Clinical efficacy and safety of hyaluronic acid dermal filler in treating nasolabial folds in Chinese population / 中华整形外科杂志

Objective@#To investigate the clinical efficacy and safety profile of hyaluronic acid dermal filler(Restylane®) in treating nasolabial folds in Chinese population.@*Methods@#103 subjects in this study were recruited from five Chinese clinical trial centers between July 2014 and December 2015. Subjects were treated with hyaluronic acid dermal filler in correcting nasolabial folds and an optional re-treatment was performed after 12 months according to the subjects′wishes. The improved of nasolabial folds was evaluated by the change of severity (wrinkle severity rating scale, WSRS) and aesthetic improvement (global aesthetic improvement scale, GAIS). Satisfaction of subjects on treatment was evaluated using subject satisfaction questionnaires (SSQ). Safety indicators such as pain, skin and soft tissue presentation at the injection site were continuously evaluated throughout the whole treatment process.@*Results@#Significant improvement in scores of WSRS and GAIS of all subjects was observed after treatment. Nine months after treatment, the scores of WSRS in 80 subjects (77.7%) and GAIS in 96 subjects (93.2%) were still improved. The 68 subjects (95.8%) received re-treatment after 12 months gained further improvement in nasolabial folds. Most adverse events were mild or moderate (transient/reversible local manifestations) and all resolved before study end, no severe adverse event related to products observed.@*Conclusions@#Hyaluronic acid dermal filler is effective and safe in treatment of nasolabial folds in Chinese population and the effect can last up to 12 months.

Proteomic analysis of serum exosomes derived from Crouzon syndrome patients carrying a mutant FGFR2C342Y / 中华整形外科杂志

Objective@#Reveal the global expression profile of serum exosomal proteins of Crouzon syndrome patients.@*Methods@#We isolated microvesicles from serum of Crouzon children with a C342Y mutation in FGFR2 by ultracentrifugation, which were further characterized by electron microscopy and immunoblotting. The protein profiling in normal subjects and Crouzon patients was systematically compared by iTRAQ proteomic analysis.@*Results@#The result demonstrated that microvesicles were between 30—100 nm in diameter, round shape with cup-like concavity and expressed exosomal marker tumor susceptibility gene (TSG) 101 and flotillin (Flot) 1. We identified a total number of 62 proteins, among which 22 proteins overlap with ExoCarta database and were different between the Crouzon patient and the normal subject. The Ingenuity Pathway Analysis showed that the functions of these proteins are mostly involved in Developmental Disorder, Hereditary Disorder, Skeletal and Muscular Disorders, which are all related to the clinical manifestations of Crouzon syndrome. In addition, the proteins were focused on the network of "Organismal Injury and Abnormalities, Hematological System Development and Function, Cell-To-Cell Signaling and Interaction" . The central protein FN1 was presented as the key protein in the network.@*Conclusions@#Our data demonstrated that serum exosomes harbor informative proteins and FN1 was selected as a potential candidate for its role in promoting osteoblast adhesion, proliferation and mineralization.

Correction of craniosynostosis using modified spring-assisted surgery.

BACKGROUND: The use of springs in craniofacial surgery was originated at Sahlgrenska University Hospital in 1997 as a way of remodeling the cranial vault postoperatively. After a decade of development, spring technology has been improved to a greater extent. However, there still exist some problems, such as the poor consistency of steel wire stretches, the wrong position of steel wire, the problem of increasing the elasticity of springs, and so on. METHOD: We have designed a spring device for external uses. This device is composed of 3 parts. The first part is the outside of the spring ring. This ring is the same as the internal spring, only a little bigger. The second part is a small U-shaped hook, which is made of titanium plates and linked to the skull portion. The U-shaped hook is approximately 1 cm long and 1 cm wide. The hang is approximately 1 cm long and 0.6 cm wide. The U-shaped level length is 1 cm, but the level width should be equal to or bigger than the thickness of the skull. The third part is a steel wire, which is placed at 1 end of hook. We first conduct a strip craniotomy, then put 2 hooks at the bone ends and, after that, fix hooks on the skull. Finally, we pull the steel wire of the hook end out of the scalp, connect it with the external spring, and draw out the external spring. We performed 24 craniofacial spring placement procedures for 12 patients with craniosynostosis. RESULTS: We used 6 springs for 3 patients who had anterior plagiocephaly, 12 springs for 6 patients who had scaphocephaly, and 3 springs for another patient who had metopic synostosis and holoprosencephaly. We also used 3 springs for 2 patients who had metopic synostosis. The 12 patients have not required further surgeries so far, and there were no major complications. Spring dislodgement had not caused any complication in early cases. We could easily change the position of the spring rings from outside the scalp, regularly correct the elasticity of the spring rings, and replace spring rings to increase the traction. The head shapes of the 12 children have been improved significantly to use external spring rings. CONCLUSIONS: This therapeutic modality in craniofacial surgery has allowed minimization of the extent of surgery without compromising clinical outcomes. The authors have shown that the use of external spring techniques is safe and, in selected situations, offer significant advantages over other methods of treatment. It makes up for a number of shortcomings of internal springs.

