Background The corresponding author's experience and recent methods employed in autologous costal cartilage grafts combined with expanded polytetrafluoroethylene(ePTFE)in Asian rhinoplasty were presented in this s...Background The corresponding author's experience and recent methods employed in autologous costal cartilage grafts combined with expanded polytetrafluoroethylene(ePTFE)in Asian rhinoplasty were presented in this study.Objectives The purpose of this study was to assess the outcomes of rhinoplasty performed on patients using autogenous costal cartilage grafts combined with an ePTFE implant.Methods Seventy-five rhinoplasty cases with autologous costal cartilage grafts and an ePTFE implant were retrospectively reviewed.Graft types,complications associated with the graft itself or graft harvesting,surgical outcomes,and patient satisfaction were assessed.Results The mean follow-up time post-operation was 13.5 months.A total of 42/75 patients underwent revision surgeries.Graft-related complications were found in 8%of cases,including two warped graft and four infection cases.Three individuals with infections had mild graft resorption.One patient with an infection removed the implant.Graft exposure,mobility,and substantial resorption were not recorded.A total of two cases underwent revision procedures for infection and perforation,respectively.Chest incision lengths for graft harvesting averaged 2.1 cm.No pneumothorax or significant donor-site pain was found.Donor-site scars were negligible,although two cases had hypertrophic chest scars.In general,functional and esthetic outcomes were mostly satisfactory among the assessed patients.Conclusions Rhinoplasty using autologous rib cartilage provides adequate support and sufficient cartilage amounts for correcting nasal contouring.Meanwhile,ePTFE alone for nasal dorsum augmentation safely achieves satisfactory outcomes.Rib cartilage rhinoplasty performed by an experienced surgeon yields excellent,long-lasting results with minimal risk;however,the potential for infection should be considered following revision surgery.展开更多
Objective To investigate the application effect and manufacturing skills of autologous costal cartilage scaffold in ear reconstruction for microtia.Methods From January 2016 to January 2019,41 patients with microtia r...Objective To investigate the application effect and manufacturing skills of autologous costal cartilage scaffold in ear reconstruction for microtia.Methods From January 2016 to January 2019,41 patients with microtia reconstruction in our hospital were selected,all of whom were type II or type III pediatric deformities.All patients underwent auricle reconstruction and retroauricular skin expansion and autologous costal cartilage stent.The first stage of the operation is to insert a skin dilator behind the residual ear and inject water to expand.The second stage of the operation is to carve and repair the soft ribs(usually 6 or 7 ribs)from the body,make a three-dimensional auricle support for auricle reconstruction,place a negative pressure drainage tube,and follow up for 3 to 6 months to observe the three-dimensional shape of the reconstructed auricle and the formation of cranioauricular angle.Results 41 patients with microtia had good three-dimensional shape of auricle reconstruction,normal auricle position,moderate cranioauricular angle,good helix and triangular fossa structure,and good bilateral symmetry.Patients and their families were satisfied with the effect of auricle reconstruction.Conclusion Autologous costal cartilage is a good scaffold for auricle reconstruction.It is through efficient and elaborate carving and splicing that a good three-dimensional auricle structure can be formed.Combined with early flap expansion,a good postoperative appearance effect can be obtained,which is the appropriate method for auricle reconstruction at present.展开更多
On account of the poor biocompatibility of synthetic prosthesis,millions of rhinoplasty recipients have been forced to choose autologous costal cartilage as grafts,which suffer from limited availability,morbidity at t...On account of the poor biocompatibility of synthetic prosthesis,millions of rhinoplasty recipients have been forced to choose autologous costal cartilage as grafts,which suffer from limited availability,morbidity at the donor site and prolonged operation time.Here,as a promising alternative to autologous costal cartilage,we developed a novel xenogeneic costal cartilage and explored its feasibility as a rhinoplasty graft for the first time.Adopting an improved decellularization protocol,in which the ionic detergent was substituted by trypsin,the resulting decellularized graft was confirmed to preserve more structural components and better mechanics,and eliminate cellular components effectively.The in vitro and in vivo compatibility experiments demonstrated that the decellularized graft showed excellent biocompatibility and biosecurity.Additionally,the functionality assessment of rhinoplasty was performed in a rabbit model,and the condition of grafts after implantation was comprehensively evaluated.The optimized graft exhibited better capacity to reduce the degradation rate and maintain the morphology,in comparison to the decellularized costal cartilage prepared by conventional protocol.These findings indicate that this optimized graft derived from decellularized xenogeneic costal cartilage provides a new prospective for future investigations of rhinoplasty prosthesis and has great potential for clinical application.展开更多
