Evaluation of the treatment effect on sinus elevation and implant restoration in cases with odontogenic maxillary sinusitis after tooth extraction / 口腔疾病防治

Objective@#To investigate the clinical effects of sinus elevation surgery and implant restorationdue to insufficient bone massafter tooth extraction in patients with odontogenic maxillary sinusitis (OMS) and to provide a reference for use in clinical practice.@*Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Forty-five teeth were extracted from patients with OMS in the maxillary posterior area (the study group). Sinus elevation and implantation were performed due to insufficient bone height in the implant area 6-8 months after tooth extraction in the study group. Forty-eight teeth were extracted from patients without "OMS" in the maxillary posterior area (the control group), and sinus elevation and implantation were performed due to insufficient bone height in the implant area 6-8 months after tooth extraction inthe control group. In the study group, 13 cases of discontinuous maxillary sinus floor bone and residual alveolar bone height of the maxillary sinus floor less than 4 mm were addressed with lateral wall sinus elevation, and the other 32 cases were addressed with crest-approach sinus elevation. In the control group, 8 cases of residual alveolar bone height less than 4 mm in the maxillary sinus floor were addressed with lateral wall sinus,and the other 40 cases were addressed with crest approach sinus elevation. Restorations were placed 6 to 8 months after surgery. The patients were followed up 21 days, 3 months, and 8 months after implantation and every 6 months after the placement of the restorations. The sinus bone gain (SBG), apical bone height (ABL) and marginal bone loss (MBL) were statistically analyzed 24 months after the restoration.@*Results@#The average preoperative mucosal thickness in the 45 patients in the study group was (1.556 ± 0.693) mm, which was significantly larger than that in the control group (1.229 ± 0.425) mm (P<0.001). There were no perforations in either group. Twenty-four months after restoration, there was no significant difference in the SBG, ABH or MBL between the two groups (P>0.05).@*Conclusion@#After the extraction of teeth from patients with OMS, the inflammation of the maxillary sinus decreased, and the bone height and density in the edentulous area were restored to a certain degree. The effects of sinus floor lifting surgery and implant restoration do not differ between patients with and without OMS.

Prediction of internal fixation failure of femoral trochanteric fracture by external wall morphology / 中国骨伤

OBJECTIVE@#To investigate the relationship between the shape of the lateral wall and the early failure of internal fixation in the fracture of the femoral trochanteric region(FFT).@*METHODS@#Total 295 patients with femoral trochanteric fracture underwent internal fixation from January 2015 to January 2020 were selected. The patients were divided into two groups according to whether there was early internal fixation failure after surgery, 19 patients in the failure group and 276 patients in the normal group. Gender, affected side, age, AO classification, body mass index(BMI), preoperative hemoglobin, X-ray measurement of lower lateral wall thickness, preoperative internal diseases, intraoperative blood loss, postoperative tip apex distance(TAD), postoperative neck shaft angle, operation time and other data were compared between two groups. The shape of the lateral wall was compared between two groups, and the correlation between the shape of the lateral wall and the early internal fixation failure of femoral trochanteric fracture was analyzed.@*RESULTS@#All patients were followed up for more than 1 year. There was no significant difference between two groups in terms of intraoperative blood loss, operation time, postoperative TAD, and postoperative neck shaft angle(P>0.05). At the latest follow-up, the visual anaglue scale (VAS) of the failure group was higher than that of the normal group(P<0.01), and the Harris score of the failure group was lower than that of normal group(P<0.05). The receiver operator characteristic (ROC) curve between shape of lateral wall and failure of early internal fixation of femoral trochanteric fracture was drawn. The critical value of the midpoint lateral wall thickness was 16.5 mm, and the area under the ROC curve was 0.845;The critical value of average sidewall thickness was 16.5 mm, and the area under ROC curve was 0.838;The critical value of the axial area of the sidewall was 7.5 mm, and the area under the ROC curve was 0.826.@*CONCLUSION@#The shape of the lateral femoral wall measured by CT could be used as a predictive factor for the early failure of internal fixation of femoral trochanteric fractures. For patients at risk, more reasonable surgical plans and postoperative preventive measures should be developed.

