Objective To search for a procedure for correction of square face. Methods 68 patients with square face (aged from 21～40 years, with 65 females and 3 males) underwent osteetomy combined mandibular angle triangle resection with lateral cortex around the mandibular angle-splitting by intraoral approach. The mandible outer cortex was splited with bone chisel and mandible angle was resected by the high-speed pneumatic drill. The bulky masseter muscle and the enbonpoint buecal fat-pad were scissored. Results The application of high-speed pneumatic drill and bone chisel facilitated resection of the mandibular angle with lateral cortex splitting osteetomy. The operative effects were satisfactory in 56 patients during 3-24 months of follow-up. The bigonial distance was effectively re-duced, and facial shape became ellipse. The gross asymmetry and mandibular fracture were not conse-quences. The lateral contour of the mandibular angle was natural. Conclusion Ostectomy of mandible angle and lateral cortex of the mandible allows the reduction of the mandibular contour of the frontal view and the lateral contour of mandibular angle becomes soft, giving a more natural appearance. This new method is worthy to be applied widely because of the good result with effective reduction of the mandibular width.

Objective To seek a method to correct the bent cartilaginous vault.Methods This study included 18 patients (12 women,6 men,aged 18-45 years) suffering from the bent cartilaginous vault with the various degrees of nasal obstruction from January 2005 to December 2009.A open surgical approach was adopted to allow correction of the dorsal and caudal deviations of the nasal septum without weakening its structural support to the dorsum or nasal tip.The approach depended on full mobilization of deviated cartilage,removal of the deviated part of the quadrangular cartilage,followed by straightening of a caudal septal extension graft and its fixation in the corrected position.Rhinoplasty was performed to correct bent cartilaginous vault.Results A satisfactory result was gained in all clinical cases,except a septum still to remain light tilt (not affect the breathing function).Follwing-up for 3-24 months,all cases dorsum of nose was straighten and nasal septum situated mediately.All patients indicated cosmetic satisfaction of nasal dorsum and tip and improvement in nasal obstruction.No nasal deformity and septum tresis was found in all patients.Conclusions ()pen rhinoplasty is a helpful technique in the treatment of the bent cartilaginous vault.Septal surgery is necessary in the patients with cartilage framework,not only to improve breathing but also to achieve a straight,symmetrical and external nose as well.

Objective To evaluate the value of the clinical application of piezosurgery-assisted sliding genioplasty.Methods A total of 9 patients (7 women,2 man,aged 19-40 years) with microgenia were performed operation by intraoral V incision with subperiosteal exposure of the mandibular mentum area.Note relaxtion and preservation of the mental nerves.A horizontal osteotomy of cortical bone on anterior mandible was underwent by the conventional electric bone saw and internal plate bone was sectioned with the piezoelectric device.The segment was divided with preservation of the lingual soft tissue attachment and was advanced in the mandibular mentum area.These was fixed in the reposition by titanium plate and screw for preventing displacement.Results The piezoelectric device produced selective sectioning of the mineralized bone structures,bone was cut precisely without damage to vital anatomic structures and dental pulp,and was much easier to control and less aggressive,creating only minimal damage to soft tissues.The operative effects were satisfactory during 3- 6 months of follow-up.Stable chin contours were created and became nature.Iatrogenic problems with bleeding,in fection,mental nerve injury had been avoided.Conclusions Piezosurgery is a safe and precise technique to reduce the complication rate and to improve the treatment outcomes of genioplasties.

Objective To investigate a safe and effective method of lengthening the short nose.Methods Thirty-nine cases of short nose were corrected by the bilateral septal spreader graft and columellar strut using autologous cartilage,combined with expanded polytetrafluoroethylene (e-PTFE)to reconstruct the supporting structures to improve the forward and upward strength of the nasal tip in order to increase the nasal length and to correct the over rotation of nasal tip.The shield and cap grafts were also used for the patients whose nasal tip were too low with vertical dome division technique.Results All the patients showed preserved nasal length after surgery with well-proportioned nasal features and the nasal lip angles were normal.There was no evidence of postoperative nasal shortening.No operative or postoperative complications were observed by follow-up for 6 months to 1 year,except for 2 cases with graft cartilage being apparent on nasal tip.All the patients were satisfied with the surgical results achieved.Conclusions It is necessary to provide powerful forward and upward strength to lengthen nose and correct the over rotation of nasal tip effectively and safely.The application of bilateral septal spreader graft and columellar strut using autologous cartilage and combined with e-PTFE represents a valuable tool for the short nose and proper cartilage grafts of nasal tip can improve the height of the nasal tip and further correct the over rotation of the nasal tip.

Objective To study the morphological characteristics of craniofacial contour in ageing.Methods Craniofacial morphology was examined in a sample of 20 young men and 20 old men.By multi-slice helical CT,a computer reconstruction technique was used to produce three dimensional images and 3-D reconstruction data were analyzed quantitatively.Results Compared with the young men,old men increased with midface(Zy-Zy),lower face(Go-Go),supraorbital projection(Fb-Sr,T-So),midface depth (N-Po),and lower facial depth(T-Gn),and decreased with maxillary height(N-Sd) and upper facial width(Ft-Ft,T-T).Conclusion Facial width and depth and supraorbital projection tend to be increased and facial height decreased with ageing.

