Objective:To analyze the application efficacy of employing high-density porous polyethylene （Su-por） in combination with temporoparietal fascial flaps via a minimally invasive scalp incision in auricular reconstruction. Methods:This study carried out a retrospective analysis of 50 patients （50 ears in total） who underwentprimary auricular reconstruction with a Su-por scaffold in our hospital from June 2022 to January 2024. All patients underwent primary auricular reconstruction using a minimally invasive scalp incision with high-density porous polyethylene （Su-por） and temporoparietal fascial flaps. The postoperative treatment effects and complications were statistically analyzed. Results:The reconstructed ears of all patients survived. After 6 months of follow-up, the scar hyperplasia of the scalp minimally invasive incision was not obvious in any patient, and no significant hair loss was observed. The reconstructed auricle of 48 patients had a realistic shape and strong three-dimensional sense. With the extension of follow-up time, the three-dimensional structure of the auricle became clearer, and patient satisfaction increased. Among the remaining two patients, one case of flap necrosis survived after skin grafting and dressing changes. One patient had scar hyperplasia at the incision of the reconstructed ear due to a scar-prone constitution, and the shape of the auricle was not ideal, but the scar hyperplasia at the scalp incision was not obvious. Conclusion:One-stage ear reconstruction with high-density porous polyethylene （Su-por） combined with superficial temporal fascia flap through a minimally invasive scalp incision can better show the fine structure of the reconstructed ear. The minimally invasive scalp incision can effectively reduce the occurrence of scar hyperplasia and postoperative alopecia at the scalp incision.
Humans ; Plastic Surgery Procedures/methods* ; Retrospective Studies ; Surgical Flaps ; Tissue Scaffolds ; Polyethylene ; Ear Auricle/surgery* ; Male ; Scalp/surgery* ; Female ; Skin Transplantation ; Fascia/transplantation* ; Porosity ; Adult ; Middle Aged

Objective:To investigate the application value of nasolabial flaps in addressing tissue defects after resection of benign and malignant nasal vestibular lesions. Methods:The clinical data of patients with benign and malignant nasal vestibular lesions were analyzed retrospectively. There were 4 cases of squamous cell carcinoma, 2 cases of black hairy nevus and 1 case of chronic proliferative inflammatory lesions, all of which were repaired by adjacent nasolabial flap. Results:After 6 months of follow-up, none of the patients developed nasal vestibular contracture or nostril stenosis, and postoperative nasal ventilation function was good. Conclusion:The preoperative design of individual nasolabial flaps is very important for maintaining maxillofacial aesthetics, protectingthe nasolabial framework, and preserving postoperative nasal ventilation function.
Humans ; Retrospective Studies ; Middle Aged ; Nose Neoplasms/surgery* ; Surgical Flaps ; Male ; Female ; Adult ; Nose/surgery* ; Plastic Surgery Procedures/methods* ; Carcinoma, Squamous Cell/surgery* ; Aged ; Skin Transplantation

Objective:To compare the clinical outcomes of reconstruction of oral and maxillofacial soft tissue defects using superficial circumflex iliac artery perforator flap （SCIA PF） and radial forearm free flap （RFF）. Methods:A retrospective analysis was conducted on 90 patients with head, neck, and maxillofacial tumors who were treated in our department from June 2019 to January 2024. Patients were divided into two groups based on the surgical method used: the SCIA group（n=45）, who underwent reconstruction with SCIA PF, and the RFF group（n=45）, who received RFF reconstruction. Six months postoperatively, clinical efficacy was evaluated by comparing flap swelling, flap survival rate, and patient satisfaction. Oral function was assessed using standardized scoring systems before surgery, at 1 week, 3 months, and 6 months post-surgery. Hemorheological parameters, including high-shear viscosity（shear rate 200/s）, low-shear viscosity（shear rate 30/s）, plasma viscosity, erythrocyte aggregation index, and erythrocyte sedimentation rate（ESR）, were also measured at each time point. Results:Compared with the RFF group, the SCIA group showed significantly larger flap size, longer flap harvesting and reconstruction times, earlier nasogastric tube removal and oral intake initiation, higher scores in all aspects of oral function, reduced flap edema and faster resolution, higher flap survival rates, and greater overall satisfaction （all P<0.05）. During the follow-up period （preoperative, 1 week, 3 months, and 6 months post-surgery）, hemorheological indices including high-and low-shear viscosity, plasma viscosity, erythrocyte aggregation index, and ESR progressively decreased in the SCIA group （P<0.05）. In the RFF group, these parameters improved significantly by 6 months postoperatively compared with preoperatively and 1-week postoperatively, with a notable decrease in erythrocyte aggregation index at 6 months （P<0.05）. Conclusion:Compared with RFF, SCIA PF provides larger flaps, better functional recovery, higher patient satisfaction, improved flap survival, fewer complications, and more favorable hemorheological profiles following reconstructive surgery for oral and maxillofacial defects.
Humans ; Perforator Flap/blood supply* ; Plastic Surgery Procedures/methods* ; Retrospective Studies ; Free Tissue Flaps ; Iliac Artery/transplantation* ; Forearm/surgery* ; Male ; Female ; Soft Tissue Injuries/surgery* ; Head and Neck Neoplasms/surgery* ; Middle Aged ; Treatment Outcome ; Adult

