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Liao X, Lu H, Wei Z, Chen W, Chen L, Huang Z, Deng M, Zhou J, Liang Y, Liu R, Nie K. Construction and study of a three-dimensional visualization model of superficial temporal artery branches: With an explicatory case. Asian J Surg 2024; 47:1351-1359. [PMID: 38065731 DOI: 10.1016/j.asjsur.2023.11.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/26/2023] [Accepted: 11/24/2023] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND The anatomical parameters of the superficial temporal artery branches were measured by a three-dimensional measurement method to provide anatomical reference for relevant clinical operations. METHODS Seventy original images were selected who had cranial CTA examination. The patients were aged 30-79 years, with an average of 60.0 years, including 32 females and 38 males. After reconstructing the superficial temporal artery by professional medical 3D reconstruction software, its anatomical parameters were measured. RESULTS The length of the secondary branches of the frontal branch of the superficial temporal artery were 47.6 ± 23.6 mm and 37.3 ± 21.6 mm in males and females, respectively, with a statistically significant difference. The length of the secondary branches of the parietal branch of the superficial temporal artery were 39.6 ± 20.4 mm and 49.2 ± 20.3 mm in young and middle-aged people and older people respectively, which were statistically different. The remaining measures were not statistically different across gender and age groups. The frontal branch of the superficial temporal artery was divided into three types, and the parietal branch of the superficial temporal artery was divided into two types. CONCLUSIONS The anatomical parameters of the superficial temporal artery branches can be accurately measured by means of 3D visualization, providing an anatomical reference for relevant clinical operations.
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Affiliation(s)
- Xiaoshuang Liao
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Hui Lu
- School of Medicine, Wuhan University of Science and Technology, Institute of Medical Innovation and Transformation, Puren Hospital Affiliated to Wuhan University of Science and Technology, Department of Orthopedics, Wuhan, China
| | - Zairong Wei
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Wei Chen
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Li Chen
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Zhonglu Huang
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Mingfu Deng
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Jian Zhou
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Yan Liang
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Rong Liu
- School of Medicine, Wuhan University of Science and Technology, Institute of Medical Innovation and Transformation, Puren Hospital Affiliated to Wuhan University of Science and Technology, Department of Orthopedics, Wuhan, China.
| | - Kaiyu Nie
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China.
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Zheng L, Lv XM, Shi Y, Huang MW, Zhang J, Liu SM. Use of free flaps with supermicrosurgery for oncological reconstruction of the maxillofacial region. Int J Oral Maxillofac Surg 2023; 52:423-429. [PMID: 35987710 DOI: 10.1016/j.ijom.2022.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/04/2022] [Accepted: 04/20/2022] [Indexed: 10/15/2022]
Abstract
Supermicrosurgery involves the dissection and anastomosis of vessels<0.8 mm in diameter with minimal donor site morbidity. This study evaluated the feasibility and outcomes of free flaps using supermicrosurgery to repair oncological defects in the maxillofacial region. Forty-two patients were treated with supermicrosurgery to repair oncological defects in the maxillofacial region between December 2015 and February 2021. The supermicrosurgery technique was used for different types of free flap, including 24 superficial circumflex iliac artery perforator flaps, seven anterolateral thigh flaps, three peroneal artery perforator flaps, five medial femoral condyle osteo-adipofascial flaps, and three profunda artery perforator flaps. An artery-to-artery approach was used in 38 patients; venous grafts for anastomosis were used in four patients to resolve an arterial discrepancy. Forty-one flaps (97.6%) survived. Thirty-six patients (85.7%) healed without any complications; three flaps required revision surgery including one lost, one demonstrated wound dehiscence, and two demonstrated wound infection. Supermicrosurgery is a useful complement to conventional microsurgery in head and neck reconstruction.
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Affiliation(s)
- L Zheng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
| | - X-M Lv
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Y Shi
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - M-W Huang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - J Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - S-M Liu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
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Escandón JM, Ciudad P, Mayer HF, Pencek M, Mantilla-Rivas E, Mohammad A, Langstein HN, Manrique OJ. Free flap transfer with supermicrosurgical technique for soft tissue reconstruction: A systematic review and meta-analysis. Microsurgery 2023; 43:171-184. [PMID: 35551691 DOI: 10.1002/micr.30894] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/16/2022] [Accepted: 04/29/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Supermicrosurgery is a technique that allows microsurgeons to accomplish dissections and anastomoses of vessels and nerve fascicles with diameters of ≤0.8 mm. Considering the potential benefits of this technique and limited literature synthesizing the outcomes of supermicrosurgery, the aim of this study was to summarize the available evidence of reconstructive supermicrosurgery and to estimate the success rate. METHODS We conducted a comprehensive search across PubMed, Scopus, Embase, and Web of Science. We included patient-based studies reporting on procedures for soft-tissue reconstruction with free flaps specifying the use of supermicrosurgery. We excluded studies reporting on lymphatic surgery, solely peripheral nerve surgery, and tissue replantation. Our primary endpoint was to calculate the flap success rate. Pooled estimates were calculated using a random-effects meta-analytic model. RESULTS Forty-seven studies reporting outcomes of 698 flaps were included for qualitative synthesis. Overall, 15.75% of flaps were used for head and neck, 4.4% for breast and trunk, 9.3% for upper limb, and 69.2% for lower limb reconstruction. The most used flap was the superficial circumflex iliac artery perforator flap (41.5%). The overall flap success rate was 96.6% (95%CI 95.2%-98.1%). The cumulative rate of partial flap loss was 3.84% (95%CI 1.8%-5.9%). The overall vascular complication rate resulting in complete or partial flap loss was 5.93% (95%CI 3.5%-8.3%). CONCLUSIONS Supermicrosurgery displays a high success rate. Further studies are necessary to explore the true potential of supermicrosurgery. This technique reformulates the boundaries of reconstructive surgery due to its extensive application.
