Objective To observe the effects of operation with large-dose of RoferonA for cutaneous malignant melanoma. Methods From January 1998 to December 2005, thirtythree patients with cutaneous malignant melanoma were treated. There were 20 males and 13 females, aging 17-79 years. The disease course was 2 months to 7 years. In 33 patients, nine patients identified as clinical-stage Ⅰ received singly enlargedresection to the primary lesion and performed split-thickness skin graft dermoplasty or adjacent skin flap repair; twenty-three patients identified as clinicalstage Ⅱ received enlargedresection to the primarylesion and performed proximal lymphaden scavenge as well as received split-thickness skin graft dermoplasty; and one patient identified as clinical-stage Ⅲ received palliative resection to the primary lesion. All patients received large dose of Roferon-A after operation. Results There are no recidivation in the 9 patients of clinicalstage Ⅰ. There are 1 recidivation and 1 quit in all the 23 patientsof clinicalstage Ⅱ. One patient of clinicalstage Ⅲ died after 18 months of operation. Conclusion The operation combined with large-dose of RoferonA after operation was a more effective way to treat cutaneous malignant melanoma.
Objective To explore better approach of resecting tumoraround the anterior skull base and reconstructing the anterior skull base.Methods In November 2004, a 49-years-old male patient with intracranial recrudescent adenoid cystic carcinoma in the anterior cranial fossa was treated using modified transcranial approach. Neurosurgeon and rhinolaryngologist cooperated to excise the tumour completely, and to reconstruct anterior skull base using the pedicle periosteum temproal musculofascial flap(15 cm×10 cm) andthe pedicle flap of aponeurosis of occipitofron talis muscle and muscular fasciae（10 cm×6 cm）.Results After operation, the wound healed by first intention. Complication, such as infection and cerebrospinal rhinorrhea, did not occur. The patient was discharged 10 days after operation, and was followed up for 8 months, no local recurrence were investigated and no scar formed over the face.Conclusion The modified transcranial approachis a relatively novel exposure that enables the skilled cranial base surgeon tosafely resect many malignant lesions previously and to reconstruct the defect of anterior skull base together.
Hemifacial microsomia (HFM) is a developmental hypoplasia of one side of face and ear due to congenital hypoplasia. At present, the causes of HFM have not been completely clarified, the classification methods are diverse, and the diagnosis and treatment methods are complex. Through reviewing the relevant study on the treatment of HFM domestic and overseas in recent years, the possible etiology and corresponding clinical manifestations of the disease are analyzed, and the existing clinical classification methods, treatment strategies and latest research results are summarized.
Facial filling injection is one of the technologies to achieve facial rejuvenation in a non-surgical way. With the application of emerging cosmetic filler preparations and the development of new technologies, there are more and more options to achieve facial rejuvenation. Complications may result from the use of new materials whose safety has not been proven in studies. This article describes common facial filler choices, facial risk areas and vascular complications, and discusses how to improve the safety of facial injections. The purpose is to enable operators to fully understand the facial risk area, select the appropriate filling injection, and be able to identify the symptoms of vascular complications as early as possible, thereby improving the safety of facial filling injection.
Objective To investigate the operative procedure and the effectiveness of cranial bone reconstruction after one-stage resection of scalp squamous carcinoma invading the skull. Methods Between January 2005 and December 2008,14 patients with scalp squamous carcinoma invading the skull were treated. There were 6 males and 8 females with a median age of 53 years (range, 29-76 years). The disease duration ranged from 3 to 8 years (mean, 6 years). The tumor locations were right temporal area in 2 cases, left temporal area in 2 cases, right frontal area in 3 cases, left frontal area in 1 case, right occi pital area in 1 case, left occi pital area in 2 cases, frontal area in 2 cases, and the top of the head in 1 case. Scalp lesions showed exogenous growth, and lesion diameter ranged from 5 to 12 cm (mean, 8 cm). TNM classification showed T4N0M0 tumor in all cases. MRI showed that tumors invaded the skull, 12 cases had smooth intradural side and 2 cases had brain involvement without lymph node metastasis or detected distant metastasis. Under general anesthesia, all the lesions of the scalp, skull, dura, and brain tissue were removed completely. The size defect of the scalp, skull, and dura ranged from 8 cm × 7 cm to 15 cm × 14 cm, from 5 cm × 4 cm to 12 cm × 12 cm, and from 4 cm × 4 cm to 9 cm × 8 cm, respectively, which were repaired with artificial patch, titanium metal, mesh, and local flaps, respectively. The donor site was repaired by spl it-thickness skin graft. Results The skin flaps and grafts survived and incision healed by first intention without cerebrospinal fluid leakage, intracranial and subdural hemorrhage, andother compl ications. All patients were followed up 2 to 5 years (mean, 4 years), and no recurrence was found. The compatibil ity of titanium mesh and local tissue was good. The patients had good hair growth without exposure of titanium mesh, seizures, partial paralysis, and other neurological damage performance. Conclusion After one-stage resection of scalp squamous carcinoma invading the skull, it is effective to reconstruct the skull with titanium mesh and to repair dural defects with artificial dura.
ObjectiveTo summarize clinical experience and curative effect in applying three-dimensional mechanical equilibrium concept to cartilage scaffold construction in total auricular reconstruction.MethodsBetween June 2015 and June 2017, ninety-seven microtia patients (102 ears) were treated with total ear reconstruction by using tissue expanders. The patients included 43 males and 54 females and their age ranged from 7 to 45 years with an average of 14 years. There were 92 unilateral cases (45 in left side and 47 in right side) and 5 bilateral ones. There were 89 congenital cases and 8 secondary cases. According to microtia classification criteria, there were 21 cases of type Ⅱ, 67 cases of type Ⅲ, and 9 cases of type Ⅳ. Tissue expander was implanted in the first stage. In the second stage, autogenous cartilage was used to construct scaffolds which were covered by enlarged flap. According to the three-dimensional mechanical equilibrium concept, the stable ear scaffold was supported by the scaffolds base, the junction of helix and inferior crura of antihelix, and helix rim. The reconstructed ears were repaired in the third stage operation.ResultsAll patients had undergone ear reconstruction successfully and all incisions healed well. No infection, subcutaneous effusion, or hemorrhage occurred after operation. All skin flaps, grafts, and ear scaffolds survived completely. All patients received 5- to 17-month follow-up time (mean, 11.3 months) and follow-up time was more than 12 months in 61 cases (64 ears). All reconstructed ears stood upright, and subunits structure and sensory localization of reconstructed ears were clear, and the position, shape, size, and height of bilateral ears were basically symmetrical. Mastoid region scar hyperplasia occurred in 3 patients, which was relieved by anti-scar drugs injection. No scaffolds exposure, absorption, or structural deformation occurred during follow-up period.ConclusionApplication of three-dimensional mechanical equilibrium concept in cartilage scaffold construction can reduce the dosage of costal cartilage, obtain more stable scaffold, and acquire better aesthetic outcomes.