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Objective:To investigate the method and effect of anatomic reduction of orbital septum fat in blepharoplasty to correct the first and second degree of upper eyelid depression.Methods:From January 2019 to January 2021, the data of patients with first and second degree upper eyelid depression admitted to Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. Orbital septum was fully exposed and cut in blepharoplasty, the orbital fat of upper eyelid central group and the medial group were dissected and seperated to form the fat flap pedicled on the medial side. The fat flap was rotated 180° to the medial side and fixed with the orbital fat of the medial group to correct the upper eyelid depression. Complications such as infection, hematoma, fat liquefaction, nodules and orthers were observed after surgery. Questionnaire was used to investigate the satisfaction of patients, with 1-4 points indicating dissatisfaction, general satisfaction, satisfaction and very satisfaction, respectively.Results:A total of 62 patients were included, all patients were female, aged 18-44 years, wit mean 27 years. All patients were bilateral upper eyelid depression. After 6 months of follow-up, the curvature of the double eyelid line was smooth, the width and narrowness of double eyelid were natural, and the upper eyelid depression was significantly improved. Satisfaction survey showed that 60 cases were very satisfied and 2 cases were satisfied. Wound infection was occurred in 1 case, and was cured after dressing change. Scar hyperplasia was observed in 2 cases, which was obviously alleviated after external treatment with anti-scar hyperplasia drugs. No fat liquefaction, nodule and other complications occured.Conclusions:For the first and second degree of upper eyelid depression, it can be corrected by anatomic reduction of orbital septal fat in blepharoplasty. The operation is simple, with fewer complication and high satisfaction.
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Objective To investigate the digital subtraction angiography (DSA) manifestations and clinical value of interventional embolization of renal artery with severe hemorrhage following percutaneous nephrolithotomy (PCNL).Methods 34 patients with severe hemorrhage following PCNL from Feb 2012 to Jun 2015 were subjected to perform renal arterial DSA, which was followed by super-selective renal arterial embolization (SRAE) with steel micro-coils and guglielmi detachable coils together with or without biological glue (GLUBRAN2). The patients were followed up for 6 ~ 12 months.Results Of the 34 patients, DSA examination showed that renal artery pseudoaneurysm (RAP) was found in 22 (64.7%), renal arteriovenous ifstula (RAVF) in 8 (23.5%) and RAP associated with RAVF in 4 (11.8%). Successful embolization with single session was achieved in all 34 patients. Both the technical success rate and the hemostasis rate were 100.0%. Meanwhile, the renal tissue and function were mainly reserved and no serious complication of embolization was observed. No hematuria recurrence or renal function failure appeared in all patients during the follow-up period. In 26 patients, different degree of embolism syndrome was observed after the treatment.Conclusions Renal artery pseudoaneurysm and renal arteriovenous ifstula are the main types of renal artery injury resulting in severe hemorrhage after percutaneous nephrolithotomy. Super-selective renal arterial embolization (SRAE) with steel micro-coils and guglielmi detachable coils together with or without biological glue (GLUBRAN2) is a minimally invasive method that can promptly stop the renal bleeding, and preserve the renal tissue and function to the greatest possible advantage. Therefore, this technique should be regarded as the ifrst choice in the treatment of the patients who suffered from severe hemorrhage occurred after PCNL.
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Objective@#To investigate the feasibility and therapeutic effect of frontal and scalp expanded skin flap combined with laser hair removal for children congenital facial giant nevi.@*Methods@#From January 2013 to December 2015, 6 cases with congenital facial giant nevi were treated with expanded frontal and scalp skin flap combined with laser hair removal in the department of plastic surgery, An Zhen Hospital, Capital Medical University. The process of treatment could be divided into three stages. Stage 1: The expander capacity was determined according to the size of lesion. Expander was implanted under the galea aponeurotica in front and scalp, and expanded regularly postoperatively. Stage 2: The expander was removed and facial giant nevi was excised. The expanded skin flap was designed according to the shape and size of nevi. Stage 3: After the expanded skin flap healed completely, laser hair removal was performed for 4-6 times with 6 weeks of interval time.@*Results@#300 ml to 350 ml expanders were selected with expanding frequency of 2 times a week. The expansion time lasted for 16 to 20 weeks(average, 18.7 weeks). The complications such as leakage, angle and skin flap blood supply obstacle didn't occurr in the process of expansion. The size of frontal and scalp skin flap ranged from 12 cm×11 cm to 20 cm×17 cm. Venous drainage disorder happened in one flap and was treated by partial suture removal and acupuncture bleeding treatment. Skin flap necrosis didn't occurred. The defects at donor sites were sutured directly with inconspicious scar. The effect of semiconductor laser hair removal was good without recurrence during one-year follow-up period. All expanded skin flaps had no obvious contraction with good match of color and texture.@*Conclusions@#This method provides a new selection of donor site for larger facial defect with reliable effet. The facial giant nevi could be excised completely and repaired in one operation with short operation time. The scar in middle face and secondary deformities can be avoided.
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OBJECTIVE@#There are many scaffold materials of repairing nasal alar cartilage defects. Auricuiar cartilage was used extensively in terms of its abundant tissues, good elasticity, little donor-site malformation, good plasticity etc. The authors dissected auricular cartilage and nasal alar cartilage, measured cartilage's morphous data and found some similar territories with nasal alar cartilage in the structure of auricular cartilage.@*METHOD@#An anatomical study was performed using 10 adult cadavers acquired through Plastic Surgery Hospital, Peking Union Medical College, Beijing, China. Seven male and three female cadav-ers were included in the study. Harvest 20 auricular cartilage specimens and 20 nasal alar cartilage specimens. Then, Computed Tomography Scan on the auricular cartilage and nasal alar cartilage were performed. The datas were imported into mimics and three-dimensional reconstructions of the auricular cartilage and nasal alar cartilage were carried on.@*RESULT@#Parts of the auricular cartilage, such as conchal fossa, tragus, intertragic notch, and cymba of auricular concha, curs of helix and curs of helix, triangular fossa, are ana-tomically similar to nasal alar cartilage.@*CONCLUSION@#This study reports the anatomy of auricular cartilage and nasal alar cartilage, found some territories in the auricular cartilage, such as conchal fossa, tragus, intertragic notch, and cymba of auricular concha, curs of helix and curs of helix, triangular fossa, are anatomically similar to nasal alar cartilage. This research provides the anatomical basis that auricular cartilage was used to repair the nasal cartilage defect.
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Adult , Female , Humans , Male , Cadaver , Ear Auricle , Ear Cartilage , Nasal Cartilages , Plastic Surgery Procedures , Tomography, X-Ray ComputedABSTRACT
Objective To conduct a morphologic and anatomic study on nasal cartilages (including nasal alar cartilage, nasal septal cartilage and upper lateral cartilage) in Chinese, and to compare measured parameters with the other races. Methods 20 adult embalmed cadavers were dissected, 40 nasal alar cartilages, 20 nasal septal cartilages and 40 upper lateral cartilages were collected and scanned by CT, and three-dimensional images were reconstructed. As Zelnik' and Ofodile's work, the data of the images were collected. Results The distances from the nostril rim to the caudal boarder of the lateral crus in the series were (4. 54 ±0. 59) mm anteriorly, (5. 54±0. 69) mm in the middle, and (10. 45± 1. 15) mm posteriorly. The length of the lateral crus was (18. 51 ±1. 63) mm, the width was (7. 99±1. 66) mm, and the thickness was (0. 49±1. 28) mm. Conclusion The Caucasian nasal cartilages are the biggest in all races, and the other's were approximately same.