No abstract available.
Facial Transplantation*

The study included 23 patients with long-term facial paralysis due to VII nerve injury who underwent free gracilis muscle transplantation between 1997 and 1999 at Hospital 108. These patients were paralysed for 10 to 36 years. This technique uses free gracilis muscle to replace the paralysed facial skin-adhered muscle, concurrently recover the nervous transmission from normal side to paralysed side.
Facial Paralysis ; Transplantation ; therapeutics

OBJECTIVETo design an animal model to study the facial transplantation of allografts in rabbits.

METHODSLivid blue rabbits and New Zealand white rabbits was applied as experiment animal, to harvest hemifacial composite-tissue flap based in the common external carotid artery with the branch of the external mandibular artery and auricularis magna artery, then allotransplantation was performed with the livid blue rabbits as recipient while new Zealand rabbits as donor, the immunosuppressive agent comprised ciclosporin, azamun and prednisone. 25 couples of rabbits were divided three groups. Group A, 5 couples of rabbits, no administered immunosuppressive agent and the artery anastomosis with end-to-end. Group B, 10 couples of rabbits, administered immunosuppressive agent and the artery anastomosis with end-to-end. Group C, 10 couples of rabbits, administered immunosuppressive agent and the artery anastomosis with end-to-side. Postoperative, to observe the survive ratio of animal and composite-tissue flap, verified the practicability of model further.

RESULTSThe blood supply of hemifacial composite-tissue flap is rich after allotransplantation. The survive ratio wasn't different with different procedure of the external carotid artery anastomosis.

CONCLUSIONSThis is a successful model of composite face flap transplantation in the rabbits.

Animals ; Facial Transplantation ; Models, Animal ; Rabbits ; Transplantation, Homologous

No abstract available.
Facial Pain* ; Immunosuppression ; Kidney Transplantation* ; Kidney* ; Organ Transplantation

OBJECTIVETo develop an experimental model of composite facial and scalp allograft in canine in order to investigate technical and immunological aspects and functional recovery of facial muscles of this new approach to facial reconstruction.

METHODS(1) Anatomic study: Four mongrel dogs were used for anatomical dissection of the head and neck region and for harvesting flap experiment. (2) Autologous transplantation (group I): Three types composite facial and scalp autologous transplantation were performed in five mongrel dogs. Type I composite tissue flap (group I a n = 2) included bilateral external ear and orbicularis oculi muscle. Type II (group I b n = 1) included single-lateral external ear, orbicularis oculi muscle, external nose upper and lower lip. Type III (group I c n = 2) included single - lateral external ear and orbicularis oculi muscle. (3) Allograft transplantation (group II): In group II a (n = 2), two allograft transplantation were performed with type III composite facial and scalp . In group II b (n = 4), four allograft transplantation were performed with the modified type III composite facial and scalp which included single - lateral external ear, orbicularis oculi muscle and one third of inferior tarsal plate and palpebral conjunctiva. To prevent allograft rejection, Cyclosporin A (CsA) and Methylprednisolone (MP) or Prednisone (PS ) were combined used as immunosuppressive protocol . Dose of CsA was adjusted depending on its blood drug level. Electromyogram (EMG) of orbicularis oculi muscle was carried out at 4 weeks, 6 weeks, 12 weeks and 6 months postoperation.

RESULTS(1) The facial anatomic characteristic of dog is similar to that of human being, external carotid artery and external jugular vein afford good blood supply to composite facial and scalp. (2) The dogs in group I c were long-term surviving with leakage of salivary juice. (3) In group II a (n = 2), one dog presented rejection reaction at 28th day postoperation, the reversal of rejection was achieved by increasing the dose of CsA and prednisone and with topical clobetasol for 2 weeks, the dog survived indefinitely( > 309 days). In group II b (n = 4), there were three dogs survived indefinitely ( > 159 days, > 129 days, > 108 days) without complication, EMG showed the function of orbicularis oculi muscle was gradually improving.

CONCLUSIONThe modified type III composite facial and scalp allograft transplantation model is an ideal model for facial allograft transplantation study.

