Objective To explore the indications and clinical effects of simultaneous mandibular angleplasty on the unaffected side, performed using preformed titanium mesh combined with mandibular angle bone graft, for the treatment of hemifacial microsomia (HFM). Methods The study group included 11 patients between 2013 and 2021 with HFM who underwent simultaneous mandibular angle reduction of the unaffected side and augmentation of the affected side using resected bone scaffolds within the titanium mesh. A series of mandibular linear measurements such as ramus height(RH)and mandibular body length(BL), angular measurements, and asymmetry index combined with clinical photographs and postoperative complications were used to assess the therapeutic effect. Results Postoperatively, all patients were satisfied. Significant improvement in mandibular contour was shown, with no obvious complications. Postoperative data, such as BL and angular measurements, showed no statistically significant differences(P>0.05) between the affected and unaffected sides with improvement in symmetry, except for RH(P<0.05). The preoperative and postoperative asymmetry index were (17.11±4.56)% and (4.81±1.73)%, respectively, with significant improvement(P=0.002). Conclusion This approach provides satisfactory results and significantly improves facial asymmetries for unilateral HFM with hypertrophy of the contralateral mandibular angle.

Objective:To compare the outcomes of the total mandibular inferior border ostectomy and the T-shape genioplasty for chin narrowing combined with mandibular contouring and to assess the indications of the total mandibular inferior border ostectomy.Methods:In this retrospective study, the clinical data were collected from the patients who received mandibular contouring and chin narrowing at the Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2015 to January 2019. According to the surgical procedure, patients were divided into Total inferior border ostectomy (Group I) and T-shaped genioplasty combined with mandibular contouring (Group II). Computed tomography scans, combined with medical records and photographs, were collected preoperatively and in the final follow-up postoperatively. Lower facial height, chin width, chin symmetry, facial proportions as well as patients’ satisfaction and complications were investigated to assess the clinical outcomes. Statistical analyses were performed using IBM SPSS Statistics, version 20.0 (IBM Corp., Armonk, NY, USA). The measurement data were expressed as Mean±SD, and the counting data were expressed as case (%). T-test was performed to compare the age difference, average satisfaction score and the relative measurements between the two groups. Pearson’s chi squared test was used to compare the sex composition ratio and complication ratio between the two groups. P<0.05 was considered statistically significant. Results:102 patients were involved in this study, including 42 patients in group I, 7 males and 35 females; 60 patients in group Ⅱ, 11 males and 49 females. All patients improved lower facial contours. No severe complications were observed during the follow-up period(6~24 months) Regarding appearance satisfaction, 30 cases were very satisfied, 11 cases were satisfied, and 1 case was neutral in group I. 43 cases were very satisfied, 15 cases were satisfied, and 2 cases were neutral in group II. There was no significant difference ( P >0.05) between group I and group II in age, sex, inferior lip numbness, hematoma, severe swelling, infection, soft tissue ptosisand appearance satisfaction.There was a statistically significant difference ( P < 0.01) in preoperative lower facial height [(63.05±4.15) mm vs. (52.87±4.07) mm], Preoperative lower and midfacial height ratio [(107.89±3.11) % vs. (91.29±7.94) %], and preoperative chin width and lower facial height ratio [(90.31±3.19) % vs. (104.32±5.28) %], chin width change [(12.11±2.59) mm vs. (8.39±1.89) mm], postoperative chin deviation [(0.17±0. 09)mm vs. (0.36±0.20) mm] and Postoperative chin width and lower facial height ratio [(76.80±1.85) % vs. (80.95±3.75) %]. No statistical difference ( P>0.05) was found in preoperative chin deviation, midfacial height, postoperative lower facial heigh, postoperative lower and midfacial height ratio. Conclusion:In conclusion, compared to T-shape genioplasty combined with mandibular contouring, total mandibular inferior border ostectomy had a large amount of chin narrowing and better postoperative symmetry and is well suited for a longer, wider, and more asymmetrical chin. The surgical options should be considered and chosen quantitatively to achieve aesthetically satisfactory results.