The Role of Computed Tomography and Radiographs in the Management of Intertrochanteric Fractures

@#Introduction: The Intertrochanteric fracture is a common hip trauma encountered in elderly patients. There is a lack of general agreement regarding its surgical management and choice of implant. Purpose of this study to conclude the final decision matrix regarding surgical management of intertrochanteric fractures based on parameters assessed on plain radiographs and CT scan. Materials and methods: We have retrospectively evaluated 55 patients with intertrochanteric fractures presented to our institute after informed consent with radiographs and CT scans between July 2017 to July 2018. Assessment of various parameters regarding fracture geometry and classification as well as measurement was done. Results: Mean lateral wall thickness in present study was 20.76mm. Incidence of coronal fragments was 90.9% and absence of coronal fragment in 5 patients. We noted the cases with anterior comminution had also a posterior comminution rendered the fracture unstable in almost 20 % cases. Conclusion: Better understanding of fracture geometry by combined used of radiograph and CT scan enhanced preoperative planning, choice of suitable implant, helps in reduction manoeuvre and improving quality of osteosynthesis.

A study of the maxillary sinus lateral wall thickness using cone-beam CT / 口腔疾病防治

Objective@#To investigate the relationship between the thickness of the lateral wall of the maxillary sinus and patient age and sex at different tooth sites to provide a reference for sinus floor elevations.@*Methods @#Cone-beam CT（CBCT） imaging data were collected from 222 patients admitted to the Department of Stomatology, the First Hospital of Shanxi Medical University, from March 2020 to October 2020. The thicknesses of the maxillary sinus lateral wall of the first premolar, second premolar, first molar and second molar were observed and measured on the coronal plane of CBCT images, and the relationship between the maxillary sinus lateral wall thickness and patient sex was analyzed. The patients were divided into the following groups according to their age: ①the young group (18~29 years old), ②the middle-aged group (30~59 years old), and ③the elderly group (≥ 60 years old). The difference in the maxillary sinus lateral wall thickness was compared among these three age groups@*Results@#The mean thicknesses of the maxillary sinus lateral wall at the first premolar, second premolar, first molar and second molar were （1.61 ± 0.58） mm, （1.68 ± 0.66） mm, （2.00 ± 0.76） mm and （1.71 ± 0.71） mm, respectively. The maximum thickness of the lateral wall was located at the first molar (P< 0.05). The thickness of the maxillary sinus lateral wall in the young group was significantly thicker than that in the middle-aged group and the elderly group at the first premolar and first molar (P < 0.05). The thickness of the maxillary sinus lateral wall in males was significantly thicker than that in females at the second molar [(1.78 ± 0.80) mm vs. (1.63 ± 0.62) mm, P=0.029].@*Conclusion@#The mean thickness of the lateral wall changes at different reference points. The maxillary sinus lateral wall is the thickest at M1. The thickness of the maxillary sinus lateral wall decreased with age, and the thickness of the lateral wall was higher in males than in females.

Deep lateral wall combined with medial wall orbital decompression for thyroid associated ophthalmopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the clinical effect and safety of deep lateral wall combined with medial wall orbital decompression in the treatment of thyroid associated ophthalmopathy(TAO).<p>METHODS: Totally 17 patients with TAO in our department from January 2019 to May 2020 were included. All patients underwent deep lateral wall combined with medial wall orbital decompression under general anesthesia, the visual acuity, recovery of exposure keratitis, exophthalmos, intraocular pressure and complications were compared before and after operation.<p>RESULTS: Eight patients(9 eyes)with TAO and dysthyroid optic neuropathy(DON)were included in the study. The best corrected visual acuity averaged 0.78±0.15 preoperatively and 0.36±0.12 1mo postoperatively, which was statistically significant(<i>P</i><0.01)compared with the preoperative visual acuity, 0.38±0.12 at 6mo after surgery, which was not statistically different from that at 1mo after surgery(<i>P</i>=0.594). The mean preoperative proptosis was 23.75±2.55mm and the mean postoperative proptosis was 14.85±1.53mm at 1mo, which was statistically significant compared with the preoperative proptosis(<i>P</i><0.01), proptosis was on average 14.60±1.64mm at 6mo after surgery and remained generally stable(<i>P</i>=0.658)from 1mo before surgery. The intraocular pressure of the patients was 25.56±3.23mmHg preoperatively and 18.42±2.35mmHg 1mo postoperatively, which was statistically significant compared with the preoperative value(<i>P</i><0.01), and the intraocular pressure of the patients was reduced to 15.82±2.57mmHg at the 6mo postoperative follow-up, which was statistically significant compared with the intraocular pressure of the patients 1mo postoperatively(<i>P</i><0.01). There were 6 eyes of 6 patients with exposure keratitis preoperatively, 4 eyes improved and 2 eyes were cured in the 1mo postoperative, and all 6 eyes were cured 6mo postoperatively. Postoperatively, the diplopia of the patients all decreased to various degrees, and there were some patients whose diplopia symptoms continued to improve 6mo thereafter without other serious complications.<p>CONCLUSION: Deep lateral wall combined with medial wall orbital decompression can effectively improve the proptosis and also have a good effect on severe complications such as DON and exposure keratitis with few complications, so deep lateral wall combined with medial wall orbital decompression is an effective surgical procedure in the treatment of severe TAO.

