Classification and reconstructive algorithm for nasal alar defect in Asians

Background:The nasal alar defect in Asians remains a challenging issue,as do clear classification and algorithm guidance,despite numerous previously described surgical techniques.The aim of this study is to propose a surgical algorithm that addresses the appropriate surgical procedures for different types of nasal alar defects in Asian patients.Methods:A retrospective case note review was conducted on 32 patients with nasal alar defect who underwent reconstruction between 2008 and 2022.Based on careful analysis and our clinical experience,we proposed a classification system for nasal alar defects and presented a reconstructive algorithm.Patient data,including age,sex,diagnosis,surgical options,and complications,were assessed.The extent of surgical scar formation was evaluated using standard photography based on a 4-grade scar scale.Results:Among the 32 patients,there were 20 males and 12 females with nasal alar defects.The predominant cause of trauma in China was industrial factors.The majority of alar defects were classified as type Ⅰ C(n=8,25%),comprising 18 cases(56.2%);there were 5 cases(15.6%)of type Ⅱ defect,7(21.9%)of type Ⅲ defect,and 2(6.3%)of type Ⅳ defect.The most common surgical option was auricular composite graft(n=8,25%),followed by bilobed flap(n=6,18.8%),free auricular composite flap(n=4,12.5%),and primary closure(n=3,9.4%).Satisfactory improvements were observed postoperatively.Conclusion:Factors contributing to classifications were analyzed and defined,providing a framework for the proposed classification system.The reconstructive algorithm offers surgeons appropriate procedures for treating nasal alar defect in Asians.

Relationship between Inter Canine Width and Inter Alar Width, Inter Commissural Width, and Inter Canthal Distance: A Pilot Study

The aim of this study was to determine the relationship between inter canine width (ICW) and inter alar width (IAW), inter commissural width (ICoW), and inter canthal distance (ICaD) in Bantu population. Materials and Methods: It was a pilot study included all participants who were aged at least 18 years, without a history of orthodontics treatment from Prosthodontics Department, Faculty of Dental Medicine, University of Kinshasa. The Ethics committee of the National Center of Research for Dental Sciences in DR Congo approved the study protocol (CNRSB 1504.218). The participants medical records were obtained from the interview and dental examination. Nature of the study was explained with participant information sheet, and an informed consent of all participants was obtained. The inclusion criteria were no missing maxillary and mandibular teeth, no diastema, and no anterior restorations, 18 years old before enrollment in the study. The exclusion criteria were inability to meet the above requirements, pregnancy, and refusal to participate in the study. The inter-canine width (ICW), inter alar width (IAW), inter canthal distance (ICaD) and inter-commissural width (ICoW) of each participant were measured with a digital Vernier caliper (Mitutoyo, UK Ltd.,) (0.01 mm) three times and the average value was recorded. The inter canthal distance (ICaD) was measured without applying pressure by bringing the recording parts of the caliper just in contact with the medial angle. The inter alar width (IAW) was marked with a fine marked pencil on the widest outer surface of the alae of the nose on either side or width. Those two points were measured without applying pressure by bringing the recording parts of the caliper just in contact with the outer surface. The participant was told to stop breathing shortly to avoid any change in shape of the nose. The inter-commissural width (ICoW) was determined by measuring the maxillary lip vermilion from commissure to commissure without the application of pressure on the tissue in the relaxed state. The inter-canine width (ICW) was measured indirectly using a dental floss. A dental floss was marked on one end prior to placement in the mouth. Using that point as reference, the dental floss was circumference along the curvature of the anterior dentition such that it passed along the contact point of all the teeth. The distal end of the canine teeth on both sides was then marked on the floss while it was stretched in the patients mouth. Floss was marked on both sides with the marker pencil. The distance between the two proximal contact points was measured and recorded. Data, analysis and validation were performed by the SPSS software (version 22.0, IBM SPSS Statistics, Chicago, IL, USA). Unpaired t-test was used, of Kolmogorov-Smirnov test. Analysis of variance (ANOVA) test was used to test for comparability between socio-demographic characteristics dental measurements. Pearsons correlation coefficients test was calculated to determine the relationship between facial and dental parameters. Significance was set at P 0.01. Results: Of 314 participants enrolled, 202 were included. The age ranged from 18 to 68 years, with a mean age of 40.62 12.99 years. Although the Pearsons correlation coefficients were negative. Ninety-three participants (46%) were men and one hundred and nine (54%) were women. The overall mean age was 40.62 12.99 years. Facial and dental measurements were greater in women than men with significant differences for ICW (p = 0.04). However, no significant difference was seen between men and women for IAW, ICaD and ICoW (p = 0.44, p = 0.23, p = 0.31 respectively). The correlation including Pearsons correlation coefficient and P-values for all participants is not demonstrated. Conclusion: Within the limitations of this study, the results suggest that IAW, ICaD and ICoW cannot be used as a preliminary method for determining the width of the maxillary for anterior teeth for edentulous patients.

