Objective To explore the outcomes and prognostic effects of Ivor Lewis esophagectomy and evalue the N staging.Methods Participants comprised 1145 patients with ESCC from Jan.2004 to Dec.2013,who under-went Ivor Lewis esophagectomy.The clinicopathologic data were analyzed.Kaplan -Meier and Cox regression methods were used for survival analysis.Results The morbidity of postoperative complication was 9.15% and with 1.83% of motality.The 1 -,3 - and 5 -year survival rates were 84.2%,58.4%,47.9% respectively.The median survival time was 55 months and average survival time was (70.16 ±2.086)months.Cox model multivariate analysis was used for those of P <0.05 in single variate analysis.Univariate analysis revealed that gender(P =0.003),smoking history (P =0.013),alcohol history(P =0.017),tumor location(P =0.001),body mass index(P =0.008),tumor length (P =0.000),differentiation degree(P =0.000),numbers of metastic zones(P =0.000)of lymph node metastasis (P =0.000),depth of invasion (P =0.000),pathological staging(P =0.000),vascular tumor thrombus (P =0.000),nerve involvement(P =0.000)and postoperative adjuvant therapy(P =0.000)were influencing prognosis factors.And multivariate analysis revealed that differentiation degree(P =0.000),depth of invasion(P =0.000), numbers of metastic zones (P =0.013 )of lymph node metastasis (P =0.000)were independent risk factors. Conclusion Ivor Lewis esophagectomy was a safe and effective treatment,and tumor differentiation degree,depth of invasion,numbers and zones of lymph node metastasis were important prognostic factors.

Congenital median cleft lip caused by all kinds of reasons is the most basic presentation of facial median cleft. Although a wide array of options is available, the technique employed will largely depend on the surgeon preference and experience, and lack of uniform standards. The basic surgical treatments of midline cleft lip and nose deformities include exposure of abnormal anatomy, repair soft tissue and skin, anatomic approximation of cartilaginous elements, orbicularis oris muscle repair and craniofacial osteotomy. In addition, there still doesn’ t have a common classification system to stratify the wide variations of midline cleft lip and nasal deformity, which is important to formulate specific surgical method for different types. This article summarized various classifications, recommended to use the Kolker' s classification by which the treatment options were summarized and proposed research prospects to provide ideas for further study.

Congenital median cleft lip caused by all kinds of reasons is the most basic presentation of facial median cleft. Although a wide array of options is available, the technique employed will largely depend on the surgeon preference and experience, and lack of uniform standards. The basic surgical treatments of midline cleft lip and nose deformities include exposure of abnormal anatomy, repair soft tissue and skin, anatomic approximation of cartilaginous elements, orbicularis oris muscle repair and craniofacial osteotomy. In addition, there still doesn’ t have a common classification system to stratify the wide variations of midline cleft lip and nasal deformity, which is important to formulate specific surgical method for different types. This article summarized various classifications, recommended to use the Kolker' s classification by which the treatment options were summarized and proposed research prospects to provide ideas for further study.

Congenital median cleft lip caused by all kinds of reasons is the most basic presentation of facial median cleft. Although a wide array of options is available, the technique employed will largely depend on the surgeon preference and experience, and lack of uniform standards. The basic surgical treatments of midline cleft lip and nose deformities include exposure of abnormal anatomy, repair soft tissue and skin, anatomic approximation of cartilaginous elements, orbicularis oris muscle repair and craniofacial osteotomy. In addition, there still doesn’ t have a common classification system to stratify the wide variations of midline cleft lip and nasal deformity, which is important to formulate specific surgical method for different types. This article summarized various classifications, recommended to use the Kolker' s classification by which the treatment options were summarized and proposed research prospects to provide ideas for further study.

