OBJECTIVEFor reconstruction of secondary orbit-zygomatic deformities after severe malar fracture.

METHODSWe made shaped segments in orbito-zygoma region using lamella osteotomy, rearranged inferior and lateral orbital segment with inner and upper movement, and fixed the zygomatic fragment in new place with lateral and upward movement. Pre and post operative measurements including Hetel measurement and the angle between orbital horizontal level with bilateral tragus linkage(A-OT) have been done.

RESULTSIn our 22 cases list, lateral and inferior orbital segment was moved to upper and inner direction with 8.1 mm in average, while zygomatic fragent was lift 9.2 mm and pushed 1.5 mm in average. In average 6.5 months follow-up, good facial contour were maintained in most of our list and no obvious relapse was occurred.

CONCLUSIONSLamella osteotomy with separated segments movement was benefit to most of secondary deformities in orbito-zygoma displace.

Adolescent ; Adult ; Craniofacial Abnormalities ; etiology ; surgery ; Humans ; Male ; Middle Aged ; Orbit ; abnormalities ; surgery ; Orbital Fractures ; complications ; Osteotomy ; methods ; Young Adult ; Zygoma ; abnormalities ; surgery

Objective To investigate the expression of homeobox gene MSX-2 during cranial suture fusion of SD rats and discuss its significance. Methods SD rats aged 1, 2, 5, 8, 12, 15, 18, 22, 30 and 45 days were selected, and immunohistochemistry and Real-time PCR were employed to localize and quantify the expression of MSX-2 in different regions of cranial sutures. Results MSX-2 expressed in calvarial suture tissues including the extreme ends of the osteogenic fronts and the underlying dura mater. The expression of MSX-2 was low in posterior frontal suture (PF) and sagittal suture (SAG) from postnatal day 1 to day 8 before the initiation of suture fusion, while it was higher in PF than in SAG from postnatal day 12 to day 22 after the initiation of PF suture fusion. The expression of MSX-2 significantly declined in PF and was moderately higher than that in SAG from postnatal day 30 to day 45 after the initiation of suture fusion. Conclusion There is different expression of MSX-2 in PF and SAG during different suture fusion periods, which suggests the expression of MSX-2 may participate in the regulation of cranial bone development and the fusion of cranial sutures.

OBJECTIVETo investigate the reconstruction of acquired orbital deformities.

METHODSThrough coronal incisions, subciliary incisions and buccal sulcus incisions, or periorbital wound, the displaced orbital walls were repositioned after osteotomy. And the mandibular outer cortex was used to repair the bone defect, so as to restore the orital integrity.

RESULTSFrom Sept. 2002 to Jun. 2006, 64 patients with acquired orbital deformities were treated. The integrity of orbit and eyeball location recovered very well.

CONCLUSIONSRestoration of the orbital integrity is the key to the treatment of acquired orbital deformities. The periorbital deformities should be corrected after osteotomy with mandibular outer cortex for bone defect.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Orbit ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; methods ; Young Adult

OBJECTIVETo discuss the application and therapeutic effect of tunable guide device in correction of prominent mandibular angle.

METHODSSince 2007, 50 cases with prominent mandible angle underwent mandible angle osteotomy with the tunable guide device. The patients were followed up for 3-6 months.

RESULTSNo severe complication happened. Local seroma occurred in one case. Improved esthetic results were achieved at both frontal and oblique view.

CONCLUSIONSThe mandibular angle osteotomy with the tunable guide device makes the procedure safe and easily performed.

Adult ; Female ; Humans ; Mandible ; abnormalities ; surgery ; Osteotomy ; instrumentation ; methods ; Young Adult

OBJECTIVETo establish the quantitative diagnostic criteria for cranio-orbito-zygomatic deformity (COZD).

METHODSComputer-assisted three-dimensional (3-D) CT measurement was performed in 30 cases with unilateral COZD. The differences of the measurement data between the affected and unaffected sides were analyzed. Then the patients were diagnosed and classified according to the affected bone, soft tissue and conjunctival sac. Based on the quantitative diagnosis, 8 patients underwent surgery to test the clinical practicability of the diagnostic criteria.

RESULTSThe quantitative diagnostic criteria for COZD could reflect the affected area and the corresponding severity of deformity. It helped to preoperative design and to predict movement of osteotomy segment and. the soft tissue volume needed for augmentation. Good postoperative results were achieved.

CONCLUSIONSThe quantitative diagnostic criteria for COZD can describe the affect area and severity of deformity in detail. It is very practical in the guidance of clinical treatment.

Adolescent ; Adult ; Bone Diseases, Developmental ; diagnostic imaging ; Child ; Diagnosis, Computer-Assisted ; standards ; Humans ; Imaging, Three-Dimensional ; Male ; Orbit ; abnormalities ; Tomography, X-Ray Computed ; methods ; Young Adult ; Zygoma ; abnormalities

OBJECTIVETo summarize the methods and experiences in surgical treatment of hemifacial microsomia.

METHODSFifty-eight cases of hemifacial microsomia that have been treated by plastic and reconstructive surgery and followed-up in our department during last 20 years have been reviewed. Every patient's characteristic was assessed by physical examination, photography, craniofacial cephalometry before planned the method of surgery. Different surgical treatments were chosen according to the side and the structures involved in the abnormalities and the severity of hemifacial microsomia, and the cases were followed up since 3 months after the treatments. The follow-up lean of midline of the lower 1/3 face with that before treatment is compared. The degrees of patients' and surgeons' satisfactions with the treatments were evaluated respectively.

