Entire restoration of deformities caused by naso-orbito-ethmoidal complex and adjacent craniomaxillofacial fracture / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To introduce the therapy of malformation caused by naso-orbito-ethmoidal (NOE) complex and adjacent craniomaxillofacial fracture.</p><p><b>METHODS</b>Seventy-six cases with NOE complex and adjacent craniomaxillofacial fracture underwent surgical replacement and internal fixation, using several cosmetically favorable incisions. At the same time, nasal reconstruction was performed to correct nasal deformities and defect through the coronal access during the exposure for the treatment of the NOE fracture. If larger nasal fragments were present, they were reduced and fixed by microplates or wires. If there was lack of septal support, dorsal nasal bone grafting was used to reestablish the height and anterior projection of the nose. Synthetic material (Medpor) was chosen for restoration of the orbital defects. Transnasal reduction was used for canthopexy.</p><p><b>RESULTS</b>After 3 - 6 months follow-up, the outcomes of these patients were satisfactory functionally and esthetically. Posttraumatic nasal malformation and enophthalmos were corrected in most cases, and residual enophthalmos occurred in 3 cases, diplopia in 2 cases, insufficient prominence in 5 cases which underwent secondary correction with good results. Transnasal reduction of canthal realignment in the type III fracture was also satisfactory. There was no complication in this group.</p><p><b>CONCLUSIONS</b>Comprehensive pre-operative evaluation of the patient and careful examinations should be taken to workout an appropriate operation plan. Simultaneous restoration for this type of complicated fracture is critical to obtain good results.</p>

Application of facial canal dissection for recovery of facial nerve after operation of parotid carcinoma / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the recovery method of facial nerve function and to compare the clinical effect after operation of parotid carcinoma, which invades stylomastoid foramen and peripheral bone in deep lobe.</p><p><b>METHODS</b>Three operation methods were taken: (1) The tumor, parotid, invasive facial nerve and bone around the tumor were resected with transplantation of facial nerve. (2) Tumor parotid and facial nerve were resected without transplantation of facial nerve. (3) Tumor and parotid were dislocated from facial nerve, keeping the continuity of facial nerve.</p><p><b>RESULTS</b>For the first method, facial nerve function of 68.2% patients came back to the patients without facial paralysis before operation, while facial nerve function of 16.7% patients came back to the patients with facial paralysis before operation. There was obvious difference between them (P < 0.05). To the patients with facial paralysis before operation, the first and the second method were taken. The ratio of local control was 33.3% and 10.0% respectively. And survival for 5 years were 25.0% and 10.0% respectively. There was no obvious difference between the two methods (P > 0.05). To the patients without facial paralysis before operation, three methods of operation were taken. The ratio of local control was 77.3%, 48.0% and 33.3% respectively. And survival for 5 years were 86.4%, 52.0% and 41.7% respectively. There was obvious difference between the first method and the other two (P < 0.05). There was no obvious difference between the second and the third methods (P > 0.05).</p><p><b>CONCLUSION</b>Facial canal dissection in operation of parotid carcinoma with recovery of facial nerve can not only resect tumor completely, but also fit for development of functional surgery. It is an ideal method for surgery operation.</p>

Application the sternocleidomastoid muscle-great auricular nerve flap in radical parotidectomy / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study a new method for repair of facial depression and facial nerve defect after parotid carcinoma resection.</p><p><b>METHODS</b>12 patients with parotid carcinoma and peripheral bone invasion were treated using facial nerve canal dissection and radical resection of the tumor, the parotid gland and the involved facial nerve and bone, including the mastoid, stylomastoid foramen, styloid process and the rear part of the mandible. A sternocleidomastoid muscle flap was elevated and transferred to repair the facial depression. The great annular nerve in the flap was anastomosed with the severed end of the facial nerve in the canal.</p><p><b>RESULTS</b>The depressed deformity of the parotid area was well corrected in 9 patients. The aesthetic results were compromised in 2 patients because of tumor recurrence and reoperation. The depressed deformity was not corrected in 1 patient because of infection. Postoperatively, the function of the facial nerve recovered to a normal level. The recovery time ranged from 12 to 20 weeks ,with an average of 16.3 weeks. The local control rate of tumor was improved.</p><p><b>CONCLUSIONS</b>Immediate transplantation of the sternocleidomastoid muscle-great auricular nerve flap and facial nerve canal dissection in radical parotidectomy can repair the depressed deformity of the parotid area, restore facial nerve function,and decrease tumor recurrence. The method is an ideal operation with functional recovery.</p>