Objective:To observe the effects of different repair methods in the defects after Mohs surgical excision of malignant nasal tumors. Methods:Twenty-two cases of external nasal malignant tumor surgery from January 2021 to May 2024 were selected as the research. The tumors were resected using Mohs surgical technique, and the defects were repaired using forehead axial flap, bipedicle flap, nasolabial flap, free full-thickness skin graft from the groin, forehead axial flap, facial kite flap, and composite flap of earlobe cartilage and perichond. The postoperative flap survival, external nasal morphology, and tumor recurrence were observed. Results:Among the 22 cases, there were 1 case of Kaposis sarcoma（KS）, 2 cases of squ cell carcinoma, and 19 cases of basal cell carcinoma. Tumors were located at the nasal root in 3 cases, the nasal dorsum in5 cases, the nasal tip in 2 cases, the ala in 8 cases, both the ala and the nasal dorsum in 2 cases, nasal columella, the nasal tip, and the ala in 1 case, the nasal tip, the nasal dorsum, the ala, and paranasal area in 1 case. The size of the defects ranged from 1.2 cm×1.4 cm to 3.7 cm×4.8 cm. Three cases were repaired with forehead axial flaps, four cases with bilobed flaps, thirteen cases with nasolabial groove flaps, one case with free full-thickness skin grafts from the inguinal region, and one case with a combination of forehead axial flaps and facial kite flaps plus a composite of earlobe cartilage and perichondrium. All flaps survived well after surgery. Patients were followed up for 6 months to 3 years after surgery, during which no tumor recurrence was observed, and most patients were satisfied with appearance of their nose. Conclusion:Mohs surgery is used to excise the malignant tumor of the external nose, and satisfactory surgical results can be obtained by using different repair methods based the location and size of the postoperative defect.
Humans ; Mohs Surgery/methods* ; Nose Neoplasms/surgery* ; Surgical Flaps ; Skin Transplantation ; Male ; Carcinoma, Basal Cell/surgery* ; Skin Neoplasms/surgery* ; Female ; Middle Aged ; Plastic Surgery Procedures/methods* ; Nose/surgery* ; Aged ; Adult ; Carcinoma, Squamous Cell/surgery*

Objective:To investigate the efficacy of sigmoid sinus constriction plus cartilage reconstruction technique for sigmoid sinus related pulsatile tinnitus. Methods:The clinical data of 31 patients with Sigmoid Sinus Diverticulum（SSD） who underwent surgical treatment from January 2020 to December 2023 were retrospectively analyzed. The surgical methods include transmastoid sigmoid sinus constriction and cartilage reconstruction, transmastoid sigmoid sinus（bone wax） return surgery. Among them, 15 patients had transmastoid sigmoid sinus strictation + cartilage reconstruction, and transmammary sigmoid sinus（bone wax） in 16 cases. The aesthetic of anesthesia include general and local anesthesia, 20 cases of general anesthesia, 11 cases of local anesthesia. The doctors of our team graded the degree of tinnitus in 1 week, 1 month and 3 months（Tinnitus Evaluation Questionnaire, TEQ）, and compared the degree of preoperative tinnitus to evaluate the surgical efficacy, and the intraoperative and postoperative complications were analyzed and summarized. Results:In 30 of 31 patients, tinnitus was cured or improved with satisfactory efficacy. Among the patients undergoing sigmoid sinus constrictation + cartilage reconstruction, one case had intraoperative sigmoid sinus rupture and bleeding; among the patients who underwent sigmoid sinus（bone wax） return, one patient did not improve postoperative tinnitus, and one patient had postoperative headache and blurred vision, which improved after 1 month of conservative treatment. Conclusion:In the treatment of intravenous pulsatile tinnitus caused by sigmoid sinus diverticulum, the precision of the return depth is difficult to control, and the insufficient and excessive return will cause poor efficacy and postoperative complications. Based on the observation of small sample size and recent curative effect, it is considered that the sigmoid sinus constriction + cartilage reconstruction technology has certain advantages in surgical efficacy, with few postoperative complications, but the operation is difficult, so pay attention to the prevention and emergency treatment of intraoperative sigmoid sinus rupture bleeding.
Humans ; Tinnitus/etiology* ; Retrospective Studies ; Cranial Sinuses/surgery* ; Male ; Plastic Surgery Procedures/methods* ; Female ; Cartilage/surgery* ; Diverticulum/complications* ; Middle Aged ; Treatment Outcome ; Adult