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Affiliation(s)
- Joseph M Escandón
- Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York, USA
| | - Pedro Ciudad
- Department of Plastic and Reconstructive Surgery, Archbishop Loayza National Hospital, Lima, Peru
| | - Horacio F Mayer
- Department of Plastic Surgery, Hospital Italiano de Buenos Aires, University of Buenos Aires, Buenos Aires, Argentina
| | - Megan Pencek
- Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York, USA
| | - Esperanza Mantilla-Rivas
- Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, District of Columbia, USA
| | - Arbab Mohammad
- School of Medicine, Aarupadai Veedu Medical College and Hospital, Puducherry, India
| | - Howard N Langstein
- Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York, USA
| | - Oscar J Manrique
- Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York, USA
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Li SY, Yu BF, Wei SY, Yin N, Yao ZJ, Wei J, Dai CC. Designing a Trifoliate Flap for Isolated Congenital Alar Rim Defect in Pediatric Patients. Plast Surg (Oakv) 2023; 31:91-97. [PMID: 36755818 PMCID: PMC9900041 DOI: 10.1177/22925503211019606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/16/2021] [Indexed: 11/16/2022] Open
Abstract
Isolated congenital alar rim defects are extremely rare, and there has been no standard technique for the reconstruction of remarkable aesthetic deformity. Herein, we introduce a trifoliate flap for the correction of isolated congenital alar rim defects in pediatric patients. Fifteen cases undergoing nasal alar sulcus rotation flap surgery were analyzed retrospectively. This rotation flap including 3 triangles was a modified flap based on prior studies. Clinical medical notes and photographs were reviewed. Patients' (or their parents) reported satisfactions with aesthetic outcome were also evaluated during the post-operative follow-up period. In all patients, the isolated congenital alar rim defects were successfully reconstructed. The rotation flap survived and the wound healed primarily. The follow-up period ranged from 6 to 22 months (average 11 months). There were no incidents of flap loss, step-off deformities, nasal obstruction, or alar retraction. At follow-up of post-operative 3 months, pale red scars were observed in the operative area in few patients (2/15). However, these scars gradually became invisible at post-operative 6 months. All patients (or their parents) were satisfied with the aesthetic outcome of this operation. This newly designed trifoliate flap can be an alternative method for the reconstruction of isolated congenital alar rim defects in pediatric patients. The scars of this procedure can be unobvious with fine surgical suture.
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Affiliation(s)
- Shi-Yan Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Bao-Fu Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shu-Yi Wei
- Department of Burns and Plastic Surgery, Minzu Hospital of Guangxi, Nanning, China
| | - Ning Yin
- Department of Ear-Nose-Throat, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Zong-Jiang Yao
- Department of Burns and Plastic Surgery, Lanzhou University Second Hospital, Lanzhou, China
| | - Jiao Wei
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chuan-Chang Dai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Wei J, Dai C, Li S. Revision Rhinoplasty in Asians. Clin Plast Surg 2023; 50:141-149. [DOI: 10.1016/j.cps.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Alar Rim Triangular Flap for Congenital Nasal Cleft Repair in Pediatric Patients. J Craniofac Surg 2021; 33:183-186. [PMID: 34320576 DOI: 10.1097/scs.0000000000008032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND According to Tessier classification, number 1 and number 2 craniofacial clefts involve the nasal ala. Congenital nasal cleft is not common and is difficult for reconstruction. Notches in the medial one-third of either nasal ala are typical manifestations in these patients. Herein, we introduce a alar rim triangular flap, which is indeed a local flap, for the treatment of isolated nasal cleft due to congenital deformities in pediatric patients. METHODS The authors conducted a retrospective cohort study including 10 consecutive pediatric patients undergoing this surgery. This alar rim triangular flap including 2 triangles was existing nasal tissue near the cleft. The alar rim defect was covered through local tissue re-arrangement. The authors reviewed the photographs and clinical medical notes of these patients carefully. Self-reported satisfactions of patients (or children's parents) with the scar morphology and correction effect of this procedure were evaluated as well at postoperative every follow-up. RESULTS All the cases were followed up regularly, and the average follow-up time was 22 months (ranged from 13-38 months). All the nasal clefts were reconstructed successfully. The alar rim triangular flap survived with no flap loss. The wound created by this procedure healed primarily. No alar retraction, nasal obstruction or step-off deformities were observed during postoperative follow-up. There were no patients unsatisfied with the outcome of the scar morphology and correction effect of this operation. CONCLUSIONS The newly designed alar rim triangular flap in this study can be an alternative treatment for correcting isolated congenital nasal cleft with optimal clinical outcome. LEVEL OF EVIDENCE Level 4.
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