A two-step correction of a congenital alar cleft in an adult patient:A case report

This report describes a two-step surgical correction of an isolated left-sided congenital alar cleft in a 21-year-old male patient presenting with a 9×6.5 mm^(2)-sized cleft.Malformations of the alar structure and displacement of the lower lateral cartilage were observed.All flaps survived,and the patient was completely satisfied with the surgical results.This surgical treatment is simple and reliable,can greatly improve the nasal appearance of patients with alar clefts,and may be an alternative to the current surgical treatment.

Delayed diagnosis of isolated alar ligament rupture:A case report

Ligament disruptions at the craniovertebral junction are typically associated with atlantoaxial rotatory dislocation during upper cervical spine injuries and require external orthoses or surgical stabilization. Only in few patients isolated ruptures of the alar ligament have been reported. Here we present a further case, in which the diagnosis was initially obscured by a misleading clinical symptomatology but finally established six month following the trauma, demonstrating the value of contrast-enhanced high resolution 3 Tesla magnetic resonance imaging in identifying this particular lesion.

A combined therapy for the repair of alar defects that consists of a modified spiral flap and postoperative nasal stent

Background: The repair of alar defects is challenging in clinics. Although skin grafts and nasolabial flaps are reliable, they can cause secondary post-surgical deformities.Methods: In this report, we describe an alar spiral advancement flap with a subcutaneous pedicle combined with postoperative nasal stent therapy for the repair of alar defects.Results: All cases showed slight asymmetry immediately after surgery, but at a median follow-up of 24 months, no cases of dissatisfaction with the nose shape or abnormal respiratory function were found. Almost all incision scars subsided within 12 months. In addition, all flaps that were dissected and rotated during the surgeries healed, and no signs of necrosis or development of vascular compromise were observed.Conclusion: Our preliminary experience suggests that the alar spiral flap followed by nasal stent therapy provides stable recovery of appearance and function for alar defects during follow-ups and shows promise for future therapies.

Three-Dimensional M-Shaped Resection for Nasal Alar Hypertrophy in Asian Patients

Background Nasal alarplasty is an important component of esthetic rhinoplasty in Asians.The two main surgical techniques that correct alar hypertrophy by reducing the height or length often leave external scars and are associated with a high relapse rate.Methods We developed a new technique,called three-dimensional(3D)M-shaped resection,which corrects both the nasal alar height and length and simultaneously minimizes external scarring.We performed this procedure from January 2013 to September 2016 in 49 consecutive female patients diagnosed with saddle nose and nasal alar hypertrophy.Their mean age was 28.6(range,18–40)years.All patients had previously undergone simple rhinoplasty.Nasal alar length and height,nostril length and width,and maximal nose width were analyzed preoperatively and postoperatively from photographs.Results After a mean of 9(range,3–24)months of follow-up,surgery was considered successful in 46 women(94%)with good cosmetic effects.In three patients,nasal alar hypertrophy recurred(6 months postoperatively).There were no early complications such as hematomas,infections,skin or mucosal necrosis,or wound dehiscence.The mean reductions postoperatively were 1.7 mm and 0.9 mm for nasal alar length and height,respectively,1.6 mm for both nostril length and width,and 3.5 mm for nose width.Conclusion The 3D M-shaped resection for nasal alar hypertrophy effectively reduced hypertrophy in 94%of patients for up to 24 months,producing minimal external scars and good cosmetic effects.It is a simple and convenient technique that is an effective and safe option for nasal alarplasty.

