Clinical observation on acupoint sticking therapy plus electroacupuncture for treating peripheral facial paralysis / 针灸推拿医学（英文版）

Objective: To observe the clinical effect of acupoint sticking therapy with Mian Tan Gao (facial paralysis paste) plus electroacupuncture (EA) for treating peripheral facial paralysis and its influence on patients' facial nerve functions, facial disability index and clinical symptoms and signs. Methods: A total of 96 peripheral facial paralysis patients were allocated into an observation group, a medicine group and an EA group by simple randomization, with 32 cases in each group. Patients in the medicine group were treated with oral mecobalamine and prednisone acetate; patients in the EA group were treated with EA on the basis of the medicine treatment; while patients in the observation group were treated with acupoint sticking therapy with Mian Tan Gao (facial paralysis paste) plus EA. After 4-week treatment, the clinical efficacy, the adverse events, and the scores of House-Brackmann (H-B) facial nerve function grading scale, visual analog scale (VAS), clinical symptoms and signs, and facial disability index (FDI) were compared. Results: After 4-week treatment, the total effective rate was 96.9％ in the observation group, higher than 68.7％ in the medicine group and 75.0％ in the EA group (both P<0.05). After 4-week treatment, the scores of H-B grading scale, VAS and clinical symptoms and signs in the three groups dropped significantly compared with those before treatment, and the scores in the observation group were lower than those in the medicine group and EA group (all P<0.05). After 4-week treatment, the facial disability index-physical function (FDIP) in the FDI in the three groups increased significantly, with a higher value in the observation group compared with that in the medicine group and EA group (both P<0.05). The facial disability index-social function (FDIS) in the FDI dropped significantly, with a lower score in the observation group compared with that in the medicine group and EA group (both P<0.05). However, the comparisons of the items above between the medicine group and the EA group showed no statistical significance (all P>0.05). The between-group comparison of the adverse event across the three groups showed no statistical significance (P>0.05). Conclusion: Acupoint sticking therapy with Mian Tan Gao (facial paralysis paste) plus EA can decrease H-B grade, reduce pain severity and improve clinical symptoms and signs as well as the facial disability condition in peripheral facial paralysis patients. This method produced more significant efficacy compared with oral medicine and medicine plus EA.

Early reconstruction of the periorbital injuries / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics and the treatment of periorbital injuries.</p><p><b>METHODS</b>61 cases were treated, including 30 cases orbitozygomatic fracture, 6 cases of frontal-orbital fracture, 8 cases of naso-ethmoid-orbital fracture, 7 cases of blow -out fracture and 10 cases of complicated fracture. The patients were diagnosed after physical examination and other examination, like CT. Through bicoronal or local mini incision at the end of eyebrow, combined with subciliary incision and local wound approach, the fractured sites were exposed completely. Then the fractured fragments were repositioned and fixed rigidly. The orbital wall was reconstructed with titanium net and Medpor.</p><p><b>RESULTS</b>The wounds healed primarily. Good cosmetic and functional results achieved in most of the patients. 4 cases underwent second-stage ophthalmectomy. 2 patients had diplopia after operation, but improved gradually. 3 cases of blepharoptosis needed further treatment.</p><p><b>CONCLUSIONS</b>Early diagnosis and treatment is very important for periorbital injuries. Fracture reposition and orbital wall reconstruction should he performed at early period.</p>

Genioplasty with two-step osteotomy for severe microgenia / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate a technique for correction of severe microgenia.</p><p><b>METHODS</b>The mandibular symphysis was exposed through intraoral mucous incision. Two parallel osteotomies were performed under mental foramen. The mobilized segments were advanced like two steps and fixed rigidly with miniplate.</p><p><b>RESULTS</b>From June, 2004 to Dec, 2005, 10 cases with severe microgenia were treated with this technique. The duration of follow-up was six months. The mean chin advancement was 1.1 cm and the mean chin vertical increase was 0.7 cm. All the patients healed very well with satisfactory aesthetic result.</p><p><b>CONCLUSIONS</b>With this two-step genioplasty, the chin can be moved to ideal position with a natural appearance. It is a reliable method for severe microgenia.</p>

Analysis of the complications following mandibular distraction using internal distractors / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the causes and the prophylactic for the complications following mandibular distraction osteogenesis using internal distractors.</p><p><b>METHODS</b>From 1997 to 2004, a total of 46 patients (61 sides) suffering from malformations or defects of mandible who underwent mandibular distraction osteogenesis were analyzed. The diseases included hemifacial microsomia in 27 cases, congenital or acquired mandibular hypoplasia and micrognathia bilateral in 8 cases and unilateral in 4 cases, electronical injury or postoperative mandibular defects in 3 cases, Treacher Collins syndrome in 2 cases, obstructive sleep apnea syndrome in 2 cases.</p><p><b>RESULTS</b>Of them, 9 patients had postoperative complications, which included 3 patients had complications associated with distractors, local infection occurred in 2 cases, apertognathia of anterior teeth in 2 case, 2 patients had sinus of the skin of the lower lip. 9 patients had been aggressivly managed and obtained satisfactory results.</p><p><b>CONCLUSIONS</b>The pivotal points to reduce complications are to understand the mechanism of mandibular distraction osteogenesis completely, and to be familiar with the anatomy of mandible and adjacent tissues. It is necessary to treat with it preoperatively and postoperatively.</p>