Objective To evaluate the clinical application of endoscopic technique in corrections of square face. Methods A total of 38 patients (age 21~40 years, 35 women and 3 men) with square face were corrected by endoscope-assisted intraoral approach and resected mandibular angle with the high-speed pneumatic drill or bulky masseter muscle and buccal fat pad. Results The use of an endoscope offered a clear view of the mandibular angle region and the application of high-speed pneumatic drill facilitated accurate and easy resection of the the mandibular angle. These patients were successfully treated for these new techniques: ruduced surgical trauma, operative bleeding and surgical time, along with a reduced risk of infection. Conclusion The endoscopic assisted correction of square face offers more satisfactory clinical results with a clear view of operation and less haematoma, risk of infection, surgical trauma and time.

Objective To evaluate the clinical effect of the facial soft tissue defect treated with platelet-rich plasma (PRP) mixed with purified fat.Methods 35 patients with facial soft-tissue defects were treated by PRP mixed with centrifuged fat tissue.Using Fuzzy judgment method the clinical effectiveness of therapeutic outcomes were evaluated on fullness,injection of frequency and satisfaction during 3 to 6 months of follow-up.Results The therapeutic outcomes showed that the reconstructed face became a relative symmetrical and natural appearance with not evidently fat resorption and stable after operation.Both patients and surgeons were satisfied with the results.The score of effectiveness was highest in Fuzzy judgment.Conclusions The efficacy of PRP is significant in enhancing fat graft,reducing fat necrosis and resorption.The fat tissue mixed with PRP is a reliable reconstruction option for the facial soft tissue defect.

Objective To investigate the impact of blood glucose level on the recurrence of liver cancer after laparoscopic surgery. Methods The clinical data of 98 patients with primary hepatocellular carcinoma from January 2012 to January 2015 were retrospectively analyzed. All patients were treated by laparoscopic radical resection of hepatocellular carcinoma. Patients were divided into elevated blood glucose group (n = 23) and control group (n = 75) according to whether the fasting blood glucose was ≥6.1 mmol/L. The recurrence of liver cancer in 1 year and 2 years after operation was compared. The factors influencing the recurrence of liver cancer were analyzed by univariate and multivariate analysis. Results The recurrence rates were 47.82% and 21.33% respectively in the patients with elevated blood glucose and the control group. The recurrence rates were 73.91% and 36.00%respectively in the 2-year postoperative patients with blood glucose and 1 year and 2 years. The recurrence rate was higher than that of the control group, the difference was statistically significant (P < 0.05). Logistic multivariate analysis showed that fasting blood glucose was high, Child-Pugh grade B, intraoperative blood transfusion, lymphatic invasion, high clinical pathology stage, postoperative alpha-fetoprotein (AFP) high, no postoperative adjuvant therapy (P < 0.05). Conclusion The recurrence rate of patients with elevated liver cancer after laparoscopic surgery is high, and fasting blood glucose is high, Child-Pugh grade is B grade, blood transfusion is high, there is lymphatic invasion, high clinical pathology stage after AFP high, no postoperative adjuvant therapy for its postoperative recurrence of risk factors, should strengthen the monitoring of high-risk patients, reduce postoperative recurrence rate.

OBJECTIVETo explore the most appropriate imaging examinations for solitary osteochondroma in primary hospitals.

METHODSA retrospective evaluation was performed to analyze the imaging examinations (including X-ray, CT, and ultrasound) of 62 patients undergoing surgeries for solitary osteochondroma in terms of the diagnostic results and preoperative expenditure of the patients.

RESULTSX-ray and CT have a high diagnostic value for solitary osteochondroma, but X-ray cannot display cartilage and lesions in surrounding soft tissues. Ultrasound is limited in diagnosis of solitary osteochondroma, but performed well as CT in displaying cartilage and lesions in surrounding soft tissues. There was no statistical difference between combined X-ray and ultrasound and CT in diagnosis of solitary osteochondroma (P>0.05), but the former had a lower cost (P<0.05).

CONCLUSIONX-ray combined with ultrasound has almost comparable value with CT in the diagnosis of solitary osteochondroma and is more practical for application in primary hospitals.

Adolescent ; Adult ; Bone Neoplasms ; diagnostic imaging ; Child ; Female ; Humans ; Male ; Osteochondroma ; diagnostic imaging ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography ; X-Rays ; Young Adult

Objective To investigate the function and necessity of ICU to supervise and cure the patients after comprehensive correction of facial skeletal contouring. Methods 178 patients were examined carefully and perfectly before operation to obviate taboo. After comprehensive correction of facial skeletal contouring operation, all the patients were transferred into ICU in order to be supervised and cured comprehensively. Results 26 (14. 61 %) patients had hypoxemia ( SPO2 ≤90 %),11(6. 18 %)kaliopenia (K+≤3. 5 mmol/L) and 18 (10. 11 %) hypertension. 21 patients appeared arhythmia. Among these 21 arhythmia patients, 15 (8.43 %) patients had pyknocardia (HR≥100/min), 3 (1. 69 %) atrial premature beat, 1 (0.56 %) fibrillation atrial, 2 (1. 12 %) premature ventricular contraction, 1 (0. 56 %) Ⅱ degree atrioventricular block. 8 patients had respiratory tract obstruction. 2 (1. 12 %) had hemorrhea of mandible and 1 transfused 600 ml blood. 17 (9. 55 %) patients had restlessness. 65 patients had nausea and vomitting. All patients in ICU having postoperative complications had been deal with corresponding management. There were no respiratory failure,hemorrhagic shock, cardiac arrest after operation in 178 patients. Conclusions ICU can offer timely, continuous, and systemic supervision and cure to patients after comprehensive correction of facial skeletal contouring,and reduce the postoperative emergency rate.