1.The 7th Costal Cartilage Graft for Correcting Saddle Nose Deformity
Parsad Surendra YADAV ; Ji-Hua WANG ; Hong WANG ; Usman MUHAMMAD ; Jin-Bo ZHAN ; Bo-Jun ZHANG
Journal of Kunming Medical University 2017;38(5):109-115
Objective To evaluate the safety and efficacy of the 7th costal cartilage graft for correcting saddle nose deformity.Methods A total of thirty-two patients,10 male and 22 female,were treated from January 2013 to December 2016.The age of the patients ranged from twelve to thirty years with an average of twenty-five years.Fourteen of the thirty-two patients were cases of post traumatic saddle nose deformity,ten were congenital saddle nose deformity,and eight were secondary cleft lip saddle nose deformity.In all of the cases,the 7th costal cartilage was used as an autologous graft for rhinoplasty.The reliability of this method was assessed in term of efficacy and safety including suitability of the graft material,donor site scarring and postoperative results and complications.Results The mean time for harvesting the cartilage was 30 minutes,and the mean length of the harvested 7th costal cartilage was four cm.Postoperatively,there were three cases of nasal deviation,one case of infection and one case where the K-wire exposed.Two patient's hypertrophic scaring on the donor site.All the other cases had positive successful outcomes.Conclusions An autologus 7th costal cartilage can be harvested safely and quickly,and its handling procedure is simple.It is a good option as an autologous graft for rhinoplasty.
2.Clinical study of percutaneous vertebroplasty combined with 125I seeds implantation in the treatment of patients with thoracic metastatic tumor complicated with posterior vertebral defect
Tiying WANG ; Zuozhang YANG ; Jiahui CHEN ; Yan LIU ; Santosh KAMAR ; Qiuyun CHEN ; Tao YUAN ; Xinghai YANG ; Jing ZHANG ; Cao WANG ; Parsad Surendra YADAV ; Shrijan SHRESTHA ; Yihao YANG ; Dongqi LI
Chinese Journal of Oncology 2020;42(12):1056-1062
Objective:To analyze the safety and efficacy of percutaneous vertebroplasty combined with interstitial implantation 125I of seeds (PVPI) in the treatment of thoracic vertebroplasty with posterior vertebra defect. Methods:A retrospective analysis of the clinical data of 64 patients with thoracic spine metastases admitted to Yunnan Cancer Hospital from November 2017 to May 2019 was conducted, including 32 patients with posterior vertebra defect (experimental group) and 32 cases without (control group). Forty-two vertebral bodies of 32 patients in the experimental group were treated with improved PVPI surgery, which performed with the secondary sealing method and inclined puncture needle injection bone cement rotary filling technology, to reduce leakage. The 54 vertebral bodies of 32 patients in control group underwent PVPI. The two groups of patients were followed up on the second day, one month, three months and six months after the operation, and the short-term efficacy, long-term efficacy and safety indicators of the two groups were compared.Results:All 64 patients successfully completed the surgical treatment. The visual analogue scores and Karnofsky scores of the experimental group and the control group were improved to varying degrees on the second day, 1 month, 3 months and 6 months after the operation. There was no statistically significant difference between the two groups ( P>0.05). The amount of bone cement in the experimental group and control group was (2.36±0.20) ml and (2.39±0.17) ml, and the difference was not statistically significant ( P=0.482). The amount of 125I seed implantation was (30.63±0.91) and (32.56±0.68), respectively, the difference was not statistically significant ( P=0.925). The partial response rates of the study group and the control group were 81.3% and 87.5%, the stable disease rates were 12.5% and 9.4%, the differences were not statistically significant ( P>0.05). The median overall survival (mOS) of the study group was 13 months, and the median progression-free survival (mPFS) was 8 months. The mOS of the control group was 14 months, and the mPFS was 8 months. The differences were not statistically significant ( P>0.05). In the experimental group, 6 (14.3%) vertebral bodies had cement leakage, of which 2 (4.8%) were cement leakage at posterior vertebra, 4 (9.5%) were paravertebral cement leakage. Seven (13.0%) paravertebral cement leakage occurred in the control group. There was no significant difference in bone cement leakage between the two groups ( P=0.097). Bone cement leakage in both groups did not cause serious complications such as spinal cord injury and paraplegia. Conclusion:The application of PVPI in the treatment of thoracic metastatic tumor patients with posterior vertebra defect can acquire better clinical efficacy and safety through conduction of the improved intraoperative technology and paying more attention to the control of bone cement distribution and other issues.
3.Clinical study of percutaneous vertebroplasty combined with 125I seeds implantation in the treatment of patients with thoracic metastatic tumor complicated with posterior vertebral defect
Tiying WANG ; Zuozhang YANG ; Jiahui CHEN ; Yan LIU ; Santosh KAMAR ; Qiuyun CHEN ; Tao YUAN ; Xinghai YANG ; Jing ZHANG ; Cao WANG ; Parsad Surendra YADAV ; Shrijan SHRESTHA ; Yihao YANG ; Dongqi LI
Chinese Journal of Oncology 2020;42(12):1056-1062
Objective:To analyze the safety and efficacy of percutaneous vertebroplasty combined with interstitial implantation 125I of seeds (PVPI) in the treatment of thoracic vertebroplasty with posterior vertebra defect. Methods:A retrospective analysis of the clinical data of 64 patients with thoracic spine metastases admitted to Yunnan Cancer Hospital from November 2017 to May 2019 was conducted, including 32 patients with posterior vertebra defect (experimental group) and 32 cases without (control group). Forty-two vertebral bodies of 32 patients in the experimental group were treated with improved PVPI surgery, which performed with the secondary sealing method and inclined puncture needle injection bone cement rotary filling technology, to reduce leakage. The 54 vertebral bodies of 32 patients in control group underwent PVPI. The two groups of patients were followed up on the second day, one month, three months and six months after the operation, and the short-term efficacy, long-term efficacy and safety indicators of the two groups were compared.Results:All 64 patients successfully completed the surgical treatment. The visual analogue scores and Karnofsky scores of the experimental group and the control group were improved to varying degrees on the second day, 1 month, 3 months and 6 months after the operation. There was no statistically significant difference between the two groups ( P>0.05). The amount of bone cement in the experimental group and control group was (2.36±0.20) ml and (2.39±0.17) ml, and the difference was not statistically significant ( P=0.482). The amount of 125I seed implantation was (30.63±0.91) and (32.56±0.68), respectively, the difference was not statistically significant ( P=0.925). The partial response rates of the study group and the control group were 81.3% and 87.5%, the stable disease rates were 12.5% and 9.4%, the differences were not statistically significant ( P>0.05). The median overall survival (mOS) of the study group was 13 months, and the median progression-free survival (mPFS) was 8 months. The mOS of the control group was 14 months, and the mPFS was 8 months. The differences were not statistically significant ( P>0.05). In the experimental group, 6 (14.3%) vertebral bodies had cement leakage, of which 2 (4.8%) were cement leakage at posterior vertebra, 4 (9.5%) were paravertebral cement leakage. Seven (13.0%) paravertebral cement leakage occurred in the control group. There was no significant difference in bone cement leakage between the two groups ( P=0.097). Bone cement leakage in both groups did not cause serious complications such as spinal cord injury and paraplegia. Conclusion:The application of PVPI in the treatment of thoracic metastatic tumor patients with posterior vertebra defect can acquire better clinical efficacy and safety through conduction of the improved intraoperative technology and paying more attention to the control of bone cement distribution and other issues.