Animals ; Dogs ; surgery ; Face ; Facial Transplantation ; Models, Animal ; Scalp ; transplantation ; Skin Transplantation ; Surgical Flaps ; Tissue Transplantation ; Transplantation, Homologous

The surgical reconstruction of complex facial injuries have focused on the following; early one-stage repair, exposure of all fracture fragments, precise anatomic rigid fixation, immediate bone grafting, and definite soft tissue management were the main surgical procedures, as in other facial bone injuries. Complex facial bone fractures involving dentition should be managed by the same principles. However, conventional methods can not achieve accurate preinjury occlusion when there are unstable fracture segments, edentulous state, or complex palatal/maxillary and mandibular fractures. Seventeen patients were surgically reconstructed in conjunction with dental impression, model surgery, and fabrication of dental splints to establish better occlusion. Among the facial fractures that had the occlusal problem, maxillary/palatal fractures and complex mandibular fractures, were the major indications for fabrication of acrylic splints. During operation, fracture segments were reduced and repositioned according to dental wear facets of the prefabricated occlusal splint and then temporary intermaxillary fixations were performed. This allowed us to accomplish precise anatomical reduction and rigid intrenal fixations. The postoperative occlusions were acceptible and no complication occurred as direct effects of dental splint. We suggest that fabrication of an acrylic occlusal splint is necessary for the management of complex facial injuries involving dentition.
Bone Transplantation ; Dentition ; Facial Bones ; Facial Injuries* ; Humans ; Mandibular Fractures ; Occlusal Splints ; Splints* ; Tooth Wear

OBJECTIVETo investigate the morphological changes after chemically extracted acellular nerve allografts transplant.

METHODSSeventy-two rabbits were divided into four groups. Acellular allografts of facial nerve were used in experimental group, and facial nerve autografts, acellular peroneal nerve allografts and peroneal nerve autografts respectively used in three control groups. The morphological changes after transplant were evaluated by modified trichrome staining, immunohistological staining and transmission electron microscope.

RESULTSThe two facial nerve grafts showed numerous regenerated nerve fibers, vessels and as well as a spindle schwann cells arranged longitudinally. No significant difference was observed in the fiber number and myelin thickness between the two groups,while the two peroneal nerve groups showed poor regeneration 6 months after operation.

CONCLUSIONSThe facial nerve allografts showed more neurite regeneration six months after transplant, and the regenerated axons passed through the distal stoma and there were well revascularized and proliferated schwann cells in the grafts.

Animals ; Disease Models, Animal ; Facial Nerve ; pathology ; transplantation ; Facial Nerve Injuries ; pathology ; surgery ; Nerve Regeneration ; Rabbits ; Transplantation, Homologous

OBJECTIVETo investigate the application and therapeutic effect of advanced orbicularis oculi muscle (OOM ) flap for eyelid defect.

METHODSUni-pedicle or bi-pedicle advanced OOM flaps were designed according to the location, depth and size of the eyelid defects. The resulted wounds in the donor sites were closed directly. The flap size ranged from 1.5 cm x 0.5 cm - 6.0 cm x 3.5 cm.

RESULTS120 cases were treated. All the flaps survived except for 3 flaps with epidermis necrosis at the end of flaps, which healed after dressing. The patients were followed up for 3 -36 months with inconspicious scar in donor sites. The flap color, texture had a good match with surrounding skin.

CONCLUSIONSThe OOM flap is ideal for eyelid defect with reliable blood supply, satisfied color and texture. The wound at donor site can be closed directly with less morbidity.

Blepharoplasty ; methods ; Cicatrix ; Eyelids ; surgery ; Facial Muscles ; transplantation ; Humans ; Surgical Flaps ; transplantation ; Transplant Donor Site ; surgery

OBJECTIVETo explore a simply, effective dynamical method to correct late facial palsy.

METHODSThe method of suspending of M. temporalis, temporal fascia was reformed below: (1) To prolong flap of M. temporalis, temporal fascia by parietal periosteum. (2) To elevate the reversal level of compound flap. (3) To fill depressed temporal area by silica gel piece.

RESULTSThe compound flap is united structurally and long enough to transfer. Temporal defect is recontoured. And zygomatic area is no longer protruded.

CONCLUSIONSThe reformative method resists defect of the old one and obtains a dynamical result.

Adult ; Facial Paralysis ; surgery ; Fascia ; transplantation ; Female ; Humans ; Male ; Skull ; transplantation ; Surgical Flaps ; Temporal Muscle ; transplantation ; Young Adult

In the history of medicine, many surgeons have been tried to reconstruct lost tissue and correct deformity, attempts to use implant materials have probably paralleled those involving autogenous tissue. Recently there has been an acceleration in the understanding of the requirements and potentials of implant materials caused by collaboration between material scientists, biomaterials engineers, clinicians, and clinical investigators. Alloplastic materials have become an essential part of reconstructing the function and contour of the craniofacial skeleton. Bone is a specialized form of connective tissue, which provides support, and protects vital and detion and summarizes their mechanical properties and clinical aspects.
Animal ; Bone Diseases/surgery* ; Bone Substitutes* ; Bone Transplantation* ; Facial Bones/surgery* ; Facial Bones/injuries ; Human ; Skull/surgery* ; Wounds and Injuries/surgery