The paper explores the evolution of "bone-approaching" acupuncture, its effect target and mechanism. The concrete operation procedure of "bone-approaching" method is recorded originally in Huangdi Neijing (Inner Canon of Yellow Emperor) as short needling and Shu needling (referring to the category of the five needling technique). The periosteum is the most effective stimulation target of "bone-approaching" acupuncture for analgesia, regaining consciousness and regulating spirit. The "bone-approaching" acupuncture is not only prominently effective on bone bi syndrome, but also has the unique effect on painful, encephalogenic and emotional diseases. The paper summarizes and improves "bone-approaching" acupuncture, i.e. "touching bone surface" with needle tip by slow insertion, "touching bone surface" without pain by swift insertion and "touching bone" with needle body by oblique insertion. It contributes to the inheritance, development and supplementation to the bone needling techniques in Huangdi Neijing and is significant for broadening the clinical application range of acupuncture.
Humans ; Acupuncture Therapy ; Periosteum ; Analgesia ; Pain Management ; Consciousness ; Pain

Periorbital dermatochalasis with upper eyelid hooding, brow ptosis, and sunken eyelids may appear with age. Because classic blepharoplasty is unable to correct all these issues, we developed a single operation, which we present herein, to correct dermatochalasis accompanied by sunken eyelids. This sub-brow approach is used with simultaneous browpexy by fixing the orbital portion of the orbicularis oculi muscle (OOM) to the periosteum immediately above the supraorbital rim using sutures with 3 or 4 points of fixation and correcting sunken eyelids by burying the elevated dermis, fat, and OOM after de-epithelization in the lower flap of the sunken upper eyelid along the submuscular plane. This method enables the correction of sunken eyelids during the same operation without requiring an additional procedure, and offers the advantages of a shortened operation time and decreased cost. The presence of sunken eyelids in patients with dermatochalasis and severe lateral hooding may be corrected by the procedure described herein, thereby achieving periorbital rejuvenation while maintaining the original shape of the eyes.
Blepharoplasty ; Dermis ; Eyelids ; Humans ; Methods ; Middle Aged ; Orbit ; Periosteum ; Rejuvenation ; Skin Aging ; Sutures

Extraskeletal osteosarcoma (ESOS) is a malignant soft tissue neoplasm producing osteoid, without any continuity with the bone or periosteum. Primary ESOS presenting in the mediastinum is an extremely rare, yet aggressive malignant tumor associated with a poor prognosis. We report a case of primary ESOS arising from the thymus in a 63-year-old male patient.
Humans ; Male ; Mediastinum ; Middle Aged ; Osteosarcoma ; Periosteum ; Prognosis ; Soft Tissue Neoplasms ; Thymus Gland

Conventional sub-orbicularis oculi fat (SOOF) lifting during lower blepharoplasty is performed by anchoring the SOOF to the periosteum of the infraorbital rim. This procedure helps to improve the concavity at the central portion of the lower eyelid and the lid-cheek junction. However, over time, the periosteum becomes progressively weaker, diminishing the anchoring effect. This paper introduces a new lower blepharoplasty technique in which the SOOF is fixed to a bony hole to strengthen the holding force and provide sustainability.
Adipose Tissue ; Aged ; Aging ; Blepharoplasty ; Eyelids ; Humans ; Lifting ; Periosteum ; Rejuvenation

Orbital tuberculosis is a rare form of extrapulmonary tuberculosis, even in endemic areas. It may involve the soft tissue, lacrimal gland, periosteum, or bones of the orbital wall. We present a case of orbital tuberculosis on the lower eyelid. An 18-year-old woman with no underlying disease visited our clinic for evaluation of an oval nodule (1.5× 1.2 cm) on the right lower eyelid. Incision and drainage without biopsy was performed 2 months ago in ophthalmology department, but the periorbital mass had deteriorated, as the patient had erythematous swelling, tenderness, and cervical lymphadenopathy. Visual acuity was normal; there were no signs of proptosis, diplopia, or ophthalmoplegia. Computed tomography revealed a small abscess cavity without bony involvement. We performed an excision and biopsy through a percutaneous incision under local anesthesia. Histological examination revealed a granuloma and was diagnosed as orbital tuberculosis. The patient was additionally treated with anti-tuberculosis therapy for 6 months and recovered without complication or recurrence by 7 months. Orbital tuberculosis occurs in patients with or without associated pulmonary tuberculosis, and should be considered as a differential diagnosis in patients with inflammatory orbital disease and an orbital mass. If recurrence occurs despite adequate initial treatment, we recommend an additional examination and excisional biopsy.
Abscess ; Adolescent ; Anesthesia, Local ; Biopsy ; Diagnosis, Differential ; Diplopia ; Drainage ; Exophthalmos ; Eyelids ; Female ; Granuloma ; Humans ; Lacrimal Apparatus ; Lymphatic Diseases ; Ophthalmology ; Ophthalmoplegia ; Orbit ; Orbital Diseases ; Periosteum ; Recurrence ; Tuberculosis ; Tuberculosis, Pulmonary ; Visual Acuity

