The perforator flap of ipsilateral nasolabial sulcus used to repair the defect after the eradication of nasal vestibular squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the feasibility of only surgical resection for nasal vestibular squamous cell carcinoma and the efficacy of perforator flap of ipsilateral nasolabial sulcus in repairing postoperative defects. Methods: The clinical data of 8 cases with squamous cell carcinoma of the nasal vestibule who admitted to Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University were analyzed, including 6 males and 2 females, aged from 38 to 75 years. The tumor of the nasal vestibule was eradicated in time after making definite diagnosis of lesions, then the perforators flap of the ipsilateral nasolabial sulcus was used for repairment, without performing further chemotherapy or radiotherapy after surgery. The tumor recurrence, facial appearance, nostril form, donor area scar, nasal ventilation function, and cutaneous sensation were evaluated after surgery. Descriptive analysis was used in this research. Results: There were 2 cases of stage T1 and 6 cases of stage T2 in 8 cases. After 32 to 45 months of following-up, no recurrence accurred and all the flaps survived well. However, there was about 2 mm necrosis of the transplanted flap in the lateral foot of the alar in one case, which was healed well by carrying out wound care after 10 d. And the dark color flap was occurred in another case, showing the flap's backflow trouble, yet it was improved with addressing timely during 5 d postoperation. Pincusion-like deformity of the transplanted flap occurred in 4 cases (50%), which subsided gradually after 6 months. The morphology of the anterior nostril was altered in 4 cases (50%), but there was no ventilation trouble and no need for addressment in any case. The postoperative facial appearance was rated as excellentor good with hidden scar in the donor site, and the sensation of the transplanted flaps was indistinct from the surrounding tissue after 3 months. Conclusions: Surgical resection of nasal vestibular squamous cell carcinoma with tumor stage T1-2 is a feasible treatment. And it is the one of the best reconstructive methods of the perforator flap of the ipsilateral nasolabial sulcus to repair the deformities after the surgery.

Involvement of acid-sensing ion channel 1a in functions of cultured human retinal pigment epithelial cells / 华中科技大学学报（医学）（英德文版）

In the retina, pH fluctuations may play an important role in adapting retinal responses to different light intensities and are involved in the fine tuning of visual perception. Acidosis occurs in the subretinal space (SRS) under pathological conditions such as age-related macular degeneration (AMD). Although it is well known that many transporters in the retinal pigment epithelium (RPE) cells can maintain pH homeostasis efficiently, other receptors in RPE may also be involved in sensing acidosis, such as acid-sensing ion channels (ASICs). In this study, we investigated whether ASIC1a was expressed in the RPE cells and whether it was involved in the function of these cells. Real-time RT-PCR and Western blotting were used to analyze the ASIC1a expression in ARPE-19 cells during oxidative stress induced by hydrogen peroxide (H(2)O(2)). Furthermore, inhibition or over-expression of ASIC1a in RPE cells was obtained using inhibitors (amiloride and PCTx1) or by the transfection of cDNA encoding hASIC1a. Cell viability was determined by using the MTT assay. The real-time RT-PCR and Western blotting results showed that both the mRNA and protein of ASIC1a were expressed in RPE cells. Inhibition of ASICs by amiloride in normal RPE cells resulted in cell death, indicating that ASICs play an important physiological role in RPE cells. Furthermore, over-expression of ASIC1a in RPE cells prolonged cell survival under oxidative stress induced by H(2)O(2). In conclusion, ASIC1a is functionally expressed in RPE cells and may play an important role in the physiological function of RPE cells by protecting them from oxidative stress.

Involvement of acid-sensing ion channel 1a in functions of cultured human retinal pigment epithelial cells / 华中科技大学学报（医学）（英德文版）

