Modified two-stage surgery for total auriculoplasty with autogenous rib cartilage / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To introduce a modified surgery for total auriculoplasty and the experience in one hundred and forty-six cases (155 ears).</p><p><b>METHODS</b>The procedure was a two-stage operation. The first stage involved fabrication and grafting of a costal cartilage framework. A U-shaped skin incision was made on the posterior edge of the lobule and the remnant ear cartilage was removed completely. The area for the insertion of the cartilage framework was undermined. Skin flaps were sutured after insertion of the cartilage framework. The second-stage surgery was usually performed six months after the first-stage operation. The reconstructed auricle was elevated, and a costal cartilage block was fixed to the posterior part of the auricle. A temporoparietal fascia flap was then used to cover the costal cartilage block. Finally, the posterior aspect of the projected auricle was covered with a spit-thickness skin graft.</p><p><b>RESULTS</b>The incisions healed in one hundred and forty-one patients (150 ears) after the first stage operation. Partial necrosis of the postauricular flap was observed in five cases (5 ears) after the first stage operation, but no exposure or absorption of the cartilage took place. The skin grafts survived in one hundred and thirty-nine cases (147 ears) after the second-stage surgery. Partial necrosis of the skin graft was observed in seven cases (8 ears), but healed after one-week of dressing changes. Ninety-four cases (97 ears) were followed up, but fifty-two cases (58 ears) were lost to follow up. The follow-up at six months to two years showed satisfactory contour and projection of the constructed ears.</p><p><b>CONCLUSION</b>This two-stage surgery is simple and ideal for auricloplasty with few complications.</p>

Biologic effect of transforming growth factor-β1 on urethra cells cultured in vitro / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of transforming growth factor-β1 (TGF-β1) on growth controlling and the expression of connective tissue growth factor mRNA(CTGF mRNA) in urethra epithelium cells and fibroblasts cultured in vitro.</p><p><b>METHODS</b>Urethra epithelial cells and fibroblasts were cultured in vitro and identified. The fourth generation cells were divided into control group (cultured by cell medium without TGF-β1) and experimental groups(cultured by cell medium containing TGF-β1 1, 2, 4 and 8 µg/L), the vital force of cells were examined by MTT and cell counting, the expression of CTGF mRNA were examined by RT-PCR after 24 hours.</p><p><b>RESULTS</b>The optical density and cell count decreased in experimental groups of urethra epithelium cells and increased in experimental groups of fibroblasts with the concentration of TGF-β1 being heightened compared with the control group (P < 0.05). The expression of CTGF mRNA increased with the heightening concentration of TGF-β1 in all experimental groups of urethra epithelium cells and fibroblasts by RT-PCR (P < 0.05).</p><p><b>CONCLUSIONS</b>TGF-β1 can inhibit the growth of urethra epithelium cells and promote the growth of fibroblasts in vitro, it can induce the expression of CTGF mRNA in two cells above-mentioned.</p>

Combined superficial temporal fascial flap with free dermis-fat graft to reconstruct hemifacial atrophy / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce a method to reconstruct hemifacial atrophy (Romberg's disease).</p><p><b>METHODS</b>Through a temporal incision, the compound grafts of pedicled superficial temporal fascial flap and free dermis-fat were inserted into the cheek to correct soft tissue depression on the face. The dermis-fat was harvested from gluteal crease site.</p><p><b>RESULTS</b>6 cases were treated with this technique. 3 to 10 months' follow-up showed satisfactory results and few resorption of the compound grafts.</p><p><b>CONCLUSIONS</b>The mentioned technique is simple and reliable in reconstructing bulk defects of the face.</p>

Repairing the defects in the chest, back and axilla with a split-breast flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate a method to repair the defects after the secondary tumor excision and radiation ulcer in the chest, back and axilla.</p><p><b>METHODS</b>Eight patients, with the defects after the secondary tumor excision and the radiation ulcer in the chest, back and axilla, were undergoing the treatment. A "T" shape incision or up-side-down "T" shape incision was designed above the breast or along the inframammary fold below breast, just close to the defect. A split-breast flap was raised above the pectoralis major or deep fascia. The defect was then repaired with a rotating and advancing way.</p><p><b>RESULTS</b>Eight patients were repaired in one stage. Blood circulation of the flaps was abundant except one with distal edge necrosis. The ptosis breast was corrected and the fullness of the chest wall was also achieved. But, the Nipple of the opposite health breast was lost the original position to the lateral or medial.</p><p><b>CONCLUSIONS</b>The above-mentioned technique may be an efficient method to repair the defects after the secondary tumor excision and radiation ulcer in the chest, back and axilla. It is adapt to the old patients whose health is worse, but it is not good for the young patients resulted from the injury breast.</p>

Early repair of full layer eyelid defect caused by chemical burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the optimal time and method of the early repair of the full layer eyelid defect caused by chemical burn.</p><p><b>METHODS</b>Free nasal septum mucosal cartilage flap with muscle flap, skin grafting, or skin flap were performed in 18 cases (19 eyelids) with chemical burn within 4 postburn weeks. Eyelid reconstruction and corneal transplantation were performed at the same time in 4 patients.</p><p><b>RESULTS</b>All the reconstructed eyelids and transplanted cornea survived. The incidence of severe complications, such as exposure keratitis, corneal ulcer and eyeball perforation decreased.</p><p><b>CONCLUSION</b>Full layer eyelid defect caused by chemical burn should receive early reconstruction and repair, including timely reconstruction of eyelid for the sake of protecting the eyesight and of alleviating the inflammatory reactions, and the corneal transplantation should be done at the same time to avoid corneal perforation. Nasal septum mucosal cartilage flap could be ideal for the eyelid reconstruction.</p>

Complication of polyacrylamide hydrogel injection for facial plasty / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the causes of complications of polyacrylamide hydrogel injection for facial plasty and reliable treatments.</p><p><b>METHODS</b>Eight patients were included in the study. Some of them were examined by MRI. All the patients received surgical treatments.</p><p><b>RESULTS</b>The injected polyacrylamide hydrogel was found in the superficial layer of the superficial temporal fasica, the loose connective tissue below the deep temporal fascia, the subcutaneous tissue or the orbicularis muscle. Polyacrylamide hydrogel injected into the superficial layer of the superficial temporal fascia could spread to the face along the SMAS. Polyacrylamide hydrogel injected into the loose connective tissue below the deep temporal fascia could spread down to the cheek. The patients' symptoms were relieved with the operation. Satisfactory results were obtained.</p><p><b>CONCLUSION</b>Polyacrylamide hydrogel injection does not adapt to facial plasty. The reliability of polyacrylamide hydrogel injection for facial plasty is in doubt.</p>

Autologous buccal mucosal graft for urethral reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To search for a new method for urethra reconstruction using autologous buccal mucosal graft while lacking of local skin.</p><p><b>METHODS</b>Since 1998, a total of 25 patients with complex hypospadias have been treated using buccal mucosal grafts for urethral reconstruction. The reconstructed urethra was anastomosed with the meatus half year later.</p><p><b>RESULTS</b>All the reconstructed urethra survived without contracture or stricture except one infection, which healed with no adverse consequence.</p><p><b>CONCLUSION</b>The key points for operation success is rich capillary network, thick epidermis and thin lamina propria of the buccal mucosa. Buccal mucosa is an excellent tissue for urethral reconstruction.</p>