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OBJECTIVES@#The long-term effect of muscular force balance reconstruction technique combined with intranasal fixation for correcting secondary nasolabial deformity after unilateral cleft lip was evaluated. The aim was to provide a basis for further improving the surgical treatment effect of secondary nasolabial deformity of acleft lip.@*METHODS@#A total of 40 patients aged 4-28 years with secondary nasal deformity and unilateral cleft lip were selected as research subjects. The two-dimensional photo measurement analysis method was used in comparing the surgical results before and immediately after the operation (7 d) and 1 year after the operation.@*RESULTS@#Columellar angle, nostril height ratio (NHR), alar rim angle, alar rim angle ratio, and nostril shape (NS) increased dimmediately after the operation, whereas alar base width ratio (ABWR) and nostril width ratio decreased (NHR) immediately after the operation (P<0.01). The ABWR, NHR, and NS immediately after the operation were not significantly different from those 1 year after the operation (P>0.05).@*CONCLUSIONS@#Muscular force balance reconstruction technique combined with intranasal fixation is effective in the repair of unilateral secondary nasolabial deformity, and stable results can be obtained 1 year after surgery.
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Humanos , Fenda Labial/cirurgia , Nariz/anormalidades , Rinoplastia/métodos , Resultado do TratamentoRESUMO
BACKGROUND: Osteochondral allograft transplantation for the treatment of knee articular cartilage defects is one of the longest clinical methods. Although this method is widely used in clinical practice and is trusted by orthopedic surgeons, it still lacks evidence-based medicine support. OBJECTIVE: To investigate the efficacy of osteochondral allograft transplantation in the knee joint, systematic review and meta-analysis of all available data, and evaluate the efficacy and safety of osteochondral allograft as a transplant substitute in knee joint surgery. METHODS: Literature search was conducted in PubMed/Medline, EMBASE, Cochrane Collaboration Library, China National Knowledge Infrastructure and Wanfang Database. The application of osteochondral allograft in knee joint transplantation was searched and selected according to the literature inclusion criteria. Articles whose data can be extracted and meta-analyzable were mainly selected. RESULTS AND CONCLUSION: (1) Twenty-five studies met the inclusion criteria and were all case series studies. The patient reported that osteochondral allograft can be used as a graft material to repair knee joint defects. A total of 1 081 patients (1 111 knees) were included in the study. The age of onset was 11-75 years old, with an average age of 34.41 years. The proportion of women was about 40.81%. The follow-up period was 4-384 months, with an average of 76.8 months. (2) In these studies, donors received a minimum age of 10 years and a maximum of 65 years. According to the donor age range and number of studies, donors aged 15-45 were the primary targets. (3) The overall success rate after surgery was 74%, and the overall secondary operation rate was 17%. The success rate of unipolar surgery was 74.44% (501/673); the success rate of bipolar surgery was 50.94% (27/53). The success rate of unipolar surgery was significantly higher than that of bipolar surgery (χ2 =13.679, P < 0.05). (4) Treatment complications occurred in 67 patients (13.14%, 67/510). Common complications were persistent pain at the surgical site (15 cases), graft fracture or fragmentation (12 cases). (5) These results indicate that osteochondral allograft is an effective and safe substitute for knee joint transplantation. The overall success rate is 74% and the secondary operation rate is 17%. It is a treatment with high success rate and low risk of reoperation.
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Objective To retrospectively analyze unplanned secondary surgical operations in neurosurgery. Methods The incidence, causes and time interval from the first operation of unplanned secondary operations were systematically reviewed, and the length of stay, hospitalization expenses and conditions of prognosis of the patients were compared with those who did not suffered from unplanned secondary operations.Results In this study,339 unplanned secondary operations were confirmed from 2012 to 2016 in neurosurgery and the incidence of unplanned secondary operations was 0.65%. 80.24% of the unplanned secondary operations were incurred by postoperative bleeding,which was proved to be higher than other causes. Conclusions Unplanned secondary operations had caused more economic burdens, thus deserving close attentions. Reducing perioperative bleeding and implementing hierarchical operation management would be key to preventing and decreasing unplanned secondary operations.
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The operative treatment of orbital blowout fracture involves restoration of intra-orbital soft tissue and bony structural integrity. In extensive blowout fracture cases, inadequate dissection inappropriate implant insertion, postoperative edema and subsequent increase of intraorbital pressure may sometimes lead to displace the implant. This case study was performed on 6 patients who underwent secondary blowout fracture operation. After primary blowout fracture reduction operation, we found severely displaced implant in the postoperative computed tomogram study. The most prevalent sites were the posterior portion of the inferior and medial wall. We performed further dissection of the fracture sites and inserted more larger sized implant than before. Then we fixated the implant to prevent postoperative displacement. Among these patients, 3 patients who operated more than 3 months after the first operation, complained residual diplopia and eyeball movement disorder. These clinical cases have troublesome and unique features, so we report our experiences with review of the literatures.
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Humanos , Diplopia , Edema , Transtornos dos Movimentos , ÓrbitaRESUMO
PURPOSE: To determine the clinical course of recurrent exotropia after a secondary operation for exotropia. METHODS: The surgical results in 58 patients who had undergone reoperation for recurrent exotropia (reoperation group) were retrospectively investigated and compared with those of 100 patients who had undergone primary strabismus surgery only (primary operation group) using survival analysis. RESULTS: In the reoperation group, recurrence occurred in 19 of the 58 patients (33%). Survival analysis revealed that the recurrence rates in the reoperation group were significantly lower than those in the primary operation group at the same follow-up period after the corresponding strabismus surgery (p=0.018). The distant esodeviation at the postoperative 1st week after reoperation was the only significant factor associated with the recurrence after reoperation (p=0.01). CONCLUSIONS: Exotropia did recur after a secondary operation, although the recurrence rate was lower than that after a primary operation only.