In the retina, pH fluctuations may play an important role in adapting retinal responses to different light intensities and are involved in the fine tuning of visual perception. Acidosis occurs in the subretinal space (SRS) under pathological conditions such as age-related macular degeneration (AMD). Although it is well known that many transporters in the retinal pigment epithelium (RPE) cells can maintain pH homeostasis efficiently, other receptors in RPE may also be involved in sensing acidosis, such as acid-sensing ion channels (ASICs). In this study, we investigated whether ASIC1a was expressed in the RPE cells and whether it was involved in the function of these cells. Real-time RT-PCR and Western blotting were used to analyze the ASIC1a expression in ARPE-19 cells during oxidative stress induced by hydrogen peroxide (H(2)O(2)). Furthermore, inhibition or over-expression of ASIC1a in RPE cells was obtained using inhibitors (amiloride and PCTx1) or by the transfection of cDNA encoding hASIC1a. Cell viability was determined by using the MTT assay. The real-time RT-PCR and Western blotting results showed that both the mRNA and protein of ASIC1a were expressed in RPE cells. Inhibition of ASICs by amiloride in normal RPE cells resulted in cell death, indicating that ASICs play an important physiological role in RPE cells. Furthermore, over-expression of ASIC1a in RPE cells prolonged cell survival under oxidative stress induced by H(2)O(2). In conclusion, ASIC1a is functionally expressed in RPE cells and may play an important role in the physiological function of RPE cells by protecting them from oxidative stress.

A study on structure of human horizontal rectus insertion by anterior segment optical coherence tomography / 中华实验眼科杂志

Background The measurement of the extraocular muscle is critical for the diagnosis of extraocular muscle diseases,but conventional medical imaging techniques present some shortcomings because of the contact pattern.The anterior segment optical coherence tomography (OCT) is thought to be an in vivo noninvasive optical diagnostic imaging method.Objective This clinical study attempted to seek an available approach to the evaluation of the anatomic structure of human horizontal rectus insertion with Visante OCT.Methods One hundred and fourteen eyes of 58 subjects were included in this study and were divided into the low refractive power group (≤-3.00 D) with 43 eyes,moderate refractive power group(＞-3.00 D-≤-6.00 D) with 49 eyes and high refractive power group(＞-6.00 D) with 22 eyes.The horizontal rectus insertion distance to the scleral spur and its thickness were measured by Visante OCT.The correlation of the refractive power with the rectus insertion distance or thickness was analyzed.Written informed consent was obtained from each subject before medial assessment.Results The average distance from the scleral spur to the lateral and medial rectus insertion were (5.23±0.50)mm and (3.81±0.46)mm respectively.The average thickness of the lateral and medial rectus insertions were (0.39±0.06)mm and (0.39±0.06)mm respectively,showing no significant differences in comparison with those of ultrasound biomicroscopy (P=0.338,P=0.759).The lateral and medial rectus insertion distances were (5.25±0.45)mm and (3.74±0.53)mm in the low refractive power the group,(5.22±0.60)mm and (3.81±0.42)mm in the moderate group and (5.20±0.35)mm and (3.90±0.42)mm in the high refractive power group,presenting inconsiderable difference among these three groups(lateral rectus: χ2=0.054,P=0.974;medial rectus: F=0.508,P=0.604).The thickness of the lateral and medial rectus insertions were (0.41±0.06)mm and (0.40±0.06)mm in the low refractive power group,(0.40±0.07)mm and (0.37±0.07)mm in the moderate refractive power group,(0.36±0.05)mm and (0.39±0.05)mm in the high refractive power group with a significant difference among lateral rectus (F=4.922,P=0.009) but not medial rectus (F=2.152,P=0.125).The lateral rectus insertions thickness in the high refractive power group was thinner than that in low refractive power group (P＜0.05).A positive correlation was found between refractive power and the thickness of lateral or medial rectus insertions (r=0.284,P＜0.01).Conclusion Visante OCT is a uscful way in measuring the distance and thickness of the extraocular muscles.Lateral rectus insertions thickness tends to be thinner with the worsening of myopia,which is obvious in high myopia.

Frontalis muscle fascial flap passing through the pulley of orbital septum for correction of severe blepharoptosis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical result of the frontalis muscle fascial flap passing through the pulley of orbital septum for correction of severe blepharoptosis.</p><p><b>METHODS</b>57 eyes in 52 cases with congenital severe blepharoptosis were treated in recent two years. After the frontalis muscle fascial flap was prepared beneath the orbicularis oculi muscle, the pulley was created by two parallel horizontal incision on the orbital septum at the upper orbital rim and 1 cm under the upper rim. The frontalis muscle fascial flap was then pulled down behind the pulley and out to be attached to the upper margin of tarsal plate.</p><p><b>RESULTS</b>The following-up period was 3-6 months. Satisfactory cosmetic result was achieved in 52 eyes. Three eyes had ptosis relapse and 2 eyes had unnatural contour of the palpebral margin which required another corrective operation. No other complication was observed.</p><p><b>CONCLUSIONS</b>The pulley created by the orbital septum makes the traction lines of the frontalis muscle fascial flap in a similar direction as the natural movement of levator muscle. So both the postoperative static and dynamic appearance of the upper lid is more natural. The technique is very practicable in correction of blepharoptosis.</p>