Objective:To compare the outcomes of the total mandibular inferior border ostectomy and the T-shape genioplasty for chin narrowing combined with mandibular contouring and to assess the indications of the total mandibular inferior border ostectomy.Methods:In this retrospective study, the clinical data were collected from the patients who received mandibular contouring and chin narrowing at the Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2015 to January 2019. According to the surgical procedure, patients were divided into Total inferior border ostectomy (Group I) and T-shaped genioplasty combined with mandibular contouring (Group II). Computed tomography scans, combined with medical records and photographs, were collected preoperatively and in the final follow-up postoperatively. Lower facial height, chin width, chin symmetry, facial proportions as well as patients’ satisfaction and complications were investigated to assess the clinical outcomes. Statistical analyses were performed using IBM SPSS Statistics, version 20.0 (IBM Corp., Armonk, NY, USA). The measurement data were expressed as Mean±SD, and the counting data were expressed as case (%). T-test was performed to compare the age difference, average satisfaction score and the relative measurements between the two groups. Pearson’s chi squared test was used to compare the sex composition ratio and complication ratio between the two groups. P<0.05 was considered statistically significant. Results:102 patients were involved in this study, including 42 patients in group I, 7 males and 35 females; 60 patients in group Ⅱ, 11 males and 49 females. All patients improved lower facial contours. No severe complications were observed during the follow-up period(6~24 months) Regarding appearance satisfaction, 30 cases were very satisfied, 11 cases were satisfied, and 1 case was neutral in group I. 43 cases were very satisfied, 15 cases were satisfied, and 2 cases were neutral in group II. There was no significant difference ( P >0.05) between group I and group II in age, sex, inferior lip numbness, hematoma, severe swelling, infection, soft tissue ptosisand appearance satisfaction.There was a statistically significant difference ( P < 0.01) in preoperative lower facial height [(63.05±4.15) mm vs. (52.87±4.07) mm], Preoperative lower and midfacial height ratio [(107.89±3.11) % vs. (91.29±7.94) %], and preoperative chin width and lower facial height ratio [(90.31±3.19) % vs. (104.32±5.28) %], chin width change [(12.11±2.59) mm vs. (8.39±1.89) mm], postoperative chin deviation [(0.17±0. 09)mm vs. (0.36±0.20) mm] and Postoperative chin width and lower facial height ratio [(76.80±1.85) % vs. (80.95±3.75) %]. No statistical difference ( P>0.05) was found in preoperative chin deviation, midfacial height, postoperative lower facial heigh, postoperative lower and midfacial height ratio. Conclusion:In conclusion, compared to T-shape genioplasty combined with mandibular contouring, total mandibular inferior border ostectomy had a large amount of chin narrowing and better postoperative symmetry and is well suited for a longer, wider, and more asymmetrical chin. The surgical options should be considered and chosen quantitatively to achieve aesthetically satisfactory results.

Objective:To evaluate the stability of the zygomatic complex in reduction malarplasty (RM) with different fixation method.Methods:The clinical data of patients with zygomatic arch protrusion at the Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2018 to January 2021 were analyzed retrospectively. All patients underwent L-shaped osteotomy reduction malarplasty which were divided into zygomatic body fixation (ZBF) and zygomatic arch fixation (ZAF) according to fixation technique. As for ZBF, there were 4 different groups including two bicortical screws (2LS), an L-shaped plate with one bicortical screw (LPLS), an L-shaped plate with short-wing on the zygoma (LPwZ) and an L-shaped plate with short-wing on the maxilla (LPwM). As for ZAF, there were 3 different groups including mortice-tenon (MT), 3-hole plate (3HP) and short screw (SS). CT imaging data of two postoperative periods (1 week later; 6 months later) were collected. ITK-SNAP and 3D Slicer software were applied to evaluate the difference in the displacement distance of relevant landmarks of the zygomatic complex, so as to compare the postoperative stability of RM under different fixation methods. Statistical analyses were performed using IBM SPSS Statistics, version 25.0, and Kruskal-Wallis method was used to compare the difference of relevant landmarks displacement distance between ZBF group and ZAF group. P<0.05 was considered statistically significant. Results:60 patients (120 zygomatic arches) who were composed of 21 men and 39 women, aged (27.1±4.9) years were included. There were 30 samples in each group of ZBF and 40 samples in each group of ZAF. Compared with the single L-shaped plate (LPwZ, LPwM) group, the displacement distance of zygomatic complex in 2LS and LPLS groups was shorter ( P<0.05). The three fixation method of zygomatic arch (MT, 3HP, SS) had similar effects on the displacement of zygomatic complex ( P>0.05). Conclusion:After RM, the "two-bridge" fixation method (2LS and LPLS) provides better stability than the single L-shaped plate. The stability of all ZAF is similar when combined with 2LS or LPLS.