Objective:To investigate the clinical effect of free anterolateral thigh myocutaneous flap combined with oral repair membrane in the reconstruction of nasal mucosa defect after maxillary malignant tumor surgery. Methods:A total of 12 patients with maxillary gingival squamous cell carcinoma and maxillary sinus cancer who had been treated in Department of Oral and Maxillofacial Surgery, Beijing Anzhen Nanchong Hospital, Capital Medical University & Nanchong Central Hospital, were selected from November 2020 to November 2023. Free anterolateral thigh musculocutaneous flap transplantation combined with oral repair membrane were used in all patients. Meanwhile, maxillary soft and hard tissue defects and nasal mucosa defects left after tumor operation were repaired and reconstructed. The clinical effect was evaluated after 6-12 months follow-up. Results:Subtotal maxillary resection was performed in 1 case, total maxillary resection in 9 cases and extended maxillary resection in 2 cases. The musculocutaneous flaps of all patients survived, the facial appearance was basically symmetrical, no obvious depression deformity, the swallowing and speech function recovered well, the mouth and nasal cavity were closed completely, the food could be eaten through the mouth, and the lower nasal passage was not blocked. Conclusion:The free anterolateral thigh musculoflap combined with oral repair membrane can be used to repair and reconstruct maxillary malignant tumor complicated with extensive maxillary tissue and nasal mucosa defect after operation, and the appearance and function can be recovered well after operation, which is a choice for maxillary malignant tumor complicated with nasal mucosa defect.
Humans ; Myocutaneous Flap ; Plastic Surgery Procedures/methods* ; Maxillary Neoplasms/surgery* ; Carcinoma, Squamous Cell/surgery* ; Male ; Middle Aged ; Female ; Nasal Mucosa/surgery* ; Maxilla/surgery* ; Thigh/surgery* ; Maxillary Sinus Neoplasms/surgery*

The reconstruction of the temporomandibular joint presents a multifaceted clinical challenge in the realm of head and neck surgery, underscored by its relatively infrequent occurrence and the lack of comprehensive clinical guidelines. This review aims to elucidate the available approaches for TMJ reconstruction, with a particular emphasis on recent groundbreaking advancements. The current spectrum of TMJ reconstruction integrates diverse surgical techniques, such as costochondral grafting, coronoid process grafting, revascularized fibula transfer, transport distraction osteogenesis, and alloplastic TMJ replacement. Despite the available options, a singular, universally accepted 'gold standard' for reconstructive techniques or materials remains elusive in this field. Our review comprehensively summarizes the current available methods of TMJ reconstruction, focusing on both autologous and alloplastic prostheses. It delves into the differences of each surgical technique and outlines the implications of recent technological advances, such as 3D printing, which hold the promise of enhancing surgical precision and patient outcomes. This evolutionary progress aims not only to improve the immediate results of reconstruction but also to ensure the long-term health and functionality of the TMJ, thereby improving the quality of life for patients with end-stage TMJ disorders.
Humans ; Temporomandibular Joint/surgery* ; Temporomandibular Joint Disorders/surgery* ; Transplantation, Autologous ; Arthroplasty, Replacement/methods* ; Joint Prosthesis ; Plastic Surgery Procedures/methods*

The unilateral cleft lip repair surgery has undergone over a century of development, marked by achievements and difficulties. Although the development of the methods for cleft lip repair has passed the period of rapid advancement, there remains an urgent need in clinical practice to further improve these methods in order to enhance clinical outcomes. This article aims to improve cleft lip repair methods by analyzing and elaborating on various aspects, including the attributes of cleft lip repair, the shift in concepts of cleft lip repair, innovations in surgical techniques, technical improvements, and classifications and repair methods for correcting secondary deformities. The analysis is based on the author's research and experience.
Cleft Lip/surgery* ; Humans ; Plastic Surgery Procedures/methods* ; Surgical Flaps