Osteomas are benign, slow-growing osteogenic lesions frequently found in the craniomaxillofacial region. They can be classified as peripheral, central, or extraskeletal. Reactive mechanisms to trauma or infection, as well as muscle traction, are thought to play a major role in the development of peripheral osteomas. In the present report, a 41-year-old woman presented with a slow-growing, painless mass on her left eyebrow. She had suffered trauma 15 years prior. In the computed tomography scan, a 2.5 × 2 × 0.7-cm radio-opaque tumor was detected just medial to the left supraorbital foramen, and a peripheral osteoma was clinically diagnosed. An elective operation under general anesthesia was planned. Following a suprabrow incision, subcutaneous and intramuscular dissection was performed. In the surgical plane deep to the corrugator muscles and superficial to periosteum, a branch of the supratrochlear nerve was encountered and preserved using a vessel loop. The osteoma beneath the periosteum was extracted in multiple fragments using a chisel and mallet to minimize trauma to the nerve. Contour and facial symmetry were corrected. To use a suprabrow incision, the surgeon must understand neighboring anatomical structures, including the course of the supratrochlear and supraorbital neurovascular bundles. When these structures are located adjacent to tumor lesions, careful surgical maneuvers should be performed to preserve them.
Adult ; Anesthesia, General ; Eyebrows ; Female ; Forehead ; Humans ; Muscles ; Osteoma ; Periosteum ; Traction

BACKGROUND: Some parts of a maxillary fracture—for example, the medial and posterior walls—may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls.METHODS: Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated.RESULTS: The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p< 0.05). The significant preoperative volume difference between the normal and traumatized sides (p= 0.024) resolved after surgery (p> 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p= 0.002).CONCLUSION: Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures.
Facial Bones ; Fracture Healing ; Fractures, Bone ; Humans ; Maxilla ; Maxillary Fractures ; Maxillary Sinus ; Periosteum ; Retrospective Studies ; Surgeons ; Tomography, X-Ray Computed

PURPOSE: Increased bone regeneration has been achieved through the use of stem cells in combination with graft material. However, the survival of transplanted stem cells remains a major concern. The purpose of this study was to evaluate the viability of transplanted mesenchymal stem cells (MSCs) at an early time point (24 hours) based on the type and form of the scaffold used, including type I collagen membrane and synthetic bone. METHODS: The stem cells were obtained from the periosteum of the otherwise healthy dental patients. Four symmetrical circular defects measuring 6 mm in diameter were made in New Zealand white rabbits using a trephine drill. The defects were grafted with 1) synthetic bone (β-tricalcium phosphate/hydroxyapatite [β-TCP/HA]) and 1×105 MSCs, 2) collagen membrane and 1×105 MSCs, 3) β-TCP/HA+collagen membrane and 1×105 MSCs, or 4) β-TCP/HA, a chipped collagen membrane and 1×105 MSCs. Cellular viability and the cell migration rate were analyzed. RESULTS: Cells were easily separated from the collagen membrane, but not from synthetic bone. The number of stem cells attached to synthetic bone in groups 1, 3, and 4 seemed to be similar. Cellular viability in group 2 was significantly higher than in the other groups (P<0.05). The cell migration rate was highest in group 2, but this difference was not statistically significant (P>0.05). CONCLUSIONS: This study showed that stem cells can be applied when a membrane is used as a scaffold under no or minimal pressure. When space maintenance is needed, stem cells can be loaded onto synthetic bone with a chipped membrane to enhance the survival rate.
Bone Regeneration ; Bone Transplantation ; Cell Movement ; Cell Survival ; Collagen ; Collagen Type I ; Humans ; Membranes ; Mesenchymal Stromal Cells ; Periosteum ; Rabbits ; Space Maintenance, Orthodontic ; Stem Cells ; Survival Rate ; Tissue Scaffolds ; Transplants

OBJECTIVE: To analyze the operative methods and clinical effects of autologous distal tibial cancellous bone graft with periosteum in treating cartilage injury of talus with Hepple III-IV type. METHODS: From June 2014 to August 2017, 25 patients (25 feet) with Hepple III to IV cartilage injury of talus were treated with autogenous ipsilateral distal tibial cancellous bone graft. Including 14 males and 11 females, aged from 18 to 52 years with an average of (38.4±3.1) years; left foot was in 8 cases and right foot was in 17 cases. According to Hepple classification, type III of 9 cases, type IV of 16 cases. The curative effect was assessed by Amercian orthopedic foot and ankle society (AOFAS) and visual analogue scale (VAS) before operation and 12 months after operation. RESULTS: All 25 patients were followed up for 12 to 28 months with an average of (14.2±2.5) months. AOFAS and VAS scores were improved from preoperative 53.02±10.06, 8.02±1.14 to 88.04±7.45, 1.26±1.74 at 12 months after operation (<0.05). According to AOFAS standard, 16 cases got excellent results, 6 good, 3 poor. CONCLUSIONS Autologous distal tibial cancellous bone graft with periosteum is an effective method for Hepple III-IV cartilage injury of talus. It can effectively relieve ankle pain and improve ankle joint function.
Adolescent ; Adult ; Bone Transplantation ; Cancellous Bone ; Cartilage ; Female ; Humans ; Male ; Middle Aged ; Periosteum ; Talus ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

Periostin, a kind of matricellular protein highly expressed in periodontal ligament and periosteum, is an important regulator of the integrity of periodontal ligament and periodontitis processes. Periostin has been shown to play a positive role in the recovery of periodontitis. This paper reviews relevant literature about the role of periostin in periodontal tissue and periodontitis.
Humans ; Periodontal Ligament ; Periodontitis ; Periosteum