surgery. This kind of disorders damages the body image of patients in mild or severe way, affects severely the social confidence of the patients themselves and their families. we summarized the research progress of the common external birth defects (the incidence top 10) from the aspects of pathogenesis, prevention, treatments and so on, in order to provide reference materials to the prevention and treatment of them.
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Objective@#This study is to investigate the outcome of unilateral cleft lip repairment using trilobate flap and nasal-labial muscle tension system reconstruction.@*Methods@#From January 2015 to December 2017, 264 children with unilateral cleft lip were performed cheiloplasty. For all the patients, trilobate flap was adopted. The tension lines group among nasal-labial muscles were reconstructed following a three-dimensional pattern. Long-term results were evaluated using postoperative photos. Three measurements were collected, to compare the nasolabial contour on the cleft side and noncleft side.@*Results@#Six to 12 months follow-up was completed in 112 patients. Asymmetry percentage of lip height was (2.98±1.65)%, while nostril width ratio was 1.02±0.05, and nostril height ratio was 0.94±0.04. Aesthetic contour of vermillion and philtrum were satisfied.@*Conclusions@#Trilobate flap technique combined with the reconstruction of nasal-labial muscle tension system have reliable effect on unilateral cleft lip repair. With proper application, satisfactory and stable outcomes can be achieved.
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Eyes play a dominating role in the facial aesthetics. In the past decades, East Asian consider the westernized stereoscopic and double eyelid eyes as beautiful, as a result, double-eyelid blepharoplasty become the most commonly performed aesthetic plastic surgery continuing to gain popularity in East Asian. The authors summarized the important progress and innovative conclusion on upper eyelid anatomy, preoperative evaluation, double-eyelid blepharoplasty for Asian males as well as objective outcome assessment of double eyelid surgery in recent 10 years, which we hope could pave the way for surgeons to better understand, investigate and modify double eyelid surgery along with better serve the patients.
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To observe and analyze the therapeutic effect of systemic administration of methotrexate on caesarean section scar pregnancy. The 160 patients who had been confirmed with caesarean section scar pregnancy in our hospital were
selected research objects. They were randomly divided into two groups [research group and control group], each containing 80 patients. The research group was subjected to systemic administration of methotrexate, while control
group was applied with local administration of methotrexate. The total treatment effective rates of two groups were observed and compared. The total treatment effective rate of research group was higher than that of control group,
p<0.05; in terms of time required for â-HCG restoring to normal state, the research group was significantly shorter than control group, p<0.05; the time required for disappearing of scar lump for research group was shorter than that of
control group, p<0.05. No complications were observed for both groups. Systemic administration of methotrexate can significantly improve the curative effect for patients with caesarean section scar pregnancy
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Objective@#This study is to repair nostril sill deformity in the cleft lip patients by reconstructing the first auxiliary muscle tension line group and to assess the therapeutic outcome.@*Methods@#437 cleft lip patients with nostril sill deformity underwent the surgery from January 1, 2012 to November 1, 2016.They were treated using the technique of first auxiliary muscle tension line group reconstruction to repair the deformity. Aesthetic correction evaluations were rated by the GAIS. Random digit was used to randomly select 24 patients during the follow-up for three-dimensional measurement and analysis. The preoperative and postoperative symmetry of the nostril sills were evaluated by paired t test.@*Results@#Mucosal ischemia or wound infection occurred in 11 cases, left obvious scar on the nostril floor. Surgical incisions of the other patients were primary healing. After 6 months to 3 years follow up, GAIS questionnaires of 378 patients demonstrated that 84% patients reported great or moderate improvement of nostril sills. Three-dimensional measurements of 24 patients suggested that there were no significant differences of the nostril sill and the nasal ala between the cleft side and the normal side.@*Conclusions@#First auxiliary tension line group reconstruction, which is to restore biomechanical balance rather than merely increase muscle volume, is an effective method of nostril sill repair in the cleft lip patients. Post-operatively, the patients achieved a stable and natural nostril sill, a middle columella, as well as a narrowed nasal ala.