Objective:To evaluate the stability of the zygomatic complex in reduction malarplasty (RM) with different fixation method.Methods:The clinical data of patients with zygomatic arch protrusion at the Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2018 to January 2021 were analyzed retrospectively. All patients underwent L-shaped osteotomy reduction malarplasty which were divided into zygomatic body fixation (ZBF) and zygomatic arch fixation (ZAF) according to fixation technique. As for ZBF, there were 4 different groups including two bicortical screws (2LS), an L-shaped plate with one bicortical screw (LPLS), an L-shaped plate with short-wing on the zygoma (LPwZ) and an L-shaped plate with short-wing on the maxilla (LPwM). As for ZAF, there were 3 different groups including mortice-tenon (MT), 3-hole plate (3HP) and short screw (SS). CT imaging data of two postoperative periods (1 week later; 6 months later) were collected. ITK-SNAP and 3D Slicer software were applied to evaluate the difference in the displacement distance of relevant landmarks of the zygomatic complex, so as to compare the postoperative stability of RM under different fixation methods. Statistical analyses were performed using IBM SPSS Statistics, version 25.0, and Kruskal-Wallis method was used to compare the difference of relevant landmarks displacement distance between ZBF group and ZAF group. P<0.05 was considered statistically significant. Results:60 patients (120 zygomatic arches) who were composed of 21 men and 39 women, aged (27.1±4.9) years were included. There were 30 samples in each group of ZBF and 40 samples in each group of ZAF. Compared with the single L-shaped plate (LPwZ, LPwM) group, the displacement distance of zygomatic complex in 2LS and LPLS groups was shorter ( P<0.05). The three fixation method of zygomatic arch (MT, 3HP, SS) had similar effects on the displacement of zygomatic complex ( P>0.05). Conclusion:After RM, the "two-bridge" fixation method (2LS and LPLS) provides better stability than the single L-shaped plate. The stability of all ZAF is similar when combined with 2LS or LPLS.

Objective:To investigate the clinical characteristics of psoriasis and status quo of medical care for patients in county areas of China.Methods:This study was a cross-sectional investigation. Based on the “Qianxian Wuyin” Project (a national project for upgrating ability for psoriasis care at county level), an online questionnaire survey was conducted in the dermatology departments of 459 county hospitals in 404 pilot administrative counties across China from February to June 2023. The questionnaire included demographic information of patients (gender, ethnicity, age, place of residence, education, marital status), and clinical characteristics of psoriasis (disease course, type, comorbidities, body surface area (BSA) and previous treatment. The Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI) were applied for assessing the quality of life and disease severity, and completed by patients or guardian and doctors, respectively.Results:A total of 16 935 patients completed the questionnaire. The age of patients was 1-102(44.17±11.58)years, and 71.0% (12 036/16 935) were 30-59 years old. The ratio of male to female was 2.21∶1; 24.3%(4 117/16 935) of patients had high school education; there were 9 940 patients(58.7%) with previous or current smoking and/or alcohol use; 42.8%(7 218/16 855) of patients had a disease course of 1-5 years. There were 15 630 patients(92.3%) with DLQI≥10, 8 346 patients(49.7%) with PASI≥10, 15 017 patients(89.2%) with BSA≥10%. The plaque type was the most common disease type ( n=14 965, 88.7%), and spotting type ranked the second ( n=1 141, 6.8%). The most common initial site was the trunk ( n=12 309, 72.9%). Among the comorbidities, hypertension was the most common one ( n=1 681, 10.0%). There were 7 650 reports of treatment response to conventional topical drug therapy and 3 112 reports of treatment response to systemic drug therapy, with 6 269 (81.9%) and 2 493 (80.1%) reporting poor or no response, respectively. Conclusions:The survey shows that in the county areas of China, the majority of psoriasis patients are severe patients with short course of disease, plaque type is the most common type, and hypertension is the most common comorbidity; and the conventional treatment is less effective for most patients.