Background The columella, nasal tip, lip relationship in the bilateral cleft lip nasal deformity remains a great challenge for plastic surgeon. An esthetically satisfying result is difficult to obtain. A subset of pat...Background The columella, nasal tip, lip relationship in the bilateral cleft lip nasal deformity remains a great challenge for plastic surgeon. An esthetically satisfying result is difficult to obtain. A subset of patients with bilateral cleft lip nasal deformity still require columellar lengthening and nasal correction and philtrial construction. This study aimed to provide a new method based on the forked flap to improve the final appearance of these patients. Methods A technique to correct this deformity is described. This consists of （1） a newly modified forked flap including the orbicularis oris muscle and nasalis muscle along the whole flap for columellar lengthening, （2） a reverse V shaped flap from the lower portion of the columella and the prolabium for normal size phitrum construction, （3） inserting the vermilion portion of the forked flap and advancing the nasal floor medially and anteriorly to lengthen and maintain the nasal septum side of the columella for proper tip positioning, （4） open rhinoplasty, allowing definitive repositioning of the lower lateral cartilages, （5） reconstruction of the orbicularis orismuscle as required, and （6） the flaring nostril floor advancing medially and constructing the sill. Results This technique was applied to 15 cases of secondary bilateral cleft lip nasal deformity. All the flaps took without signs of partial necrosis. In all cases, the nasal tip was projected forward with adequate columella elongation, and the height of the prolabium was added with normal size philtrial dimensions. Conclusions This method makes maximum use of the tissue containing the scar in the lip and limits tissues in the lower portion of the columella and the prolabium for adequate columella elongation and reconstruction with normal size philtrial dimensions. It is a very reasonable and useful method in correction of secondary bilateral cleft lip nasal deformities.展开更多
Bifid nose is a rare congenital abnormality and its surgical correction is difficult. We represent a case of bifid nose with mild nasal deformity without cerebral or lip deformity. We performed rhinoplasty with a kind...Bifid nose is a rare congenital abnormality and its surgical correction is difficult. We represent a case of bifid nose with mild nasal deformity without cerebral or lip deformity. We performed rhinoplasty with a kind of the forked flap at one year of age and the appearance improved.展开更多
Flapping plates of typical fishlike tail shapes are simulated to investigate their locomotion performance using the multi-block Lattice Boltzmann Method （LBM） and Immersed Boundary （IB） method. Numerical results s...Flapping plates of typical fishlike tail shapes are simulated to investigate their locomotion performance using the multi-block Lattice Boltzmann Method （LBM） and Immersed Boundary （IB） method. Numerical results show that fishlike forked configurations have better locomotion performance compared with unforked plates. Based on our results, the caudal fin in carangi- form mode has greater thrust, and the lunate tail fin in thtmniform mode has higher efficiency. These findings are qualitatively con- sistent with biological observations of fish swimming. Analysis of wake topology shows that the wake of the forked plate consists of a chain of alternating reverse horseshoe-like vortical structures. These structures induce a backward jet and generate a positive thrust. Moreover, this backward jet has a more favorable direction compared with that behind an unforked plate.展开更多
文摘Background The columella, nasal tip, lip relationship in the bilateral cleft lip nasal deformity remains a great challenge for plastic surgeon. An esthetically satisfying result is difficult to obtain. A subset of patients with bilateral cleft lip nasal deformity still require columellar lengthening and nasal correction and philtrial construction. This study aimed to provide a new method based on the forked flap to improve the final appearance of these patients. Methods A technique to correct this deformity is described. This consists of （1） a newly modified forked flap including the orbicularis oris muscle and nasalis muscle along the whole flap for columellar lengthening, （2） a reverse V shaped flap from the lower portion of the columella and the prolabium for normal size phitrum construction, （3） inserting the vermilion portion of the forked flap and advancing the nasal floor medially and anteriorly to lengthen and maintain the nasal septum side of the columella for proper tip positioning, （4） open rhinoplasty, allowing definitive repositioning of the lower lateral cartilages, （5） reconstruction of the orbicularis orismuscle as required, and （6） the flaring nostril floor advancing medially and constructing the sill. Results This technique was applied to 15 cases of secondary bilateral cleft lip nasal deformity. All the flaps took without signs of partial necrosis. In all cases, the nasal tip was projected forward with adequate columella elongation, and the height of the prolabium was added with normal size philtrial dimensions. Conclusions This method makes maximum use of the tissue containing the scar in the lip and limits tissues in the lower portion of the columella and the prolabium for adequate columella elongation and reconstruction with normal size philtrial dimensions. It is a very reasonable and useful method in correction of secondary bilateral cleft lip nasal deformities.
文摘Bifid nose is a rare congenital abnormality and its surgical correction is difficult. We represent a case of bifid nose with mild nasal deformity without cerebral or lip deformity. We performed rhinoplasty with a kind of the forked flap at one year of age and the appearance improved.
基金the National Natural Science Foundation of China (Grant No. 10832010)the Innovation Project of the Chinese Academy of Sciences (Grant No. KJCX2-YW-L05)the 111 Project (Grant No. B07033)
文摘Flapping plates of typical fishlike tail shapes are simulated to investigate their locomotion performance using the multi-block Lattice Boltzmann Method （LBM） and Immersed Boundary （IB） method. Numerical results show that fishlike forked configurations have better locomotion performance compared with unforked plates. Based on our results, the caudal fin in carangi- form mode has greater thrust, and the lunate tail fin in thtmniform mode has higher efficiency. These findings are qualitatively con- sistent with biological observations of fish swimming. Analysis of wake topology shows that the wake of the forked plate consists of a chain of alternating reverse horseshoe-like vortical structures. These structures induce a backward jet and generate a positive thrust. Moreover, this backward jet has a more favorable direction compared with that behind an unforked plate.