Operative Hysteroscopy in Infertility Patients and Its Complications.

The problem of infertility is increasing over the years and so are the couples seekingmedical help for it. Estimates of infertility in India goes to around 10 - 15 percent.Hence evaluation of the couple with the help of history and accompanyinginvestigations are foremost required. Various modalities are available foridentifying the cause. One such cause is abnormalities in the uterine cavity. Thisstep is important because its inner layer, called endometrium is responsible forimplantation of the embryo in the blastocyst stage. For such assessment of theuterine cavity, the gold standard procedure is the diagnostic hysteroscopy. Itinvolves direct visualization of the cavity and simultaneous correction of theintrauterine pathology. Hysteroscopy is a simple procedure with low risk ofcomplication; moreover, complications occur with operative procedures mostcommonly. This study aims to evaluate these complications and critically appraisethe changes in trend of complications.METHODSThis is an observational study. Study included 32 patients with infertilityundergoing operative hysteroscopy at obstetrics and gynaecology department inour hospital.RESULTSAmong the 32 patients, the most common hysteroscopic procedure was lateral wallmetroplasty (40.6%) followed by septal resection (25%). Polypectomy, adhesiolysisand tubal cannulation. Complication rate was 6.25 percent, among which post-opinfection and bleeding per vaginum were the most important

Effectiveness of proximal femoral nail anti-rotation combined with minimally invasive percutaneous plate osteosynthesis versus Intertan intramedullary nail fixation in treatment of intertrochanteric fracture with incomplete lateral wall / 中国修复重建外科杂志

Objective: To compare the effectiveness of proximal femoral nail anti-rotation (PFNA) combined with minimally invasive percutaneous plate osteosynthesis (MIPPO) and Intertan intramedullary nail fixation by closed reduction in the treatment of AO/Orthopaedic Trauma Association (AO/OTA) type 31-A3.3 intertrochanteric fracture with incomplete lateral wall. Methods: The clinical data of 54 patients with AO/OTA type 31-A3.3 intertrochanteric fracture who met the selection criteria and were admitted between January 2012 and January 2018 were retrospectively analyzed. According to different surgical methods, the patients were divided into group A (24 cases with lateral wall reconstruction by MIPPO combined with PFNA internal fixation) and group B (30 cases with Intertan intramedullary nail fixation by closed reduction only). There was no significant difference between the two groups ( P>0.05) in terms of gender, age, side of injury, cause of injury, and combined medical diseases. The operation time, intraoperative blood loss, time to weight-bearing, fracture healing time, and postoperative complications were recorded and compared between the two groups. The tip apex distance (TAD) was measured at 2 days, 2 months, and 1 year after operation. At 12 months after operation, the hip joint function was evaluated according to Harris scoring standard, and the rate of conformity (Harris score were more than 70) was calculated. Results: The wounds of the two groups healed by first intention, without infection, skin deformity, and other incision complications. The operation time and intraoperative blood loss of group A were significantly more than those of group B, and the time to weight-bearing and fracture healing were significantly shorter than those of group B ( P0.05). There was 1 case of infection, 1 case of screw withdrawal, 2 cases of screw removal, and 1 case of bone nonunion in group B, the incidence of complications was 16.7%; there was only 1 case of screw withdrawal combined with screw blade withdrawal in group A, the incidence of complications was 4.2%; there was no significant difference between the two groups ( χ2=2.109, P=0.146). At 12 months after operation, the Harris scores of pain, function, malunion, range of motion, and total score in group A were significantly better than those in group B ( P<0.05). The rate of conformity of group A was 95.83% (23/24) and 76.67% (23/30) in group B, and the difference between the two groups was significant ( χ2=3.881, P=0.049). Conclusion: For the AO/OTA type 31-A3.3 intertrochanteric fracture with incomplete lateral wall, compared with the closed reduction Intertan intramedullary nail fixation, the incidence of internal fixation failure after MIPPO reconstruction with lateral wall combined with PFNA fixation was lower, the time to weight-bearing was earlier, and the postoperative function was better.

