ABSTRACT
Objective:To discuss the principle and effect of augmentation rhinoplasty with auricular cartilage and expanded polytetrafluoroethylene.Methods:From January 2018 to January 2020, 161 patients (10 males and 151 females; aged from 19 to 48 years, with an average of 26 years) underwent " auricular cartilage plus expanded polytetrafluoroethylene" augmentation rhinoplasty in Nanfang Hospital of Southern Medical University. The expended polytetrafluoroethylene was carved into a willow leaf shape (I Shape) to fill the nasal dorsum, and the cartilage taking from cymba concha was constructed into an arched bridge shape for the nasal tip shaping. Pre-operative and 1-year post-operative measurements nasal length, nasal height, nasal depth, nasal columella height, nasal tip width, nasofrontal angle, nasolabial angle, survey of satisfaction and complication rate 1-2 years after operation were taken. The statistical analysis of nasal morphological indicators and nasal aesthetic indicators were employed.Results:The nose shape of 161 patients was improved to varying degree. All morphological indicators were improved, and difference was statistically significant ( P<0.05). The nasofrontal angle reached the standard in 90 cases, accounting for 55.9%; The nasolabial angle reached the standard in 143 cases, accounting for 88.8%. 2 cases had prosthesis (ePTFE) deviation and were corrected by surgical repair; 1 case had prosthesis (ePTFE) rejection and was corrected by prosthesis (ePTFE) removal surgery. Conclusions:Corresponding to the anatomical characteristics of the external nose, the prosthesis material is designed and made to correspond to the dorsum shape of the nasal stent. The shape of the alar cartilage, the prefabricated arched bridge shape of the cymba concha cartilage are used to reconstruct the nasal tip, which can effectively elevate the nasal dorsum, improve the protruding degree and rotation degree of the nasal tip, and have good long-term support. The flexibility and activity of the nasal tip are similar to the biological nose.
ABSTRACT
External treatment of Traditional Chinese Medicine (TCM) is a common treatment for lumbar disc herniation, which mainly includes fumigation and washing of TCM, and hot ironing therapy. It can cooperate with oral administration of TCM, Tuina, acupuncture and other therapies to play a synergistic effect and enhance the efficacy. External application of TCM in the treatment of lumbar intervertebral disc herniation is effective with long duration, easy-operated and safe It has showed curative effect in alleviating clinical symptoms and improving lumbar function. Its mechanism mainly includes regulating nerve inflammatory reaction, improving hemorheology and exerting analgesic effect.
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<p><b>OBJECTIVE</b>To assess the outcome of large facial defect reconstruction with "partition" pre-expanded cervico-scapulo-dorsal flaps (CSDF) based on the superficial cervical artery (SCA).</p><p><b>METHODS</b>Surgical course consisted of 3 stages. In stage I, a skin flap was designed along the axis of SCA according to the facial defect and an expander was implanted in the cervico-scapulo-dorsal region by means of "partition" expansion. The expanders were implanted beside the flap axis and beneath the posterior half of flaps so as to expand only half area of the flap. During the stage II, expanders were injected with saline regularly for continuous expansion. In stage III, the pre-expanded CSDFs were transferred to cover the facial defect of which the CSDFs included about half of non-expanded area.</p><p><b>RESULTS</b>From November of 2008 to December of 2013, 15 patients with facial hypertrophic scar or scar contracture were reconstructed with pre-expanded CSDF based on the SCA. The expansion lasted for 3 to 4 months, and the expanded volume varied from 680 to 960 ml. One case of 4.0 cm x 1.5 cm epidermal flap necrosis occurred and healed subsequently with superficial scar; and another case of blister formation in the distal part of flap was found, which recovered without scar; the other 13 flaps survived without complications. After a follow-up for 12 to 38 months( average 26. 2 months), patients regained satisfactory appearance of face, with no obvious hypertrophic scar in the donor site.</p><p><b>CONCLUSIONS</b>Partition preexpanded CSDF based on the SCA is a good choice for large facial defect reconstruction, and the partition expansion is an effective strategy for prevention of venous congestion.</p>