Objective To introduce a better operation method to repair the skin and soft tissue defects in the forehead.Methods This kind of frontalis musculocutaneous flap was applied to repair the skin and soft tissue defects in the forehead in 8 cases.The flap was designed carefully according to the shape and the size of the focal lesion before the operation. The maximum area of the flap was 2.9cm?1.6cm, and the minimum area was 1.2cm?1cm. The full flap contained muscle in its proximal area and skin, muscle, and fascia in its distal one. A muscular pedicle with appropriate length was outlined on the paramedian and lateral forehead. The pedicle was composed of frontalis muscle fibers, the terminal part of the frontal branches of the superficial temporal artery, and some small branches from the supraorbital and the supratrocheal arteries. The body of the flap was designed into triangle shape. Full thickness skin was incised around the inverted pattern of the defect. The skin of the paramedian and lateral aspect was then undermined laterally. Superficial dissection was carried out in a subcutaneous layer. The flap was undermined beneath the galea and frontalis muscle just external to the skull. The muscle pedicle was prepared by incising a parallel horizontal incision. Careful attention should be taken so as not to injure the vascular pedicle. At that time, the supraorbital and supratrocheal arteries were carefully ligated to obtain complete hemostasis. Then the flap was advanced and transferred down to cover the wound in the forehead. The donor site could be sutured directedly by undermining the margins of the defect without much difficuties. Results All flaps in 8 cases survived. Venous congestion was observed in early postoperative period in only one case. But the flap survived completely after proper management in final healing. Follow-ups were made from 6 months and 12 months after operations. The color and texture of the flaps were similar to the adjacent skin in the forehead. The shapes were satisfying. Conclusions This kind of flap is a much better method for the repairing of some small or moderate defects in the forehead. It can be easily operated and allow a rapid aesthetic restoration.

OBJECTIVETo summarize the therapeutic experience in removing huge craniofacial hemangioma in 135 cases and reveal the rules of repairing the damaged tissues or organs caused by the extirpation.

METHODSThe procedure was to remove the focal lesion correctly, control hemorrhage, keep the stable blood volume, repair and rebuild the damaged tissues or organs reasonably.

RESULTSThe focal lesion was removed rather completely without accidental injuries or deaths. The damaged tissues or organs were repaired and rebuilt quite satisfactorily.

CONCLUSIONHuge craniofacial hemangioma of any type should be operated on as early as possible with sufficient preoperative preparations.

Adult ; Facial Neoplasms ; surgery ; Female ; Hemangioma ; surgery ; Humans ; Male

Objective To observe neuropsychological development status in children after surgical treatment of congenital heart diseases(CHDs)and analyze the risk factors. Methods 89 children who received outpatient review in Fuwai Hospital from September 2015 to March 2016 after surgical treatment of CHDs were recruited in this study and 90 normal children were recruited as the control group. The children with CHDs were divided into simple CHDs group(RACHS- 1 score≤2)and com-plex CHDs group(RACHS- 1 score≥3)according to RACHS- 1 classification. Neuropsychological development status was meas-ured according to pediatric-psychological mental test scale developed by Capital institute of pediatrics,Beijing and statistical a-nalysis was compared. Results The measurements of neuropsychological development showed the normal children behaved better than the children with CHDs(P < 0. 05). The simple CHDs group achieved better distribution of development quotient than complex CHDs group(P = 0. 032)and there was no difference between the normal control group and simple CHDs group (P = 0. 420). Multivariate regression analysis indicated that younger age at cardiac surgery,lower preoperative blood urea ni-trogen(BUN),higher preoperative creatinine(Cr)and prolonged duration of cardiopulmonary bypass(CPB)accounted for low-er scores in the test scale(P < 0. 05). Conclusion Distinct neuropsychological difficulties could be present especially in chil-dren with complex CHDs. Younger age at cardiac surgery,preoperative BUN,Cr and CPB duration were perioperative factors that were associated with long-time neuropsychological development.

[Objective] To review the clinical information, imaging features, pathological manifestations and prognosis of low-grade oncocytic tumor (LOT), so as to improve the clinical understanding of the disease. [Methods] The imaging, clinicopathological and postoperative follow-up data of 3 LOT cases treated in Peking University Third Hospital during Feb.2020 and Sep.2022 were retrospectively collected. [Results] All patients were male, aged 51—70 years.All tumors were single, with the maximum diameter of 14—21 mm. None of the patients had any specific clinical manifestations.The mass showed a circular isodense shadow on CT.All patients underwent nephron-sparing tumor resection.Postoperative pathology showed that the incision surface of the tumors was brownish-yellow or brown, and the tumors were solid or partially cystic.HE staining showed that the cells were uniformly eosinophilic; the nucleus was round or oval, with slight local perinuclear halo.Immunohistochemistry showed positive CK7 but negative CD117.Genetic testing in case 2 showed 1 potentially clinically significant somatic mutation TSC2.During the follow-up of 12-23 months, no recurrence occurred. [Conclusion] There were no obvious clinical symptoms and imaging features of LOT, which morphologically showed heterozygous or borderline characteristics with renal eosinophilia and renal chromophobe cell carcinoma, and the biological behavior was indolent.Nephron-sparing tumor resection promised good prognosis.