RESULTSThe average angle of lean of midline of skeletal and soft tissue of the lower 1/3 face decreased 4.2 degrees and 2.9 degrees respectively after treatment. Fifty (82.6%) cases satisfied with the outcome of the surgical treatment and surgeons satisfied with 84.5% of the outcome of all the cases.

CONCLUSIONSIndividual surgical treatment based on the side and the structures involved in the abnormalities can effectively correct facial asymmetry of hemifacial microsomia.

Adolescent ; Adult ; Child ; Child, Preschool ; Facial Asymmetry ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo explore the transcranial surgical method with lateral orbital approach for the treatment of cranio-orbital fibrous dysplasia.

METHODSLateral orbital transcranial extradural approach was adopted to correct complicated fibrous dysplasia in which the frontal, orbital, sphenoid, temporal bones were involved. Partial lesion removal and optic nerve decompression were performed through the transcranial extradural route by fronto-temporal cranial bone flap exposure. The fronto-orbital skeleton was shaped after bone flap deactivation.

RESULTS8 cases were treated successfully with no complication. The period of follow-up ranged from 9 months to 3 years. The appearance and the vision improved greatly. Cranial CT showed good bony union with no relapse.

CONCLUSIONSLateral orbital transcranial surgical approach is an optimal technique to correct cranio-orbital fibrous dysplasia.

Adolescent ; Adult ; Female ; Fibrous Dysplasia of Bone ; surgery ; Humans ; Male ; Orbit ; surgery ; Orbital Diseases ; surgery ; Skull ; surgery ; Young Adult

OBJECTIVETo evaluate the 3-D position changes of periorbital structures after midface distraction osteogenesis in patients with Crouzon syndrome.

METHODSThe CT data of 8 cases who had accepted the midface distraction osteogenesis following Le Fort III osteotomy were retrospectively analyzed. The patients were averagely 11.9 years old, and the CT was performed before and one year after operation. After 3-D image reconstruction, a right-hand coordinate system based on the preoperational Frankfurt Plane was then established. The pre- and post-operative positions of the superior orbit point (SOr), inferior orbit point (IOr), median orbit point (MOr), lateral orbit point (LOr), anterior ocularis point (AO), ocularis eyeball point (PO) and the four insertion ocularis rectus were documented and compared. The positions of these marked points in normal controls were also documented and compared with those in patients.

RESULTSAfter midface distraction osteogenesis, the position of AO was not changed significantly on the y-axis and z-axis, but the distance between two AO points on x-axis was reduced by 3.40 mm; IOr moved averagely 12.24 mm on y-axis and 4.25 mm on z-axis, MOr moved averagely 10.11 mm on y-axis and 2.80 mm on z-axis, LOr moved averagely 9.86 mm on y-axis and 2.31 mm on z-axis. The Inferior Rectus attachment moved averagely 3.63 mm on y-axis and 2.98 mm on z-axis. No other significant change was observed on other marked points.

CONCLUSIONSMidface distraction osteogenesis following Le Fort III osteotomy can significantly move the medial, lateral and inferior peri-orbital bone structure anteriorly and inferiorly. The eyeballs have no markedly sagittal position changes after distraction except slight medial, downwards movements and anterior-upwards rotations.

Adolescent ; Child ; Facial Bones ; diagnostic imaging ; surgery ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Orbit ; diagnostic imaging ; Osteogenesis, Distraction ; methods ; Osteotomy, Le Fort ; methods ; Tomography, X-Ray Computed

OBJECTIVETo introduce an effective method for reconstruction of hypoplastic orbit caused by eradiation therapy.

METHODSThe orbital reestablishment was carried out by using the orbital ostectomy to enlarge the orbital cavity and a flap transferring for the socket reconstruction and the repair of the concave deformity around the orbit.

RESULTSTwelve treated patients demonstrated the satisfactory improvement.

CONCLUSIONSThe ostectomy combined with the flap transplantation may be available for reconstruction of the hypoplastic orbit.

Child ; Humans ; Male ; Orbit ; abnormalities ; surgery ; Osteotomy ; methods ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Treatment Outcome

OBJECTIVETo analyze and describe the advantages and disadvantages of the Millard repair in the unilateral cleft lip (UCL).

METHODSIn 30 patients with UCL undergoing the cleft lip repair with the Millard I or II method, the vermilion was repaired by a modified method with a triangle flap, while the alar cartilage reposition was performed.

RESULTSPostoperative follow-up of 6-12 months revealed the good results with invisible scar, good preservation of philtrum dimple and column, full vermilion and lengthened columella, good alar cartilage reposition.

CONCLUSIONThe Millard method is good for UCL repair. The modified technique with a triangle flap on the vermilion edge can overcome Millard's disadvantages. The anatomic reposition of the affected alar cartilage by blunt dissection at the first stage is suitable for the oriental.

Adolescent ; Child ; Cicatrix ; Cleft Lip ; surgery ; Esthetics ; Humans ; Lip ; surgery ; Nasal Cartilages ; surgery ; Nasal Septum ; surgery ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps