Case report and literature review of tongue artery embolism caused by hyaluronic acid augmentation of chin / 中华整形外科杂志

In December 2018, a 29-year-old female patient with lingual artery embolism after hyaluronic acid injection was admitted to the Second Affiliated Hospital of Kunming Medical College. The examination showed swelling tongue, the mucosa on the front and back of the right tongue became white, and the tip of the tongue slightly atrophied. The movement of tongue was disturbed. The patient′s pronunciation was unclear. The right tongue was numb, resulted by the weak circulation. Hyaluronidase was injected into tongue. The vasodilator was used. And hyperbaric oxygen chamber was applied. Thereafter, the blood supply and oxygen concentration of embolized area were increased, and collateral circulation was established. Antibiotic therapy and continuous treatment with neurotrophic drugs (rat nerve growth factor + methylcobalt ammonium) were given to promote the repair of nerve. After treatment, the embolism of lingual artery was significantly improved. Three months later, the patients had mild muscular atrophy on the right side of the tongue, with partial recovery of the right tongue mucosa. Tongue movement, sensory and taste functions recovered. Hyaluronic acid injection needs to be standardized, performed by surgeons who masters the anatomical structures, the injection layer and spot. If the vascular embolism occurs, hyaluronidase should be used as early as possible. It also needs to reduce local tension in both injected and affected area, reduce the pressure of injection on blood vessels, improve local blood circulation, so as to achieve better therapeutic effect.

Forehead skin expansion combine with auricular cartilage for repairing nose alar full-thickness defects / 中华医学美学美容杂志

Objective To discuss clinical curative effects of using Forehead skin expansion combine with auricular cartilage for repairing nose alar full-thickness defects.Methods From August 2010 to August 2010,36 patients with nose alar full-thickness defects in the second affiliated hospital of kunmin medical university,The defect range exceed 1.5 cm× 1.2 cm.50-80 ml expander was implanted in forehead and injected saline water to expand in order to acquire extra skin.We Turn around the skin of defect as the lining of nose,harvest ipsilateral auricular cartilage for nose ala framework,Expanded forehead pedicle flap was transferred to cover framework.The donor area was sutured directly.The pedicle of flap was cut and trimmed after 2 months.Results Follow-up time of 3-18 months after the operation,All flaps are survive,nose alar defects are repaired successfully.Some cases were performed second surgery,postoperative,nose alar color,thickness,nostril size and shape the same with the contralateral side.Donor site healed with linear scar.Conclusions This method could be easy to obtain excess skin,for repairing large sides nose alar full-thickness defect.Frontal scar is not obvious,It is a practical.

Auricular Composite Tissue Flap for Repairing Nasal Ala Defect / 昆明医科大学学报

Objective To discuss the effects of repairing nasal ala defects by free transplantation of autogenous auricle composite tissue flap. Methods 50 cases with nasal ala defects were repaired by free auricular composite tissue flap transplantation from Janu 2003 to May 2013. The defects size was 0.5cm x 0.7cm~1.3cm x 1.5cm. According to the size of the defects, full thick wedge-shaped auricle composite tissue flap were cut off, then inserted into the nasal ala defects area and fixed stablely, the donor sites were sutured directly avoiding ear cartilage. Salvianolate and hyperbaric oxygen were used in postoperative treatment for 5-7 days. Results 48 cases achieved good results, 2 cases had partial necrosis of composite tissue flap after operation, also achieved good results after reoperation. Over 3 months~5 years follow-up, all cases had satisfactory results. The volume of auricle composite tissue flap reduced less than 10%. Surgical incisions had a linear scar, good color matching, nostril symmetry. All patients were satisfied with the overall appearance. Conclusions Autogenous auricle composite tissue flap free transplantation for repairing middle and small size of nasal ala defects can recover ala formation and structure very well, nasal appearance can be improved greatly with nostril symmetry. There is no hypertrophic scar in donor sites. This method is simple and easy,and is also a good method for repairing nasal ala defects.