2020-2022年第一师阿拉尔市恶性肿瘤发病分析

目的分析2020—2022年第一师阿拉尔市(以下简称阿拉尔市)参保人群的恶性肿瘤发病情况,为本地区的恶性肿瘤防控工作提供参考。方法收集并整理2020—2022年阿拉尔市参保人群的恶性肿瘤发病数据,统计分性别、民族(汉族和少数民族)及年龄的恶性肿瘤粗发病率、中标发病率、世标发病率、0~74岁累积率、35~64岁截缩率、发病顺位及其构成。结果2020—2022年阿拉尔市参保人群覆盖全市人口79.02%,新发恶性肿瘤2778例,粗发病率为276.84/10万,中标发病率为225.64/10万,世标发病率为220.66/10万,累积率(0~74岁)为23.72%,截缩率为394.11/10万,其中女性、汉族的各项发病指标均高于男性及少数民族。40岁后发病率快速增加,60岁前女性发病率高于男性,60岁后男性高于女性。发病前5位依次为肺癌、甲状腺癌、结直肠癌、乳腺癌和胃癌,占比58.42%。男性及汉族以肺癌及消化道肿瘤为主,女性及少数民族中甲状腺癌、乳腺癌相对突出。结论阿拉尔市参保人群中,肺癌、乳腺癌、甲状腺癌和消化道恶性肿瘤是阿拉尔市参保人群中常见肿瘤,女性恶性肿瘤发病率较高。

新型经鼻气管插管固定器在头颈外科手术中的应用评价

目的探讨一种新型经鼻气管插管固定装置在头颈外科手术中的应用效果。方法选取2020年6月~2021年4月在我院中心手术室经鼻气管插管全身麻醉手术的成年患者180例,采用随机数字表法分成观察组和对照组,每组90例。观察组采用自主研发的新型经鼻气管插管固定装置固(获得国家新型实用专利授权,专利号:ZL 202020903995.3),对照组采用常规方法结合水胶体敷料固定。比较两组鼻部压力性损伤、呼吸管路松动的发生率,以及通过视觉模拟量表方法比较麻醉医生和手术室护士对两种固定方法的满意度。结果观察组患者鼻翼压力性损伤的发生率为3.33%(3/90),对照组为12.2%(11/90),观察组发生率明显低于对照组,差异有统计学意义(χ^(2)=5.149,P<0.05)。观察组患者中无一例发生因术中转变头位导致的呼吸通路过滤器与气管插管衔接口松动或脱落,对照组中共发生7次。麻醉科医护人员对两种固定方式的满意度调查,观察组医护人员平均得分为(8.0160.673),对照组平均得分(3.1731.006),观察组满意度高于对照组,得分有显著性统计学差异(t=6.245,P<0.05)。结论使用新型经鼻气管插管固定装置能显著降低鼻部压力性损伤的发生率,不增加其他部位的压力性损伤。并且能预防术中呼吸管路松动脱落,便于麻醉医护人员使用,值得在临床推广使用。

1990—2020年南疆阿拉尔垦区棉花物候期的动态变化

物候是气候变化的感应器,能客观反映气候变化对棉花生长周期的影响。为探究气候暖湿化背景下南疆阿拉尔垦区棉花物候期的动态变化,选取1990—2020年南疆阿拉尔垦区棉花物候期数据,运用距平、累积距平、Mann-Kendall非参数检验和滑动t检验等统计学方法,分析南疆阿拉尔垦区棉花物候期动态变化及其突变情况。结果表明,1990—2020年南疆阿拉尔垦区棉花平均播种期、出苗期、现蕾期、开花期、吐絮期和停止生长期分别出现在4月14日、4月29日、6月3日、7月2日、9月17日和10月20日,极差分别为25、23、20、22、44和24 d。1990—2020年垦区棉花播种期和出苗期均呈现极显著提前趋势,表现为“显著提前-稍微提前”的过程变化;开花期和停止生长期均呈现显著提前趋势,表现为“显著提前-稍微提前”的过程变化;吐絮期提前和现蕾期延迟均不显著。1990—2020年垦区棉花现蕾期、开花期和吐絮期阶段性变化特征明显,主要表现在现蕾期的阶段性推迟、吐絮期的阶段性提前、开花期的阶段性推迟与提前上,棉花播种期、出苗期和停止生长期阶段性变化特征不明显。研究结果为更好地评估气候暖湿化背景下垦区棉花生长和科学管理棉田提供理论依据。