Artificial femoral head arthroplasty versus proximal femoral nail antirotation for the injured lateral wall Intertrochanteric fracture in elderly adults / 中国组织工程研究

BACKGROUND: For the treatment of intertrochanteric fracture in elderly patients, if there is no operative contraindication, surgical treatment is recommended. Operative methods include internal fixation and joint replacement. Surgical techniques are mature, but the choice of surgical methods is controversial. OBJECTIVE: To compare the efficacy of artificial femoral head arthroplasty and proximal femoral nail antirotation in elderly patients with injured lateral wall femoral intertrochanteric fracture so as to provide the basis of clinical method selection and to provide the original data for the systematic analysis of large sample. METHODS: According to the case criterion, 48 cases of AO classification of type A2.2, A2.3 intertrochanteric fractures were selected in Department of Orthopedics, the 71 Group Army Hospital of Chinese PLA from January 2012 to December 2017. They were divided into femoral head arthroplasty group (n=29) and proximal femoral nail antirotation group (n=19). All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. The patients were followed up for 1-3 years. Operation time, bleeding volume, hospitalization expenses, the incidence of complications, and Harris hip score at 1 month and 1 year after the surgery were compared between the two groups. RESULTS AND CONCLUSION: (1) After statistical analysis, operation time was significantly shorter in the femoral head arthroplasty group than in the proximal femoral nail antirotation group (P 0.05). The cost of hospitalization was significantly more in the femoral head arthroplasty group than in the proximal femoral nail antirotation group (P 0.05). (3) There was no significant difference in the incidence of complications between the two groups (P > 0.05). (4) For the patients over 70 years old with intertrochanteric fracture of injured lateral wall, artificial femoral head replacement has the advantages of early getting out of bed, high quality of life and quick recovery of joint function. It is suggested to choose artificial femoral head replacement first.

Clinical significance of external wall of femoral intertrochanteric fracture and the treatment of internal fixation / 中国组织工程研究

BACKGROUND: The concept of the lateral wall as a hot area has emerged in recent years, and has great guiding significance for the treatment of intertrochanteric fractures. OBJECTIVE: To review the definition, scope, thickness of the lateral wall and its important role in the surgical treatment of intertrochanteric fractures. METHODS: The authors searched Wanfang, CNKI, PubMed, and Web of Science. The search terms were “intertrochanteric fracture, lateral wall, fracture fixation” in Chinese and English. The retrieved documents were sorted, analyzed and summarized. RESULTS AND CONCLUSION: (1) The definition, scope, thickness and measurement method of the lateral wall and its clinical significance were sorted out. (2) Classification criteria based on lateral intertrochanteric fractures of the femur were summarized. (3) In terms of treatment, four kinds of treatment methods: Extramedullary fixation, intramedullary fixation, artificial joint replacement and other treatment methods were listed. Causes and treatment of fracture of lateral wall during and after operation were analyzed. (4) The results showed that the integrity of the lateral wall directly affected the stability of the internal fixation, even the success of the internal fixation. The complete lateral wall can prevent the distal femur from moving inward and the head pin from withdrawing, and prevent the coxa varus deformity. Clinicians should make use of detailed imaging examination, analyze fracture types, comprehensively consider various factors, and select appropriate repair methods.