Partial midfacial duplication.

A case of craniofacial duplication is presented. Details on this rare form are described, and its treatment is discussed with brief review of the pertinent literature. We excised the duplicate maxilla and also discovered bilateral macrostomia. A year later, a mass appeared again. By CT scan, we found that there was a mass in the skull base extruding to the superior wall of cavitas pharyngis. The mass below the sphenoid bone and the ethmoid bone connected with the skull base. CT scan also showed malformation of the first cervical vertebra and odontoid process had bifurcated. Once again, we excised the mass and found a cranial meningocele on the skull base, repaired the palate cleft, and closed the cerebral meningocele. The patient had a palate fistula after operation. A year later, the palate fistula and macrostomia were repaired. We think the patient should be operated on immediately after she was born so that we could relieve the dyspnea; furthermore, by one well-planned operation, we could repair the palate cleft and other deformity just after we excised the mass.

Construction of three dimensional finite element model of the nasomaxillary complex / 中国耳鼻咽喉头颈外科

OBJECTIVE To develop a method to construct three dimensional finite element model of nasomaxillary complex,in order to provide the foundation of studying nasomaxillary biomechanics characteristics.METHODS DICOM data from HelixCT were analyzed and reconstructed in software Mimics,then complete constructing three dimensional finite element model of nasomaxillary complex in Ansys.RESULTS The nasomaxillary complex model was similar to original case in structure,which is a high finite element model.CONCLUSION Computer assistant in constructing finite element model from DICOM data is a convenient,exact and efficient method .The nasomaxillay complex finite element model is exact and reproductable,and can provide the foundation of studying biomechanics mechanism of nasomaxillary fracture in otolaryngology.

Reconstruction of the anophthalmic orbit by orbital osteotomy and free flap transfer.

It is a challenging problem for the plastic surgeon to perform adequate reconstruction of the postenucleation and radiated orbit of patient with retinoblastoma. Rebuilding of the orbital structure, reconstruction of the eye socket, and restoration of periorbital volume are required in this kind of orbital reconstruction. In this study, we reviewed 12 patients with hypoplastic orbital deformities who underwent orbital osteotomy and free flap transfer. Reconstruction of the orbital cavity was achieved using "C" osteotomy of the lateral portion of the orbit in mild and moderate cases or transverse "U" osteotomy of the lateral wall, roof, and floor by an intracranial approach in a portion of severe cases. Socket reconstruction and periorbital volume restoration was achieved using dorsalis pedis free flap transfer by microsurgery. What we concluded from our experience was that the combination of orbital osteotomy and free flap transfer could meet the multirequirements for anophthalmic orbital reconstruction, including both orbital bony enlargement and soft tissue restoration.

A preoperative planning system for unilateral craniofacial malformation restoration surgery based on the volume measurement of eye sockets / 生物医学工程学杂志

The surgical treatment of craniofacial malformation is a sophisticated task which needs careful and detailed preoperative planning. However, based on the patient's 2-D CT and X-ray images, the surgeons always feel hard to produce a convincible and satisfying surgical scheme. In this article, a craniofacial surgery simulation system based upon 3-D reconstruction and volume calculation of two eye sockets is presented. By using this system, the surgeon can virtually repose bone fragment according to the D-value between the volumes of two eye sockets. The D-value serves as a guideline to direct the bone reposing. The simulated key steps of real surgical procedure are presented, which demonstrate the efficiency of the system. The contrast images between postoperative and preoperative surgery are also given.