OBJECTIVE: To investigate the effectiveness of modified single patellar tunnel medial patella femoral ligament (MPFL) reconstruction in the treatment of recurrent patellar dislocation. METHODS: Between January 2023 and June 2023, a total of 61 patients with recurrent patellar dislocation who underwent MPFL reconstruction with autologous semitendinosus were enrolled and divided into 2 groups using random number table method. In the patellar anchor group, 31 patients were treated with MPFL reconstruction with double medial patellar anchors, and 30 patients in the patellar tunnel group were treated with MPFL reconstruction with single patellar tunnel. The femoral ends of both groups were fixed with absorbable compression screws. There was no significant difference in baseline data such as gender, age, side, tibial tubercle-trochlear groove (TT-TG), Q angle, Caton-Deschamps index, number of dislocation, and preoperative Kujala score, preoperative patellar inclination angle ( P>0.05). Patellar tunnel, patellar anchor position, patellar reduction, and the patellar inclination angle were measured by CT scan after operation. Kujala score was used to evaluate the function of knee joint before operation, at 2 weeks and 1, 3, 6, 12 months after operation. Incision aesthetic satisfaction score was performed at 3 months after operation. The signal-to-noise quotient (SNQ) of the transplanted tendon was measured by knee MRI at 12 months after operation to compare the maturity of the graft between the two groups. RESULTS: There was no significant difference in operation time and intraoperative blood loss between the two groups ( P>0.05). Knee CT reexamination showed that the patellar tunnel and the patellar anchor position were consistent with the intraoperative fluoroscopy. There was no significant difference in the difference of the patellar inclination angle between the two groups before and after operation ( P>0.05). All patients were followed up 12-14 months (mean, 12.8 months). There was 1 case of patellar anchor suture rejection in patellar anchor group, and the wound healed after debridement and dressing change. During the follow-up, there was no complication such as recurrence of patellar dislocation, infection and postoperative stiffness. The Kujala scores of the two groups significantly improved at each time point after 1 month of operation when compared with those before operation ( P<0.05), and the Kujala scores of the two groups returned to normal levels at 3 months after operation. The Kujala score in the patellar tunnel group was significantly higher than that in the patellar anchor group in the very early stage (2 weeks) ( P<0.05), and there was no significant difference between the two groups at other time points ( P>0.05). Patients in the patellar tunnel group were significantly better than those in the patellar anchor group in the score of incision aesthetic satisfaction at 3 months after operation and the SNQ at 12 months after operation ( P<0.05). CONCLUSION Modified single patellar tunnel MPFL reconstruction was used to treat patients with recurrent patellar dislocation without pathological TT-TG. The slide-fixation structure formed by single patellar tunnel positioning provides a variable degree of freedom for the reconstructed MPFL, which shows good effectiveness in the very early stage of the rehabilitation process.
Humans ; Patellar Dislocation/surgery* ; Male ; Female ; Plastic Surgery Procedures/methods* ; Adult ; Patellar Ligament/surgery* ; Recurrence ; Treatment Outcome ; Young Adult ; Adolescent ; Patella/surgery* ; Suture Anchors ; Hamstring Tendons/transplantation* ; Knee Joint/surgery* ; Transplantation, Autologous

OBJECTIVE: To investigate the effectivess of arthroscopic Wafer surgery combined with triangular fibrocartilage complex (TFCC) insertion point reconstruction in the treatment of Palmer type ⅡC combined with typeⅠB ulnar impingement syndrome. METHODS: The clinical data of 14 patients with Parlmer type ⅡC combined with type ⅠB ulnar impingement syndrome who met the selection criteria between July 2021 and April 2024 were retrospectively analyzed. There were 7 males and 7 females with an average age of 43 years ranging from 16 to 59 years. The causes of injury were fall in 8 cases and sprain in 6 cases. The time from injury to operation ranged from 1 to 6 months, with an average of 2.3 months. Distal radioulnar joint instability was found in all cases. Arthroscopic Wafer surgery combined with TFCC insertion point reconstruction was used. The effectiveness was evaluated by comparing the wrist flexion-dorsiflexion range of motion, wrist ulnar deviation-radial deflection range of motion, forearm pronation-supination range of motion, visual analogue scale (VAS) score, and modified Mayo wrist score before and after operation. RESULTS: All patients were followed up 6-12 months, with an average of 9.1 months. The positive variation of ulna was (3.2±0.7) mm before operation, and the negative variation of ulna was (2.2±0.6) mm after operation. There was a significant difference in ulna variation between pre- and post-operation ( t=23.851, P<0.001). The pain symptoms and forearm rotation function of the patients after operation significantly improved. At last follow-up, the wrist flexion-dorsiflexion range of motion, wrist ulnar deviation-radial deflection range of motion, forearm pronation-supination range of motion, VAS score, and modified Mayo wrist score significantly improved when compared with those before operation ( P<0.05). CONCLUSION Arthroscopic Wafer surgery combined with TFCC insertion point reconstruction can effectively relieve wrist pain, enhance the stability of the distal radioulnar joint, and restore the function of the wrist in patients with Palmer type ⅡC combined with type ⅠB ulnar impingement syndrome.
Humans ; Male ; Adult ; Arthroscopy/methods* ; Female ; Triangular Fibrocartilage/surgery* ; Middle Aged ; Range of Motion, Articular ; Retrospective Studies ; Wrist Joint/physiopathology* ; Adolescent ; Young Adult ; Ulna/surgery* ; Treatment Outcome ; Wrist Injuries/surgery* ; Plastic Surgery Procedures/methods* ; Joint Instability/surgery*