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Objective@#Explore the method for volumetric measurement of alveolar bone defect.@*Methods@#This study applied 2 advanced preoperative volume measurement methods: three-dimensional (3D) printing and computer-aided engineering (CAE). Twenty-six unilateral alveolar cleft patients were enrolled in this study from April 2015 to December 2016. Their computed tomographic data were sent to 3D printing and CAE software. A simulated graft was used on the 3D-printed model, and the graft volume was measured by water displacement. The volume calculated by CAE software used mirror-reverses technique.@*Results@#The volume of alveolar bone defect could be detected by both methods. The average volume of the simulated bone grafts by 3D-printed models was 1.61 ml, a little higher than the mean volume of 1.60 ml calculated by CAE software. The difference between the 2 volumes was from -0.34 ml to 0.54 ml. The paired Student t test showed no statistically significant difference between the volumes derived from the 2 methods.@*Conclusions@#This study demonstrated that the volume of alveolar bone defect is about 1.6ml in unilateral alveolar cleft patients aged 9-12 years. The mirror-reversed technique by CAE software is as accurate as the simulated operation on 3D-printed models. These findings further validate the use of 3D printing and CAE technique in alveolar defect repairing.
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Objective According to the fine artery anatomy of the lower lip, we developed an innovative partial-thickness myocutaneous flap based on the vascular network of the submucosal and subcutaneous layers of the lower lip.We attempted to treat the secondary bilateral cleft lip deformities using this innovative cross-lip flap.Methods From July 2009 to June 2015, this new technique was used in 98 patients with secondary bilateral cleft lip deformities.The central defects usually occurred in these patients.The defects were reconstructed partially or completely according to the severities of the defects.The operative procedures were as follows: The split flap was elevated from the posterior portion of the oris orbicularis muscle after the inferior labial arteries were divided.Then the partial-thickness flap was rotated 180 degrees horizontally and inverted 180 degrees upward to the upper lip defect.Results All 98 musculomucosal pedicle flaps were viable.The upper lips were reconstructed according to the severities.Conclusions This myocutaneous cross-lip flap with musculomucosal-pedicle has a more reliable blood supply, better flexibility and plasticity.It is an effective method for aesthetic reconstruction for the secondary bilateral cleft lip deformities.
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Objective To compare the effect of Q-switch Nd ∶ YAG laser and intensive pulsed light on freckles.Methods 80 patients with freckles were divided into 2 groups randomly.One group of patients were treated with Q-switch Nd ∶ YAG 532 nm frequency-doubled laser,the interval was 8 weeks.The other group of patients were treated with 570 nm intensive pulsed light,the interval was 8 weeks.Results We used Mann-Whitney U test to compare the curative effect of the two groups (P ＜0.05),and the mean rank (34.00) of the Q-switch Nd;YAG laser treatment group was greater than that (47.00) of the intense pulsed light treatment group.Conclusions The curative effect of Q-switch Nd ∶ YAG laser is better than that of intensive pulsed light on freckles.