Pantrochanteric Fracture: Incidence of the Complication in Patients with Trochanteric Fracture Treated with Dynamic Hip Screw in a Hospital of Southern Brazil / Fratura pantrocantérica: incidência da complicação em pacientes comfratura trocantérica tratados comparafuso dinâmico de quadril em um hospital do Sul do Brasil

Abstract Objective The aim of the present study was to investigate the incidence of pantrochanteric fractures in cases of trochanteric fractures treated with dynamic hip screw in our service. Methods A sample of 54 patients with trochanteric fractures treated with dynamic hip screws was included in this retrospective study. Preoperative radiographs were evaluated for fracture classification using the Arbeitsgemeinschaft für Osteosynthesefragen (Association for the Study of Internal Fixation, in German)/Orthopedic Trauma Association (AO/OTA) system for the identification of radiographic osteoporosis and for the measurement of the lateral femoral wall thickness. In the immediate postoperative images, the presence of pantrochanteric fracture was evaluated. Results The final sample presented an incidence of 16.7% of pantrochanteric fractures. The thickness of the lateral wall was significantly lower in the group with the complication (p < 0.001). Although fractures classified as 31-A2 were more numerous in the group with pantrochanteric fracture, the difference was not statistically significant (p = 0.456). Conclusion The percentage of pantrochanteric fractures in this service is in accordance with previous studies. There was an association between lateral femoral wall thickness and the occurrence of iatrogenic fracture of the lateral cortex. There was no significant difference between fracture classification and pantrochanteric fracture, possibly due to sample size.

Resumo Objetivo Investigar a incidência de fraturas pantrocantéricas nos casos de fraturas trocantéricas tratadas com parafuso dinâmico de quadril em nosso serviço. Métodos Uma amostra de 54 pacientes comfraturas trocantéricas tratadas comparafuso dinâmico dequadril foi incluída neste estudo retrospectivo. Foramavaliadas radiografias précirúrgicas para classificação das fraturas com o sistema AO/OTA, identificação de osteoporose radiográfica emensuração da espessura da cortical lateral, enquanto nas imagens pósoperatórias imediatas foi avaliada a presença de fratura pantrocantérica. Resultados Aamostrafinal apresentou a incidência de 16,7%defraturaspantrocantéricas. A espessura da parede lateral foi significativamentemais baixa no grupo coma complicação (p < 0,001). Embora a incidência de fraturas classificadas como 31.A2 tenha sido maior no grupo com fratura pantrocantérica, a diferença não foi significativa (p = 0,456). Conclusão O percentual de fraturas pantrocantéricas nesse serviço encontra-se em acordo com trabalhos prévios. Houve associação entre espessura da cortical lateral e ocorrência de fratura iatrogênica da parede lateral. Não houve diferença significativa entre classificação das fraturas e fratura pantrocantérica, possivelmente devido ao tamanho da amostra.

Fixation with proximal femoral nail antirotation-Ⅱ for femoral intertrochanteric fractures involving lateral wall / 中华创伤骨科杂志

Objective To evaluate the fixation with proximal femoral nail antirotation-Ⅱ (PFNA Ⅱ) for femoral intertrochanteric fractures involving the lateral wall.Methods A retrospective study was conducted of the 491 patients with femoral intertrochanteric fracture who had been treated from January 2013 to December 2017 at Department of Hip Surgery,Orthopedic Hospital,Affiliated Hospital to Panzhihua University.Of them,the lateral wall was involved in 104 (group A),43 males and 61 females with an age of 72.3 ± 2.1 years;their later wall fractures were classified as type Ⅰ (simple lateral wall fracture) in 45 cases,as type Ⅱ (fragmental lateral wall fracture) in 23 cases and as type Ⅲ (combined fracture of lateral wall and subtrochanter) in 36 cases.In the other 387 cases (group B),the lateral wall was not involved.They were 186 males and 201 females with an age of 74.7 ± 1.5 years.The 2 groups were compared in terms of incision length,operating time,intraoperative blood loss,fracture healing time,postoperative weight-bearing time,Harris scores at the last follow-up and complications.Results There were no significant differences between the 2 groups of patients in their preoperative general data,indicating they were compatible(P ＞ 0.05).All the 491 patients obtained an average follow-up of 25.5 months (from 12 to 50 months).The fracture healing time in group A (27.2 ± 12.1 weeks) was significantly longer than in group B (13.1 ±2.2 weeks)and the rate of delayed union in the former (16.4％,17/104) was significantly higher than that in the latter (2.3％,9/387) (both P ＜ 0.05).There were no significant differences between the 2 groups in incision length (7.1 ± 1.2 cm versus 6.5 ±2.2 cm),operating time (60.8 ± 1.2 min versus 56.5 ± 1.5 min),intraoperative blood loss (96.2 ± 2.1 mL versus 92.1 ± 2.4 mL),postoperative weight-baring time (2.5 ± 2.1 d versus 2.1 ± 2.9 d),the Harris scores at the last follow-up (83.3 ± 2.3 versus 85.1 ± 3.4) or incidence of other complications [5.8％ (6/104) versus 4.7％ (18/387)] (all P ＞ 0.05).Conclusion Femoral intertrochanteric fractures involving the lateral wall can be effectively treated by PFNA Ⅱ fixation,but they usually take longer time to get united than those without lateral wall fracture.

