A modified preauricular-temporal approach for fixing comminuted and redisplaced zygomatic arch fractures with the resorbable bone plate.

OBJECTIVE: To evaluate the effectiveness of the rigid internal fixation for comminuted and redisplaced zygomatic arch fractures by modified preauricular-temporal approach with the resorbable bone fixation. METHODS: Totally twenty patients aged from 14 to 68 years and admitted to our hospital between September 2006 and June 2011 were reviewed, of whom seventeen had a unilateral comminuted zygomatic arch fracture and three re-displaced arch fracture after failed closed reduction. The fracture segments were aligned to restore the preinjury form of the arch by rigid fixation with resorbable plates and screws through a modified preauricular-temporal incision. RESULTS: The fractures were well reduced, preauricular-temporal scar and lateral facial contour were aesthetically satisfying, and no case had limited mouth opening as well as facial palsy. The resorbable plates were not palpated one year after the operation. CONCLUSION: The rigid internal fixation through the preauricular-temporal approach with the resorbable bone is an effective method for the comminuted and redisplaced zygomatic arch fractures.

[Comparative study of clinical efficacy between surgery by intraoperative MRI navigation versus traditional surgical resection for malignancy of parapharyngeal space].

OBJECTIVE: To investigate the clinical efficacy between mobile intraoperative magnetic resonance imaging (iMRI) navigation with a high field strength and routine surgical resection for malignancy of parapharyngeal space. METHODS: The surgical efficacy indexes of patients at our hospital during the time range from February 2010 to February 2011 were compared between two groups consisting of 29 or 42 individuals undergoing surgery with the assistance of the technique of iMRI navigation with a high field strength 1.5T or routine operation. RESULTS: No difference existed between two groups in terms of age, gender, maximal diameter of tumors, tumor stages, surgical approach or pathologic diagnosis (P > 0.05). The operative duration of the group by iMRI navigation was more than the group of routine operation ((3.1 ± 0.6) h vs (2.7 ± 0.7) h, P < 0.05). And the hemorrhagic loss ((185 ± 20) ml vs (230 ± 22) ml), the volume of drainage in 72 hours, the positive rate of initial surgical margins, the postoperative hospital stay ((9.1 ± 2.1) d vs (10.3 ± 2.3) d) and the complication incidence rate (3.4% vs 9.5%) were less (all P < 0.05). CONCLUSION: The operation by the iMRI navigation offers a much better clinical efficacy than the traditional surgery in the resection of malignancy of parapharyngeal space.

[The preliminary study of the use of MRI navigation in identifying the safe surgical margin of the maxillofacial malignancy].

OBJECTIVE: To evaluate the feasibility of MRI navigation in identifing the safe surgical margin of the maxillofacial malignancy. METHODS: The pathology results of the surgical margin identified by the technique of MRI navigation form 20 patients with maxillofacial malignancy were compared with those of 45 patients with maxillofacial malignancy who underwent the routine operation without MRI navigation. RESULTS: There was no difference between the two groups of patients in age, sex, size of tumor, tumor stages, pathologic diagnosis (P > 0.05). The negative rate of the surgical margin of the lesions treated by surgery with the technique of MRI navigation was significantly lower than that of the lesions treated without MRI navigation (P = 0.007) and highly correspondent with the pathology results. CONCLUSIONS: MRI navigation was helpful in identifying the safe surgical margin of the maxillofacial malignancy.

[The clinical application of acellular dermal matrix to repair the defect of oral mucosa].

OBJECTIVE: To evaluate the clinical effect of acellular dermal matrix allograft in repairing the defect of oral mucosa. METHODS: Forty-two cases of large superficial defects in oral cavity were repaired by acellular dermal matrix. Defect areas included vestibule, tongue, the floor of mouth, buccal mucosa, palate, gingival and lip. Defect size was between 2.25 cm(2) and 12 cm(2). The basement membrane side of acellular dermal matrix was exposed to oral cavity, and another side was attached to the surgical wound surface. It was fixed by suture, reverse strapping and prepared template to overlaid large superficial defect of oral mucosa. The patients were followed up from 3 months to 1 year after operation. RESULTS: The wounds were completely healed in 40 cases, partially healed in 2 cases. There was no failure case. The healing was divided into two types: epithelialization healing pattern in 12 cases, attached healing pattern in 30 cases. Contraction of grafts occurred at 2 - 4 weeks. The contraction rate was 3.7% +/- 1.1% at fourth week. Scarring did not appear. CONCLUSION: The clinical result of acellular dermal matrix allograft in repair the defect of oral mucosa is good. Acellular dermal matrix can be taken as a substitute to autograft of skin.