新疆阿拉尔市就诊猫肠道寄生虫感染的调查

目的:为了解新疆阿拉尔市就诊猫肠道寄生虫感染情况。方法:该试验收集新疆阿克苏地区阿拉尔市就诊猫自然排便的粪便样本68份,进行编号,并询问主人猫的情况(比如年龄、体重、疫苗接种情况、驱虫情况)再详细记录,采用直接涂片法、饱和食盐水浮聚法和饱和蔗糖溶液漂浮法检查粪便中虫卵和卵囊。结果:就诊猫中肠道寄生虫感染为阴性的样本有42份,阳性有26份,其中肠道寄生虫3种,分别为猫弓首蛔虫、狮弓蛔虫和猫等孢球虫,感染率分别为22.06%、10.30%和5.88%。结论:新疆阿拉尔市就诊猫存在肠道寄生虫感染,感染情况较严重,其主要感染虫种为猫弓首蛔虫。

新疆阿拉尔地区宫颈癌筛查中HPV结果的分析

目的分析新疆阿拉尔地区宫颈癌筛查中的人乳头瘤病毒(HPV)检测结果。方法选取9791例宫颈癌筛查的健康女性为研究对象,均开展HPV16、18、31、33、35、39、45、51、52、56、58、59、68型13个高危基因型检测,观察其检测结果。结果9791例受检者中HPV总阳性检出率10.69%,其中汉族检出率与维吾尔族比较,差异无统计学意义(P>0.05);>50岁阳性检出率明显高于其他年龄段(P<0.05);单一感染阳性检出率明显高于多重感染(P<0.05);单一感染HPV分型检出率最高为52,其次是16、58及66等。HPV52型好发于>50岁年龄段;HPV39、31、51型好发于31~40岁年龄段,HPV 45、35型好发于21~30岁年龄段,HPV56型好发于41~50岁年龄段。结论新疆阿拉尔地区HPV感染率处于全国中等水平,无明显民族差异,依据该地区的HPV型分布情况,应增加疫苗接种率,促进HPV感染防控。

阿拉尔棉田烟粉虱捕食性天敌的SCAR分子标记检测

为了明确阿拉尔垦区棉田烟粉虱种群隐种以及烟粉虱捕食性天敌种类,采集阿拉尔十二团棉田中的烟粉虱及烟粉虱捕食性天敌,利用B-F/B-R、Q-F/Q-R特异性引物检测烟粉虱隐种类型,利用烟粉虱TB-F94585/TB-R 94585特异性引物检测捕食性天敌肠道内是否存在烟粉虱DNA。结果表明:新疆阿拉尔垦区烟粉虱为MED隐种,初步发现烟粉虱的捕食天敌共有4目5科,包括多异瓢虫成虫、多异瓢虫幼虫、东亚小花蝽、中华草蛉幼虫、黄褐新园蛛、灌木新园蛛、直伸肖蛸。利用SCAR分子标记技术可以快速检测阿拉尔垦区烟粉虱捕食性天敌种类。