Application of iliac cancellous and chondral bone to repair the cleft of alveolar process and the nasal deformity at the same time / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study a new method of simultaneous repair of alveolar cleft and the deformity of the nose and lip.</p><p><b>METHODS</b>42 patients with cleft of alveolar process were included in this study. We filled the cleft of alveolar process with iliac cancellous bone and covered the depression of piriform aperture and the nasal side with iliac cartilage. Simultaneously, we corrected the nasal deformity using V-Y plasty of a mucosa-cartilage compound flap at the nasal vestibule.</p><p><b>RESULTS</b>In the patients aged 9 approximately 11 years, the mean height of the repaired alveolar process was 86.7%; the mean thickness was 89.6%; the contour and function of the alveolar process was grade I or II. The canine erupted at the place of bone grafting. The depression of the piriform aperture and alae nasi was repaired. The contour of the nares was symmetrical. In the patients over 12 years, the mean height of the alveolar process was 70.1%; the mean thickness was 71.7%; the contour and function of the alveolar process was grade II or III. The deflexion of nasal dorsum and nasal dome was not ameliorated in 2 patients of 18 years old.</p><p><b>CONCLUSIONS</b>The application of iliac cancellous and chondral bone to simultaneously repair cleft of alveolar process and the nasal deformity is an ideal plastic method. It can recover the height of alveolar process and the continuity of dental arch, ameliorate the nasal deformity, and redress the deflexion of nasal dorsum and nasal end. It can also eliminate the psychological obstacle of the patients at an early stage.</p>

The effect of autogenous vein cuff and injection of cerebral cell growth peptide on the recovery of injured facial nerve / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the effect of autogenous vein cuff and injection of cerebral cell growth peptide on the recovery of the injured facial nerve.</p><p><b>METHODS</b>The injured facial nerve was anastomosed and covered with an autogenous vein cuff. Cerebral cell growth peptide was then injected to it. The different repairing methods were evaluated and compared with electromyography and observing functional recovery of the mimetic muscles.</p><p><b>RESULTS</b>The new repairing method accelerated the recovery of the injured facial nerve. The recovery period of mimetic muscle function was significant shorter than the traditional method (P < 0.01). The recovery period of I-stage repairing was significant shorter than that of II--stage repairing (P < 0.01). The conduction velocity of the repaired facial nerves had no obvious differences between the new repairing method and the traditional method (P > 0.05).</p><p><b>CONCLUSION</b>Application of the autogenous vein cuff to cover the nerve anastomosis and injection of cerebral cell growth peptide is a promising method for facial nerve repairing.</p>

Restoration of deformities caused by complex fracture of the orbit region and adjacent cranio-maxillofacial fracture / 中华口腔医学杂志

<p><b>OBJECTIVE</b>In order to improve the diagnosis and treatment of the complex fracture of the orbit region and adjacent cranio-maxillofacial fracture.</p><p><b>METHODS</b>73 cases with blowout fracture of the orbit and adjacent cranio-maxillofacial fracture in recent years were retrospectively analyzed and comparied with different methods of treatment. All cases had undertaken CT examinations.</p><p><b>RESULTS</b>The positive rate of the CT examinations with blowout fracture of the orbit and adjacent cranio-maxillofacial region were 100%. Operating repositioning, rigid fixation and artificial material placement were used to treat this kind of deformities.</p><p><b>CONCLUSIONS</b>With the progress of modern photographic methods, blowout fracture of the orbit and adjacent cranio-maxillofacial fracture can be diagnosed clearly and help the operation procedure. Operations with reduction, rigid fixation and filling materials can be used to restore this kind of fracture and appearance.</p>