Objective:Analyzing the morphological and functional changes of the temporomandibular joint (TMJ) post L-shaped reduction malarplasty. And evaluating the surgical safety.Methods:The female cosmetic patients who underwent L-shaped reduction malarplasty in the Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from December 2015 to March 2019 were recruited as the study object. Three-dimension models of pre-operation and post-operation were created by the analysis of computed tomography (CT) data via Materialise ProPlan CMF 3.0. Seventeen groups of data relating to the length and angle of the TMJ were measured in the axial plane, coronal plane and sagittal plane. These measurements included condylar anteroposterior diameter in the axial plane and condylar anterior space, superior space and posterior space in the sagittal plane. Data were analyzed via SPSS 22.0 statistical software.Results:Thirty female cosmetic patients who underwent L-shaped reduction malarplasty were included. Patient age ranged from 21 to 36 years and the mean age was (26.19±4.08) years. Fifteen patients were less than 25 years old, and other fifteen patients were more than or at least 25 years old. The condylar anteroposterior diameter post-operation was significantly longer than pre-operation in the axial plane [(9.406±1.241) mm vs.(9.259±1.276) mm], and the difference was (0.146±0.388) mm. The condylar anterior space, superior space and posterior space post-operation were all significantly smaller than pre-operation in the sagittal plane [(1.080±0.537) mm vs.(1.193±0.533) mm/(1.598±0.591) mm vs.(1.907±0.755) mm/(1.239±0.568) mm vs.(1.670±0.926)mm], and the differences were (0.113±0.409) mm, (0.309±0.711) mm, and(0.431±0.786) mm, respectively. Other thirteen measurements showed none significant differences when compared to pre-operation and post-operation ( P>0.05). Conclusions:L-shaped reduction malarplasty could trigger slight morphological changes to the TMJ. However the TMJ could adapt these changes and reach to a new balance due to compensated adaptation. The normal physiological function would not be impacted. Surgery itself could be considered as a safe contour cosmetic surgery.

Congenital median cleft lip caused by all kinds of reasons is the most basic presentation of facial median cleft. Although a wide array of options is available, the technique employed will largely depend on the surgeon preference and experience, and lack of uniform standards. The basic surgical treatments of midline cleft lip and nose deformities include exposure of abnormal anatomy, repair soft tissue and skin, anatomic approximation of cartilaginous elements, orbicularis oris muscle repair and craniofacial osteotomy. In addition, there still doesn’ t have a common classification system to stratify the wide variations of midline cleft lip and nasal deformity, which is important to formulate specific surgical method for different types. This article summarized various classifications, recommended to use the Kolker' s classification by which the treatment options were summarized and proposed research prospects to provide ideas for further study.

Congenital median cleft lip caused by all kinds of reasons is the most basic presentation of facial median cleft. Although a wide array of options is available, the technique employed will largely depend on the surgeon preference and experience, and lack of uniform standards. The basic surgical treatments of midline cleft lip and nose deformities include exposure of abnormal anatomy, repair soft tissue and skin, anatomic approximation of cartilaginous elements, orbicularis oris muscle repair and craniofacial osteotomy. In addition, there still doesn’ t have a common classification system to stratify the wide variations of midline cleft lip and nasal deformity, which is important to formulate specific surgical method for different types. This article summarized various classifications, recommended to use the Kolker' s classification by which the treatment options were summarized and proposed research prospects to provide ideas for further study.

Congenital median cleft lip caused by all kinds of reasons is the most basic presentation of facial median cleft. Although a wide array of options is available, the technique employed will largely depend on the surgeon preference and experience, and lack of uniform standards. The basic surgical treatments of midline cleft lip and nose deformities include exposure of abnormal anatomy, repair soft tissue and skin, anatomic approximation of cartilaginous elements, orbicularis oris muscle repair and craniofacial osteotomy. In addition, there still doesn’ t have a common classification system to stratify the wide variations of midline cleft lip and nasal deformity, which is important to formulate specific surgical method for different types. This article summarized various classifications, recommended to use the Kolker' s classification by which the treatment options were summarized and proposed research prospects to provide ideas for further study.