Surgical management of craniomaxillofacial fibrous dysplasia / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the method to obtain good aesthetic and functional results in surgical management of craniomaxillofacial fibrous dysplasia and correct the grotesque deformity.</p><p><b>METHODS</b>According to the type of the lesions, different excision and reconstruction methods were used.</p><p><b>RESULTS</b>19 cases (4 monostotic cases and 15 polyostotic cases) were surgically treated. The period of follow-up range from 9 months to 5 years, all patients obtained satisfactory aesthetic and functional results. No relapse happened during follow up.</p><p><b>CONCLUSIONS</b>Based on modern craniomaxillofacial techniques and computer aided design, extensive radical excision and craniomaxillofacial skeleton reconstruction could be safely accomplished, and the better results were obtained, both aestheticly and functionally.</p>

Individual prefabricated titanium implant for the reconstruction of the skull bone defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>This paper presents a new method of individual prefabricated titanium implant for the reconstruction of the skull bone defect.</p><p><b>METHOD</b>A computer-based 3D model of the cranial bone defect is created from helical CT-data and serves as the basis for the computer aided design and manufacturing (CAD/CAM) of the individual prefabricated titanium implant for the cranial bone defect reconstruction.</p><p><b>RESULT</b>Since 2001, a total of nine patients suffering from the cranial bone defect have been operated on by this method with satisfied result. The fallow-up is 3 to 12 months.</p><p><b>CONCLUSION</b>These individual prefabricated titanium implants have won a high precision, a good biomechanics and a excellent biocompatibility. It is a quite ideal and very simple method with much less complication for the surgical treatment of the cranial bone defect.</p>

Chin augmentation with bone transplantation from the mandible / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore a new method for mentoplasty.</p><p><b>METHODS</b>The bilateral prominent mandibular angle or outer lamina was resected through the intraoral approach. The resected bone fragments were shaped and rigid fixed to the chin with miniplates and screws.</p><p><b>RESULTS</b>A total of 30 patients (28 females, 2 males) accepted chin augmentation with this method. The mandibular angle bone was used in 20 cases and the mandibular outer lamina was used in 10 cases. The operative results were satisfactory, and the patient's facial contour was improved substantially.</p><p><b>CONCLUSION</b>No rejection reaction was found after this procedure. Chin augmentation with autogenous mandibular bone is an ideal method for genioplasty.</p>

Applications of autogenous outer table of the calvarial and mandibular bone in posttraumatic deformities of the nose / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the applications of bone grafts from the cranium or mandible in the repair of posttraumatic deformities of the nose.</p><p><b>METHODS</b>From 1997 to 2002, a total of 44 patients, who presented with secondary nose deformity as well as facial fractures, were reconstructed by autogeneous outer table grafts of the calvarial or mandibular bone after facial skeleton reposition. In this series, 32 cases used the calvarial bone, 12 cases used the mandible bone, which was harvested through a coronal incision and an oral approach respectively.</p><p><b>RESULTS</b>The surgical incisions healed primarily in all patients with minimal scar. The facial appearance was greatly improved. No implant infection, extrusion and shift were observed in the postoperative follow-up of 6 months to 2 years. There was not obvious bone resorption, nor donor site morbidity.</p><p><b>CONCLUSION</b>Autogeneous calvarial and mandibular bone was an ideal material of bone graft in reconstruction of severe posttraumatic deformities of the nose. Compared with other autogeneous and alloplastic materials, the outer table of the calvarial and mandibular bone produced less morbidity of the donor site, invisible scar, no rejection and less resorption.</p>

Compositive treatment of square face / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the treatment of square face with compositive methods. METHODS A total of 71 patients with square-shape face were treated. According to the different face skeleton and desire of patient, mandible angle curved-osteotomy and mentoplasty were used as main methods and zygomatoplasty, buccal fat pad resecting and other aesthetic methods as assistant methods to recontour the whole face skeleton.</p><p><b>RESULTS</b>The face skeleton of all patients was improved with satisfaction. The following-up period was 6 months to 2 years. In this patients group, massive haemorrhage was occurred during operation in one patient, mental nerve of of one side was injured in two patients, the lip mucosa was wounded in five patients.</p><p><b>CONCLUSION</b>Mandible angle curve-osteotomy and mentoplasty combined with other assistant aesthetic operations were ideal methods to recontour square face. The result was satisfactory.</p>

Secondary reconstruction of post-fracture deformities in the nasal-orbital ethmoid region / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the surgical reconstruction of secondary fracture deformities of the nasal-orbital ethmoid area.</p><p><b>METHODS</b>Typical bicoronal and subciliary incisions or the adjacent scar incision were employed to expose the fractured area. The flattened nasal bone was narrowed by curved osteotomy along the medial orbital rims and trimed with a bur. 2-3 pieces of cranial outer table were used to reconstruct the nasal framework, which were fixed to the frontal bone with mini-plates. After the medial orbital wall and orbital floor were exposed, the herniated orbital contents were released and reduced to the orbital cavity. The fractured orbital walls were repaired precisely with autogenous cranial outer table or Medpor. The medial canthal tendons were anchored superior-posteriorly to the lacrimal fossa with transnasal wires.</p><p><b>RESULTS</b>From December 1996 to December 2001, 34 cases of severe nasal-orbital ethmoid fracture deformities were repaired with this technique. Of them, 12 cases had combined orbital-zygomatic fracture, 4 cases had fontal sinus fracture, 1 case had Le Fort II and 1 case had Le Fort III fracture. All the patients recovered well and their facial appearance improved greatly.</p><p><b>CONCLUSIONS</b>The key points for surgical reconstruction of the periorbital post-fracture deformities are narrowing the flattened nasal root by curved osteotomy, the nasal framework reconstruction with autogenous bone graft, the orbital wall repair to correct enophthalmos, and most importantly, the medial canthal tendon reduction and canthal plasty.</p>