ObjectiveTo summarize the treatment strategies and clinical experiences of 5 cases of giant plexiform neurofibromas (PNF) involving the head, face, and neck. MethodsBetween April 2021 and May 2023, 5 patients with giant PNFs involving the head, face, and neck were treated, including 1 male and 4 females, aged 6 to 54 years (mean, 22.4 years). All tumors showed progressive enlargement, involving multiple regions such as the maxillofacial area, ear, and neck, significantly impacting facial appearance. Among them, 3 cases involved tumor infiltration into deep tissues, affecting development, while 4 cases were accompanied by hearing loss. Imaging studies revealed that all 5 tumors predominantly exhibited an invasive growth pattern, in which 2 and 1 also presenting superficial and displacing pattern, respectively. The surgical procedure followed a step-by-step precision treatment strategy based on aesthetic units, rather than simply aiming for maximal tumor resection in a single operation. Routine preoperative embolization of the tumor-feeding vessels was performed to reduce bleeding risk, followed by tumor resection combined with reconstructive surgery. Results All 5 patients underwent 1-3 preoperative embolization procedures, with no intraoperative hemorrhagic complications reported. Four patients required intraoperative blood transfusion. A total of 10 surgical procedures were performed across the 5 patients. One patient experienced early postoperative flap margin necrosis due to ligation for hemostasis; however, the incisions in the remaining patients healed without complications. All patients were followed up for a period ranging from 6 to 36 months, with a mean follow-up duration of 21.6 months. No significant tumor recurrence was observed during the follow-up period. Conclusion For patients with giant PNF involving the head, face, and neck, precision treatment strategy can effectively control surgical risks and improve the standard of aesthetic reconstruction. This approach enhances overall treatment outcomes by minimizing complications and optimizing functional and cosmetic results.
【Abstract】 Objective To improve the method of obtaining purified and viable human hair foll icle stem cells (HFSCs)from bulge cells (BCs). Methods Firstly, the BCs were isolated from human hair foll icles by microdissection. Secondly, the CD200+ HFSCs were selected from BCs using magnetic cell sorting method. The viabil ity of these purified HFSCs was detected under l ight microscope. The purification rate was analyzed by flow cytometry. The pre- and post-purification cells were compared by immunofluorescence staining. Results The adherent BCs displayed a typical cobblestone morphology on day 6. The BCs expressed K19 bly. The viabil ity rate of pre-purification cells was 95.0% ± 0.6% while that of post- purification cells was 94.2% ± 1.0%. There was no significant difference (P lt; 0.05). By flow cytometry and immunofluorescence staining examination, the CD200+ cell rate was 8.31% before cell sorting purification while that was 82.31% after cell sorting purification. Con clu sion Highly purified and viable HFSCs could be obtained by micromanipulation and magnetic cell sorting assay.