Reconstruction of orbital deformity after radiotherapy with transcranial orbitotomy advancement combining free flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study clinic therapeutic effect about reconstruction of severe orbital and cul-de-sac deformity after the radiotherapy with transcranial orbitotomy advancement combining cascade free flap both dorsum pedis flap and anterior tibial fascial flap.</p><p><b>METHODS</b>Five cases was subjected to orbital and cut-de-sac severe deformities after both operation and radiotherapy because of retinoblastoma. The technique included transcranial orbital advancement by anterior orbital osteotomy and rigid fixed with titanic plate by coronal incision, and meanwhile incising the cul-de-sac which would be extended circumference around the central incision separation, and then designing extent of cascade flap consisted of dorsum pedis flap and anterior tibial fascial flap according to the size of cul-de-sac defect and extent of temporal depression. Then, the aforementioned two parts of cascade flap were transplanted into cul-de-sac and temple respectively. There is either the superficial temporal artery and vein or facial artery and jugular vein to chose vascular anastomosis.</p><p><b>RESULTS</b>All flaps survived. After 3 to 6 months following up, the results showed satisfactory orbital contour and temporal depression improved significantly in all cases. After the conjunctival sac were fixiformed with prefabricated eye prosthesis mode about 3 months. 3 cases have good appearance with wearing eye prosthesis and the other 2 cases' appearance is poor. One of the poor appearance cases, with depressed eye socket, have orbital implant underlying conjunctival sac in secondary operation. The other one, with swallowed inferior fornix, is transplanted autogenous hard palatal mucosa into inferior fornix in secondary operation. In addition, delayed healing in donor site of dorsum pedis occurred in one of the 4 cases.</p><p><b>CONCLUSIONS</b>It is a reliable procedure about reconstruction of severe orbital and cul-de-sac deformity after both the operation and radiotherapy with transcranial orbitotomy advancement combining cascade free flap both dorsum pedis flap and anterior tibial fascial flap. All deformity was corrected by one staged procedure which lessen patient's suffering and shorten patient's hospital stay and spare patient's costs.</p>

Modified transcranial orbitotomy for treating exophthalmic intraorbital tumor / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the feasibility of the modified osteotomy of transcranial orbitotomy in the treatment of intraorbital tumor.</p><p><b>METHODS</b>We treated 8 patients with intraorbital tumor during six years. By the bicoronary incision, all cases underwent double bone flap osteotomy on the frontal bone: the superior orbital rim bone flap and roof flap instead of single fronto-orbital bone flap in the conventional transcranial orbitotomy. After removal of bone flaps, intracranial and intraorbital operation was performed. Then, two bone flaps were reduced respectively and fixated with titanic micro-plates and nails. At last, the scalp flap was sutured.</p><p><b>RESULTS</b>The operative field was very well exposed. It was found that the retrobulbar tumor was located at the superolateral, median and superonasal area respectively, which was coincided with the preoperative CT and MRI. The tumor included adenocarcinoma of the lacrimal gland, neurinoma, meningioma, and cavernous hemangioma. Four patients had blood transfusion during the operation. No other postoperative complications happened except 3 cases of diplopia and one case of blindness. After 3 to 6 months follow up, diplopia of the 3 cases gradually disappeared. Of the 8 cases, 6 reached the same visual acuity as the preoperative state. One decreased visual acuity and one lost light perception. There was well-balanced fronto-orbital appearance and eyeball position compared with the healthy side in all cases.</p><p><b>CONCLUSIONS</b>This surgical method for the treatment of intraorbital tumor is safe with well-exposed operative field. It has advantages not only in simpleness and less trauma, but also in keeping orbital roof and anterior fossa intact and decreasing complications.</p>