Objective To explore the method of treatment of sunken cheek deformity.Methods The longitudinal platysma-faseial flap was overturned 180 degree upward,the flap's pedicle located in the margin of mandible,and then combined with abdominal dermis fat graft to form as a sandwich,which filled in the sunken area of face.Results Five patients were treated with this method from 2003 to 2007,and satisfactory results were gained but only mild absorption was found in the transplanted tissue area during followed up for 3 months to 3 years.Conclusion Platysma-fascial flaps survive easily with rich blood supply and strong anti-infection,and are also easy to incise and operate as well,which,together with free abdominal dermis fat flap,could increase the amount of the needed tissue.It is a better approach to repair the sunken cheek deformity and in particular suitable for the more serious deformity in patients with sunken cheek.

Objective To investigate the practical anatomy and clinical applications of the lateral sural nerve-lesser saphenous vein vascular plexus island flap with median sural nerve preserved.Methods Ten lower limbs injected with color red latex and 20 fresh limbs were observed.Based on anatomical studies,the island flap pedicled with the vascular axis of lateral sural nerve and lesser saphenous vein was designed for clinical application in 63 cases.In procedure,the median sural nerve were preserved in donor site and the distal end of the lesser saphenous vein were not ligated.Results The accompanying arteries formed a favourable vascular plexus around the nerve and the vein,lied along the lateral sural nerve and the lesser saphenous vein and nourished the skin through cutaneous branches.The distance of the lateral ankle to the confluent of lateral and median sural nerve was (8.5± 0.8) cm.63 patients with soft tissue defects in the distal leg and foot were repaired.Their appearance and function were satisfaction without feeling lose in the heel and lateral side of the foot.Conclusions The lateral sural nerve-lesser saphenous vein vascular island flap is a reliable source of soft tissue to cover defects in the lower leg and foot.This flap has sufficient blood supply and high survival rate without the sacrifice of the median sural nerve.

Objective To evaluate the application of modified Abbe flap in repairing moderate defects of the upper lip and time point to divide the pedicle.Methods Classic Abbe flap was modified in its design,pedicle cutting and dividing time,which was used to repair moderate defect of the upper lip in 12 cases.Surgery was divided into two phases:one with modified Abbe flap surgery was performed for the combined nasal deformity repair simultaneously,and then the pedicle was divided 9days after surgery.Results 12 patients underwent modified Abbe flap.No vascular complications were found in these flaps.Upper lip shape was well and satisfactory functional recovery,corresponding improvement in nasal appearance.Conclusions The surgery that the modified Abbe flap with the pedicle is divided 9 days after surgery is very simple.On one hand,it greatly improves the patient's appearance and function of the upper lip,improve the overall shape of midface,on the other hand,dividing pedicle time is significantly shorter than in the past,specially reducing the suffering of patients and duration.It is particularly suitable for unilateral and bilateral cleft lip of the upper lip on secondary moderate deformities and combined nasal deformities.

Objective To explore the design of forehead flap pedicled with supratrochlear artery and shift way for aesthetic reconstruction of the nose without secondary operations for debulking.Methods Origin of blood supplies and the distributed situation of the vessel in the frontal region were studied through the internal carotid artery and the external carotid artery X-ray angiography.The frontal region existed polyphyletic blood supplies,the supratrochlear artery and the supraorbital artery set out many branches,respectively,in the level of frontal bone eyebrow plane.One constant,thicker horizontal branch from the superficial temporal artery obviously extended to the forehead median.The branches from three blood vessels mentioned above constituted the network of artery adequate in the muscle and the subcutaneous tissue level,assumed the three-dimensional distribution in the forchead region.The nasal reconstruction had been done for 9 patients with the oblique orientation designed forehead flap by using one side of supratrochlear artery as the pedicle and cutting skin paddle with the same or the opposite side of forehead flap.Results All flap survived completely with the restoration of nasal shape and functional satisfaction.Conclusion The forehead oblique orientation flap pedicled with one side supratrochlear artery is nourished by the rich blood supply.The flap can be split into two flaps:a myofascial flap and a skin flap in far part.Myofascial flap may be the good package of cartilage framework,and simultaneously split skin flap is favorable of the shape models.The flap may satisfy the demand of the nasal restoration.

Objective To observe the clinical effects of unilateral cleft lip repairmen via improved Millard technique. Methods 64 cases of patients with unilateral cleft lip were collected from July 2014 to June 2015. The traditional Millard technique was improved by moving traditional fixed point of columella nasi to close with the lateral nasal columella roots,and the moving range was adjusted according to the nasal columella deformity and nostril size. Meanwhile ,the nasal floor and the alar basal incisions were not designed. Instead ,fully free of affected side orbicularis oris muscles were applied to making apposition suture with the healthy side. Results It showed that anatomic form of the upper lip and the philtral column of patients ,whose unilateral cleft lips were repaired by the improved Millard technique,were normal,and both sides of the lip peak were basically symmetrical after 1 ~ 12 month(s)follow-up. Conclusions Compared with the traditional Millard technique,the improved technique could bring a better effect on appearance of the patients. And it will be one of the ideal repairing techniques for unilateral cleft lip.

Objective: To observe the regeneration of palatal fracture in patients with unilateral complete cleft lip and palate. Methods: A total of 35 patients with unilateral complete cleft lip and palate were randomly included as the observation group and 20 with normal teeth as the control group. All the subjects underwent CT with high resolution. Based on the formation of bone bridge, the observation group was further divided into bone bridge formation group and non-bone bridge formation group. The regenerated bone of the bone bridge was measured. The width of the anterior segment, middle segment and posterior segment of the dental arch were measured and statistically analyzed between the observation group and the control group. Results: ①A total of 25 cases with varying degrees of regenerated bone was interconnected to form bone bridge in palatal process, while in the remaining 10 cases, bone was regenerated, but not connected to form bone bridge. ②The width of the middle section of the arch in the observation group was greater than that in the non-bone bridge formation group. The width of each segment in the observation group was less than that in the control group. Conclusions Bone was regenerated to various extent in the palate after cleft palate. The formation of bone bridge is beneficial to the development of dental arch.