“双拱”弹性支架与“2+2”支架鼻尖成形术的临床比较

目的:比较“双拱”弹性支架与“2+2”支架在鼻尖成形术中的临床应用效果。方法:回顾性分析2022年1月-2023年8月笔者医院收治的100例行肋软骨综合鼻整形术就医者的临床资料。依据手术方式的不同分为观察组与对照组,各50例。观察组采用“双拱”支架鼻尖成形联合膨体植入鼻部的手术方式,对照组采用“2+2”鼻尖成形联合膨体植入鼻部的手术方式。对比两组手术时长、鼻尖突出度、鼻尖突出率,鼻尖活动度及美学满意度。结果:本组100例就医者均获随访9个月。观察组手术时长较对照组长(P<0.05);观察组鼻尖突出度与对照组比较,差异无统计学意义(P>0.05);观察组鼻尖突出率与对照组比较,差异无统计学意义(P>0.05);观察组9个月的鼻尖活动满意度评分均高于对照组(P<0.05)。结论:“双拱”弹性支架鼻尖成形术是一种模拟鼻尖解剖结构的手术方式,与主流的鼻尖成形术比较,效果及稳定性可靠,需术者对手术有更细致的把控与更资深的经验,就医者的鼻尖活动度明显提升,是一种值得推广的鼻尖成形术。

Greater Alarm与Interface Security合并

美国安防整合商Greater Alarm Co.Inc.和Interface Security Systems Holdings Inc.已经宣布合并了。

改良鼻内镜下经鼻腔翼管神经切断术与鼻甲部分切除术治疗过敏性鼻炎的效果及其对复发的影响

目的探讨改良鼻内镜下经鼻腔翼管神经切断术与鼻甲部分切除术治疗过敏性鼻炎(allergic rhinitis,AR)的效果,并分析对复发的影响。方法回顾性选取2019年4月至2021年12月温州医科大学附属第二医院收治的96例AR患者,按照手术方法进行分组,将接受改良鼻内镜下经鼻腔翼管神经切断术治疗的患者纳入切断组(n=50),接受鼻甲部分切除术治疗的患者纳入切除组(n=46)。采用鼻部临床症状评分改善情况评估临床疗效,观察两组患者临床疗效、术后并发症、复发情况,比较两组患者治疗前后的鼻结膜炎生存质量量表(rhinoconjunctivitis quality of life question naire,RQLQ)评分、视觉模拟评分(visual analogue scale,VAS)、鼻腔鼻窦结局测试-20(sino-nasal outcome test-20,SNOT-20)评分及肺通气功能。结果切断组患者近期临床疗效显著高于切除组(P<0.05);治疗后两组RQLQ评分、VAS、SNOT-20评分显著降低,且切断组显著低于切除组(P<0.05);治疗后两组用力呼气流量、最大通气量显著升高,且切断组显著高于切除组(P<0.05);两组患者并发症发生率及短期复发率比较,差异无统计学意义(P>0.05)。结论与鼻甲部分切除术治疗AR患者比较,改良鼻内镜下经鼻腔翼管神经切断术能更有效缓解鼻腔症状,改善肺通气功能,提高患者治疗后的生活质量,且不增加并发症及复发的风险。

基于光谱指数建模的阿拉尔垦区土壤盐渍化信息提取与分析

为了探究反演新疆维吾尔自治区阿拉尔垦区土壤盐渍化最优遥感盐分监测指数模型,以Landsat8 OLI遥感影像和野外实测数据为基础,通过盐分指数(salinity index,SI)、归一化植被指数(normalized difference vegetation index,NDVI)、修改型土壤调节植被指数(modified soil-adjusted vegetation index,MSAVI)、地表反照率(Albedo)构建遥感盐分监测指数模型(salinization detection index,SDI),提取阿拉尔垦区土壤盐渍化信息并验证模型精度,对比分析得出最优遥感盐分监测指数模型。结果表明:4类遥感盐分监测指数模型中SDI1(SI-NDVI),SDI2(SI-MSAVI),SDI3(SI-Albedo)和SDI4(Albedo-MSAVI)总体分类精度为83.45%,69.78%,53.23%和71.94%;SDI1模型最适合反演阿拉尔垦区土壤盐渍化程度,SDI2和SDI4模型对阿拉尔垦区土壤盐渍化监测有一定参考意义;利用SDI1模型反演阿拉尔垦区土壤盐渍化分布,垦区以非盐渍土和轻度盐渍土为主,重度盐渍土和盐土主要分布在垦区的东北和东南地区。由SI和NDVI构建SDI1对阿拉尔垦区土壤盐渍化信息提取精度较高,可作为反演垦区土壤盐渍化的遥感盐分监测指数模型,可为垦区土壤盐渍化治理和防治提供有效的技术参考。