Accurate understanding of the lateral wall of intertrochanteric fracture / 中国修复重建外科杂志

With the deepening of the research on intertrochanteric fracture, the importance of "lateral wall" of femur is gradually recognized. The integrity of the lateral wall can affect the stability of intertrochanteric fractures, the choice of surgical methods and internal fixation, and the outcome of patients after surgery, which has become a research hotspot. However, there is no unified understanding on the definition of lateral wall, the judgement of injury status and the treatment of lateral wall fracture. This article reviews the literature, and combines with the clinical understanding of the role of the lateral femoral wall, in order to provide reference for orthopaedic surgeons and relevant researchers.

Fixation with proximal femoral nail antirotation-Ⅱ for femoral intertrochanteric fractures involving lateral wall / 中华创伤骨科杂志

Objective@#To evaluate the fixation with proximal femoral nail antirotation-Ⅱ (PFNAⅡ) for femoral intertrochanteric fractures involving the lateral wall.@*Methods@#A retrospective study was conducted of the 491 patients with femoral intertrochanteric fracture who had been treated from January 2013 to December 2017 at Department of Hip Surgery, Orthopedic Hospital, Affiliated Hospital to Panzhihua University. Of them, the lateral wall was involved in 104 (group A), 43 males and 61 females with an age of 72.3±2.1 years; their later wall fractures were classified as type Ⅰ (simple lateral wall fracture) in 45 cases, as type Ⅱ (fragmental lateral wall fracture) in 23 cases and as type Ⅲ (combined fracture of lateral wall and subtrochanter) in 36 cases. In the other 387 cases (group B), the lateral wall was not involved. They were 186 males and 201 females with an age of 74.7±1.5 years. The 2 groups were compared in terms of incision length, operating time, intraoperative blood loss, fracture healing time, postoperative weight-bearing time, Harris scores at the last follow-up and complications.@*Results@#There were no significant differences between the 2 groups of patients in their preoperative general data, indicating they were compatible(P>0.05). All the 491 patients obtained an average follow-up of 25.5 months (from 12 to 50 months). The fracture healing time in group A (27.2±12.1 weeks) was significantly longer than in group B (13.1±2.2 weeks) and the rate of delayed union in the former (16.4%, 17/104) was significantly higher than that in the latter (2.3%, 9/387) (both P<0.05). There were no significant differences between the 2 groups in incision length (7.1±1.2 cm versus 6.5±2.2 cm), operating time (60.8±1.2 min versus 56.5±1.5 min), intraoperative blood loss (96.2±2.1 mL versus 92.1±2.4 mL), postoperative weight-baring time (2.5±2.1 d versus 2.1±2.9 d), the Harris scores at the last follow-up (83.3±2.3 versus 85.1±3.4) or incidence of other complications [5.8% (6/104) versus 4.7%(18/387)] (all P>0.05).@*Conclusion@#Femoral intertrochanteric fractures involving the lateral wall can be effectively treated by PFNA Ⅱ fixation, but they usually take longer time to get united than those without lateral wall fracture.

Effect of Cochlear Implant Electrode Array Design on Electrophysiological and Psychophysical Measures: Lateral Wall versus Perimodiolar Types

BACKGROUND AND OBJECTIVES: The present study aims to investigate whether the cochlear implant electrode array design affects the electrophysiological and psychophysical measures. SUBJECTS AND METHODS: Eighty five ears were used as data in this retrospective study. They were divided into two groups by the electrode array design: lateral wall type (LW) and perimodiolar type (PM). The electrode site was divided into three regions (basal, medial, apical). The evoked compound action potential (ECAP) threshold, T level, C level, dynamic range (DR), and aided air conduction threshold were measured. RESULTS: The ECAP threshold was lower for the PM than for the LW, and decreased as the electrode site was closer to the apical region. The T level was lower for the PM than for the LW, and was lower on the apical region than on the other regions. The C level on the basal region was lower for the PM than for the LW whereas the C level was lower on the apical region than on the other regions. The DRs on the apical region was greater for the PM than for the LW whereas the DR was narrower on the apical region than on the other regions. The aided air conduction threshold was not different for the electrode design and frequency. CONCLUSIONS: The current study would support the advantages of the PM over the LW in that the PM had the lower current level and greater DR, which could result in more localized neural stimulation and reduced power consumption.