Objective:Analyzing the morphological and functional changes of the temporomandibular joint (TMJ) post L-shaped reduction malarplasty. And evaluating the surgical safety.Methods:The female cosmetic patients who underwent L-shaped reduction malarplasty in the Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from December 2015 to March 2019 were recruited as the study object. Three-dimension models of pre-operation and post-operation were created by the analysis of computed tomography (CT) data via Materialise ProPlan CMF 3.0. Seventeen groups of data relating to the length and angle of the TMJ were measured in the axial plane, coronal plane and sagittal plane. These measurements included condylar anteroposterior diameter in the axial plane and condylar anterior space, superior space and posterior space in the sagittal plane. Data were analyzed via SPSS 22.0 statistical software.Results:Thirty female cosmetic patients who underwent L-shaped reduction malarplasty were included. Patient age ranged from 21 to 36 years and the mean age was (26.19±4.08) years. Fifteen patients were less than 25 years old, and other fifteen patients were more than or at least 25 years old. The condylar anteroposterior diameter post-operation was significantly longer than pre-operation in the axial plane [(9.406±1.241) mm vs.(9.259±1.276) mm], and the difference was (0.146±0.388) mm. The condylar anterior space, superior space and posterior space post-operation were all significantly smaller than pre-operation in the sagittal plane [(1.080±0.537) mm vs.(1.193±0.533) mm/(1.598±0.591) mm vs.(1.907±0.755) mm/(1.239±0.568) mm vs.(1.670±0.926)mm], and the differences were (0.113±0.409) mm, (0.309±0.711) mm, and(0.431±0.786) mm, respectively. Other thirteen measurements showed none significant differences when compared to pre-operation and post-operation ( P>0.05). Conclusions:L-shaped reduction malarplasty could trigger slight morphological changes to the TMJ. However the TMJ could adapt these changes and reach to a new balance due to compensated adaptation. The normal physiological function would not be impacted. Surgery itself could be considered as a safe contour cosmetic surgery.

Objective:To investigate the morphological characteristics of skull base in children with hemifacial microsomia (HFM) by three-dimensional reconstruction and measurement of skull base.Methods:Three-dimensional spiral CT data of HFM children with unilateral involvement who had not received any treatment from the First Center of Maxillofacial Plastic Surgery, Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from February 2010 to December 2020 were collected. The patients were divided into four groups according to the Pruzansky-Kaban classification standard: Ⅰ, Ⅱa, Ⅱb and Ⅲ. The three-dimensional reconstruction and measurement of the skull base were performed using Mimics 17.0 software. Linear measurements of the skull base included the distance from tuberculum sellae to optic canal (OT), foramen rotundum (FrT), foramen ovale (FT), internal acoustic meatus (IT), hypoglossal canal (HT), and the distance from anterior clinoid process to the lesser wing of the sphenoid bone (ClS) and the petrous ridge of the temporal bone (ClP). The measurement indexes of skull base angle included anterior cranial angle (ACA), middle cranial angle (MCA), posterior cranial angle (PCA), and petrous ridge angle (PRA). SPSS 26.0 software was used for statistical analysis of the measurement result. Paired t-test was used for comparison within each group, and one-way ANOVA was used for comparison between different types. P<0.05 was statistically significant. Results:A total of 40 children with HFM were collected, with 10 cases in each group. The result of skull base angle measurement showed that the MCA of the healthy side of typeⅠHFM was significantly larger than that of the affected side, and the MCA and PRA of the healthy side of type Ⅲ HFM were larger than those of the affected side ( P<0.05). There was no significant difference in the angle of skull base between the healthy side and the affected side of typeⅡa andⅡb HFM ( P>0.05). In terms of linear distance measurement of skull base, FrT and HT on the healthy side of typeⅠHFM were longer than those on the affected side; FrT, IT, HT and ClP on the healthy side of typeⅡa HFM were significantly longer than those on the affected side; IT, HT and ClP on the healthy side of typeⅡb HFM were longer than those on the affected side; and HT on the healthy side of type Ⅲ HFM was longer than those on the affected side ( P<0.05). The difference between FrT and ClP (affected / healthy) of four types of HFM was statistically significant ( P<0.05). Conclusions:The morphology of HFM is different between the affected side and the healthy side. As for the angle of skull base, MCA was obvious smaller in the affected side than that in the healthy side in the type Ⅰ and type Ⅲ HFM. As for the linear measurement, the distance from the hypoglossal canal to the tuberculum sellae on the affected side is shorter than that on the healthy side in each type HFM, indicating that the growth and development of the cranial base on the affected side is affected in a certain degree.