阿拉尔市生态空间演变规律研究

阿拉尔市位于塔克拉玛干北缘的绿洲沙漠,生态环境脆弱。研究绿洲空间的演变规律对于把握沙漠绿洲生态空间、防止沙漠地区荒漠化和促进绿洲区域扩展有着极其重要的意义。以阿拉尔市1994年到2020年Landsat影像为基础,对阿拉尔市的生态环境空间进行空间界定,基于RS、GIS等技术,利用生态空间特征计算方法得到阿拉尔市的生态空间变化规律。结果表明:研究期内总体绿洲范围持续增加,绿洲向北扩展,随着绿洲面积的增加;生态空间总体呈人工化、整合化趋势。破碎化程度降低。绿洲生态空间中农田所占比重较大,其生态空间特征上,在地块破碎度方面逐渐下降,呈整合趋势。在形状指数方面,阿拉尔市的农田地块与同面积正方形间的偏离程度偏小,地形形状的复杂程度较低,形状较为规则。在分形维数方面,农田自相似性较强,地块的形状比较有规律,受人类干扰程度大。

鼻整形术中常规放置鼻翼缘移植物对术后鼻翼缘退缩的影响

目的:分析鼻整形术中放置鼻翼缘移植物对术后鼻翼缘退缩的影响。方法:选取2018年12月-2020年12月在笔者医院初次行鼻整形术的女性就医者40例,采用随机数字表法分为实验组和对照组,每组20例。实验组鼻整形术中常规放置鼻翼缘移植物,对照组不放置鼻翼缘移植物。拍摄就医者侧面观照片,观察就医者鼻小柱与鼻翼缘关系,测量其鼻孔长轴以及鼻翼缘最高点与鼻孔长轴线之间的距离并计算鼻孔轴距比。比较就医者术前及术后1年的鼻孔轴距比。结果:术后随访1年,失访12例。最终实验组15例,对照组13例。实验组与对照组术前鼻孔轴距比差异无统计学意义(P>0.05)。术后实验组鼻孔轴距比小于对照组,差异有统计学意义(P<0.01)。实验组术前与术后鼻孔轴距比比较差异无统计学意义(P>0.05)。对照组术前与术后鼻孔轴距比差异有统计学意义(P<0.01)。两组就医者均未出现并发症。结论:鼻整形术中常规放置鼻翼缘移植物,对术后就医者鼻翼缘退缩有明显的改善作用。

上颌Le Fort Ⅰ型截骨术对鼻形态影响的研究进展

上颌Le Fort Ⅰ型截骨术是正颌外科中矫治上颌骨畸形最常采用术式之一。但是,上颌骨的移动、肌肉的剥离会影响周围软组织的形态,其中鼻形态的改变越来越受到重视。已有研究报道,正颌手术后鼻形态的不利改变是降低患者手术满意度的主要原因之一。明确上颌Le Fort Ⅰ型截骨术对鼻形态的影响能够帮助医生更准确地预测术后鼻形态的变化,从而优化手术设计、提高医患沟通效率。本文将对上颌Le Fort Ⅰ型截骨术后鼻部形态变化的研究进展作一综述,旨在为临床实践提供相应的参考。

阿拉尔垦区新疆杨农田防护林防风效果研究

以阿拉尔市新疆杨农田防护林为研究对象,通过林业调查和野外风速测定,依据疏透度将新疆杨防护林的林带结构划分为通风型、疏透型、稀疏型3种结构类型,并采用隶属函数法对比分析各林带防风效果。结果表明:1)水平方向上,防风效能随防护距离的增加呈下降趋势。3种结构类型防护林的防风效能表现为稀疏型>疏透型>通风型。2)防风效能与树高、胸径、林带行数、冠幅呈正相关,与密度、疏透度呈负相关。3)8条林带综合隶属函数值在0.097~0.770之间,依次表现为林带Ⅲ>林带Ⅴ>林带Ⅳ>林带Ⅶ>林带Ⅷ>林带Ⅱ>林带Ⅵ>林带Ⅰ。其中,林带Ⅲ、林带Ⅴ为稀疏型,隶属函数值在0.50以上,综合防护效益表现较好。