Research progress of lateral wall injury of intertrochanteric fracture / 中国修复重建外科杂志

Objective: To summarize the general concept of lateral wall, the causes of lateral wall injury, and surgical strategies in order to improve the understanding of lateral wall and reduce the complications of operation. Methods: The related literature on lateral wall was extensively reviewed, summarized, and analyzed. Results: The superior extent of the lateral wall is vastus lateralis ridge and the inferior extent is the intersection between the lateral femoral cortex and a line drawn at a tangent to the inferior femoral neck. The integrity of the lateral wall is important to prevent the failure of fixation and reoperation of intertrochanteric fractures. The main causes of injury are that there is no suitable typing criteria as a guide, the fracture pattern shown by X-ray does not match with the actual situation of the fracture, the type of fracture is special, and the operation is improper. The main treatment is to reconstruct the lateral wall and choose different reconstruction methods according to different fracture patterns. Conclusion: The lateral wall is very important for the treatment of intertrochanteric fracture. Lateral wall fracture should be internal fixation in order to minimize the risk of reoperation.

The development of techniques served to widen the lateral velopharyngeal space for treating OSAHS / 临床耳鼻咽喉头颈外科杂志

Since Fujita first described uvulopalatopharyngoplasty(UPPP)in 1981,UPPP and its modified procedures have been widely used to treat obstructive sleep apnea and hyponea syndrome(OSAHS).However,despite of its wide application,the success rates was uncertain,ranging from 20% to 80%,with patients of varing Friedman stages.It is well known that the principle of UPPP is to remove the redundant tissue of palate,elongated uvula and hypertrophic tonsils in order to widen the anteroposterior space at the level of palate.But recently,surgeons have found that not only the collapse of soft palate but also the collapse of lateral wall at the palate level can contribute to the obstruction of upper airway at the level of palate.As a result,many surgeries which can widen the lateral velopharyneal space have sprung up in these years.This review focuses on the development of techniques that emphasize the enlargement of lateral velopharyneal space in patients with OSAHS.

Internal fixation with proximal femoral nail anti-rotation for intertrochanteric fracture involving lateral wall: a finite element analysis / 中华创伤骨科杂志

Objective To study the biomechanical performance of proximal femoral nailing antirotation (PFNA) in the treatment of femoral intertrochanteric fracture involving the lateral wall using finite element analysis and the significance of the lateral wall.Methods A healthy senior volunteer,male,80 years of age,was recruited for this study.The CT data of his proximal femur were used to establish a three-dimensional finite element model of proximal femur by software Mimics17.0 and Geomagic Stusio.After the intertrochanteric fracture of AO-type 31-A1.2 was simulated together with coronal displacement of the lateral wall fracture,it was assembled with PFNA into the three-dimensional finite element model.Finite element analysis was performed on the femoral head,neck,fracture ends,lateral wall,and internal components of the model to observe the stress values of various parts of the model under the same load,with different degrees of fracture reduction (no displacement,anterior displacement of 5％,10％,15％ and 20％,posterior displacement of 5％,10％,15％ and 20％) and with or without the lateral wall.Results The stress values for internal components at the femoral head,neck,fracture ends,main nail with anatomical reduction of fracture ends and integrity of the lateral wall were 0.40 MPa,30.05 MPa,74.35 MPa and 121.68 MPa,respectively.The respective stress values of the above with lateral wall fracture were 0.82 MPa,47.32 MPa,151.92 MPa and 266.88 MPa,increased by about 100％.With every horizontal reduction loss increased by 5％ forward or backward,the stress exerting on the corresponding spots would see a 10％ progressive growth,plus 20％ lateral wall fracture and reduction loss.The stress of the main nail (468.43 MPa) was thrice that (121.68 MPa) of the stress posing on the complete lateral wall with the fracture ends 100％ reduced.Conclusions When PFNA is used in the treatment of femoral intertrochanteric fractures involving the lateral wall,stresses on the internal components may be doubled.Loss of coronal reduction may lead to the most significant increase in stress on the bonding site between the main nail and screw blade.