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<p><b>OBJECTIVE</b>To investigate the nasolabial muscle anatomy and biomechanical characteristics.</p><p><b>METHODS</b>Micro-computed tomography scan was performed in 8 cases of spontaneous abortion fetus lip nasal specimens to construct a three-dimensional model. The nasolabial muscle structure was analyzed using Mimics software. The three-dimensional configuration model of nasolabial muscle was established based on local anatomy and tissue section, and compared with tissue section. Three dimensional finite element analysis was performed on lip nasal muscle related biomechanics and surface deformation in Application verification was carried out in 263 cases of microform cleft lip surgery.</p><p><b>RESULTS</b>There was close relationship between nasolabial muscle. The nasolabial muscle tension system was constituted, based on which a new cleft lip repair surgery was designed and satisfied results were achieved.</p><p><b>CONCLUSIONS</b>There is close relationship among nasolabial muscle in anatomy, histology and biomechanics. To obtain better effect, cleft lip repair should be performed on the basis of recovering muscle tension system.</p>
Subject(s)
Humans , Aborted Fetus , Biomechanical Phenomena , Cleft Lip , General Surgery , Facial Muscles , Diagnostic Imaging , Physiology , Finite Element Analysis , Lip , Diagnostic Imaging , Muscle Tonus , Nose , Diagnostic Imaging , Software , X-Ray MicrotomographyABSTRACT
<p><b>BACKGROUND</b>Maxillary anterior segmental distraction osteogenesis (MASDO) is a recently used method for correction of severe maxillary retrusion in cleft lip and palate (CLP) patients. In this article, we evaluated the feasibility of MASDO using rigid external distraction (RED) and rapid orthodontic tooth movement to correct severe maxillary retrusion in CLP patients.</p><p><b>METHODS</b>Fourteen male and five female complete CLP patients between the ages of 18 and 22 years (mean age 19.7 years) at the time of distraction, with severe maxillary retrusion, were treated with the rigid external distraction (RED) device after maxillary anterior osteotomy. Rapid orthodontic tooth movement was started one week after the MASDO. Standard profile photographic, cephalometric films were obtained preoperatively and after therapy. Sella-nasion-point A (SNA) and Sella-nasion-point B (SNB) angles were measured to reflect changes in maxillary and mandibular position, and the distance between anterior nasal spine and posterior nasal spine (ANS-PNS) was measured to represent the maxillary dental arch length.</p><p><b>RESULTS</b>The SNA angle increased from an average of 74.6° (range 73.0°-78.0°), preoperatively, to 83.4° (range 78.6°-88.0°) after the RED was removed (P < 0.01). All cases of severe maxillary retrusion were improved. Nine patients' profiles became harmonious after therapy. One patient had a bimaxillary protrusion deformity and needed further surgery. The regenerate alveolar crest and edentulous space on both segments was almost completely eliminated after rapid orthodontic tooth movement.</p><p><b>CONCLUSION</b>MASDO with the RED system and rapid orthodontic tooth movement is a successful way of correcting severe maxillary retrusion in CLP patients.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Cleft Lip , General Surgery , Cleft Palate , General Surgery , Osteogenesis, Distraction , Methods , Tooth Movement TechniquesABSTRACT
To investigate the protective effects of Zuogui Pill (ZGP), a compound Chinese herbal medicine, on retina ganglion cells (RGCs) in rats after optical nerve clipping injury.
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Objective To investigate the blood supply of the expanded skin flap from medial up-per arm and its application in the reparation of cervical scar contracture due to sear resection. Methods The operation was carried out for three steps: (1) The expander was implanted under the superficial fascia. (2) The skin flap from medial upper arm was created with superior ulnar collateral artery as blood supply and attributive branches of basilica and axillary veins as blood collection. (3) After thes car contracture was released, the defect was covered with medial upper arm flap with maximal area of 25 cm×15 cm. Results Ten patients in all with cervical scar contracture were treated with the skin flap. All the skin flaps survived at last with nearly normal skin color, texture and contour. And the scar in donor sites seemed to be neglectable. Conclusions Reparation of cervical scar contracture with medial upper arm skin flap after expanding could be recommended. But 3 months long time and fixation of upper limb and head might be disadvantages.
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Objective To study the possibility and effects of fixed TH glue embolization through gastroesophageal and percutanenous. Methods Forty-six patients of bleeding esophageal varices were divided randomly into two groups: in treatment group:twenty-five patients treated with TH glue (?-cyanoacrylate) embolization PTVE+PSE. Absolute alcohol-cilia steel ring-TH glue ,but in control group, 21 patients of esophageal varices by variceal ligation. Analysis the percentage of rebleeding, death rate and improvement rate of liver functions. Results In the treatment group,the rebleeding of gastroesophageal varices was 8.7%, the percentage of death was 4.3%, the function of liver improved by 87.0% . In the control group, the percentage of rebleeding was 28.6%, death rate was in 19.1% and liver function improved by 48.0%. Conclusion PTVE+PSE fixed TH glue embolization is safe, less destroyed. Compared with dense edoscopic ligation, DEVL, the advantage is lessre bleeding, less death rate and higher liver function improvement rate. It is an effective method for gastroesophageal varices.