Biomechanical study of the lateral wall of the femur in the treatment of femoral intertrochanteric fracture with intramedullary or extramedullary fixation / 中国骨伤

<p><b>OBJECTIVE</b>To observe the biomechanical effects of the lateral wall of the femur in treating femoral intertrochanteric fractures with intramedullary or extramedullary fixation to guide the choice of clinical fixed methods.</p><p><b>METHODS</b>Twelve adults femur specimens of intertrochanteric fractures were belong to the type A1 of the AO fracture classification and randomly divided into the lateral wall complete PFNA group, the lateral wall complete PF-LCP group, the lateral wall breakage PFNA group, lateral wall breakage PF-LCP group, every group had 3 specimens. The four groups of specimens were subjected to compressive loading experiment with Universal Material Testing Machine. The maximum loading force was observed. The distance between fracture ends, the distance of fracture dislocation and the sliding distance of the fracture fragments along the intertrochanteric were measured with Calipers.</p><p><b>RESULTS</b>The maximum loading force of lateral wall complete PFNA group were larger than that of lateral wall complete PF-LCP group, and the maximum loading force of lateral wall breakage PFNA group were larger than that of lateral wall breakage PF-LCP group, there were significant differences (<0.05). The distance between fracture ends of the four groups before compression were not significant differences(>0.05). The distance between fracture ends, the distance of fracture dislocation and the sliding distance of the fracture fragments were not significant differences between lateral wall complete PFNA group and lateral wall complete PF-LCP group after compression (>0.05). But the distance between fracture ends, the distance of fracture dislocation and the sliding distance of the fracture fragments of lateral wall breakage PFNA group were less than that of lateral wall breakage PF-LCP group(<0.05).</p><p><b>CONCLUSIONS</b>Intramedullary fixation of intertrochanteric fractures have stronger loading force. Both intramedullary and extramedullary fixation of intertrochanteric fractures have strong stability when the lateral wall of the femur is complete, but intramedullary fixation of intertrochanteric fractures is stronger stability than extramedullary fixation when the lateral wall of the femur is broken. So the intramedullary fixation is the first choice for the treatment of intertrochanteric fracture.</p>

Research on the lateral wall in trochanteric hip fractures / 中华创伤骨科杂志

The lateral wall,a new concept in the study of trochanteric hip fractures,has a great influence on the choice of internal fixation methods,stability of the fracture and prognosis of the patients.Currently,the research on the lateral wall focuses on the factors leading to its rupture,its anatomical features and its effect on internal fixation,but results in controversial views which are mostly influenced by the subjective and experimental factors.This review deals with how the concept of lateral wall was proposed,the importance and anatomical features of lateral wall,the causes for lateral wall rupture and current treatment perspectives of trochanteric hip fractures,aiming at increasing the awareness of the lateral wall among orthopedic surgeons and related researchers.

Study of adjacent anatomy between the middle and distal section of bony nasolacrimal Duct and the anterior wall of maxillary sinus / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo observe the anatomic relationship between the middle and distal section of bony nasolacrimal duct and anterior wall of maxillary sinus. METHODS206 cases of sinus CT without maxillary disorders were enrolled. The middle and distal section of bony nasolacrimal duct and anterior wall of maxillary sinus is divided into fusion type and separation types, and the angle between the anterior and medial wall of the maxillary sinus is divided into frontal and lateral types in relation to the middle and distal section of bony lacrimal duct.RESULTSThe fusion type accounted for 40.05%, and the separate type was 59.95%. There was no statistical difference between male and female.The proportion of inconsistency on both sides was 16.02%. The frontal type of the angle between the anterior and medial wall of the maxillary sinus accounted for 64.08%, meanwhile the proportion of the lateral type was 35.92%. The lateral type was 84.24% out of the cases of fusion type, whereas the frontal type was15.76%. In the separate type, the frontal type accounted for 97.17%, and the lateral type was 2.92%. CONCLUSIONThe anatomic relationship between the middle and distal section of bony nasolacrimal duct and anterior wall of maxillary sinus shows different type, which is helpful to choose operative strategy.