Autologous costal cartilage is an excellent source of graft in rhinoplasty due to its rich supply,durability,versatility,and functionality.For a long time,rhinoplasty surgeons have been critical of using autologous co...Autologous costal cartilage is an excellent source of graft in rhinoplasty due to its rich supply,durability,versatility,and functionality.For a long time,rhinoplasty surgeons have been critical of using autologous costal cartilage based on the potential for associated complications including donor site morbidities,postoperative pain,warping,and long operation time.Even with this criticism,costal cartilage is still a gra昀material of choice in cartilage depleting revision rhinoplasty.Recently,there has been a steady increase in costal cartilage use even in primary augmentation rhinoplasty,especially in Asian.展开更多
Asian rhinoplasty is a very common cosmetic procedure.Many Asians desire a higher nasal bridge,for which they undergo several procedures,including filler injections,implantations and insertion of threads.Surgeons enco...Asian rhinoplasty is a very common cosmetic procedure.Many Asians desire a higher nasal bridge,for which they undergo several procedures,including filler injections,implantations and insertion of threads.Surgeons encounter many patients who have had several procedures done on them previously.In this paper,we introduce the use of autologous grafts for Asian rhinoplasty(primary and secondary),and discuss the rib carving techniques and difficulties encountered during harvesting,carving and placements of grafts and how to overcome these problems and prevent complications.展开更多
Aim: To assess the safety profile and practice trend of autologous costal cartilage harvest by facial plastic surgeons in the United States (US).Methods: A 10-question online survey was distributed by the American Aca...Aim: To assess the safety profile and practice trend of autologous costal cartilage harvest by facial plastic surgeons in the United States (US).Methods: A 10-question online survey was distributed by the American Academy of Facial Plastic and Reconstructive Surgery to its members.Results: Of the 2,639 members, 2,379 received the survey with 137 (5.76%) members responded. The majority (33.6%)of the respondents were expert facial plastic surgeons. One hundred and nine (79.6%) of the respondents performed rib harvest with 49.6% of them performing the procedure at a hospital facility. Among them, 21.5% exclusively performed their surgery at an ambulatory surgical center not physically attached to a hospital while 6.67% of them at the in-office accredited operating room. When comparing techniques, 64.7% performed only full-thickness rib grafts vs. 12.0%harvesting partial-thickness rib grafts. Most used an incision length between 2.1 and 4 cm (64.4%) while 2 surgeons used < 1 cm incision. The occurrence of pneumothorax after autologous rib harvest remained low (< 1%) in most (73.1%).Regarding safety practices of the surgeons, only 24.6% would order a chest X-ray post-operatively while 54.5% would not. In addition, 58.7% of respondents never kept their patients overnight for observation after autologous rib grafting while 15.0% always would. For pain management, most respondents (50.4%) did not utilize any additional analgesia protocol besides oral pain medications.Conclusion: Two thirds of the US facial plastic surgeons performed autologous costal cartilage harvest in a hospital setting. Routine chest imaging or overnight observation post-operatively was not warranted as the percentage of pneumothorax remained low and pain control was adequate.展开更多
Rhinoplasty and septal reconstruction often require the use of cartilage grafts.Complete nasal septal reconstruction may be required in very specific situations like difficult secondary septoplasty or severely deforme...Rhinoplasty and septal reconstruction often require the use of cartilage grafts.Complete nasal septal reconstruction may be required in very specific situations like difficult secondary septoplasty or severely deformed post traumatic noses.Usually in these cases the septal cartilage or bone is insufficient for septal reconstruction.The authors hereby describe a new technique of complete septal reconstruction by using the 7th rib(costal)cartilage combined with author’s ingenious technique to prevent warping.展开更多
目的探讨切开复位内固定手术治疗胸骨骨折合并肋软骨骨折的疗效。方法回顾性分析2013年10月—2021年9月联勤保障部队第九〇九医院心胸外科收治的胸骨骨折合并肋软骨骨折患者78例,男性43例,女性35例;年龄18~60岁,平均42.0岁。胸骨角骨折1...目的探讨切开复位内固定手术治疗胸骨骨折合并肋软骨骨折的疗效。方法回顾性分析2013年10月—2021年9月联勤保障部队第九〇九医院心胸外科收治的胸骨骨折合并肋软骨骨折患者78例,男性43例,女性35例;年龄18~60岁,平均42.0岁。胸骨角骨折14例,胸骨体骨折64例;单侧肋软骨骨折42例,双侧肋软骨骨折36例;患者均合并纵隔挫伤。受伤至手术时间0~2d,平均1.1d。根据胸部固定方式不同分为治疗组(46例)和对照组(32例),治疗组行骨折切开复位内钢板固定手术,对照组行胸部护板胸壁外固定术。比较术前5min和术后1~7d静息和咳嗽咳痰时疼痛数字评分量表(numerical rating scale,NRS)评分,相应时间点第一秒用力呼气容量(forced expiratory volume in the first second,FEV1)和FEV1占用力肺活量百分比(forced expiratory volume in the first second/forced vital capacity,FEV1%),疼痛持续时间,总住院时间,骨痂形成时间,术后肺部感染并发症发生率以及术前5min及术后1、3、6个月和末次随访健康状况调查简表(short-form 36 health survey scale,SF-36)评分。结果患者均获随访12个月,两组患者术前5min静息时NRS评分[(8.8±0.3)分vs.(8.7±0.4)分],咳嗽咳痰时NRS评分[(9.0±0.5)分vs.(9.1±0.4)分],差异无统计学意义(P>0.05)。术后1~7d静息和咳嗽咳痰时NRS评分比较差异有统计学意义(P<0.001)。两组患者术前5minFEV1[(1.8±0.2)L vs.(1.7±0.3)L],FEV1%[(56.3±7.7)%vs.(55.6±8.5)%]比较差异无统计学意义(P>0.05)。术后1~7d相应时间点FEV1、FEV1%比较差异有统计学意义(P<0.001)。治疗组较对照组疼痛持续时间短[(7.9±0.8)d vs.(16.9±0.5)d],总住院时间短[(7.5±1.8)d vs.(10.7±1.9)d],骨痂形成时间短[(2.5±0.4)周vs.(3.2±0.8)周],术后肺部感染发生率低(6.5%vs.21.8%),差异有统计学意义(P<0.001)。两组术前5min SF-36评分[(53.3±2.7)分vs.(54.6±3.5)分],差异无统计学意义(P>0.05)。与对照组比较,治疗组术后1个月[(73.4±10.9)分vs.(64.7±11.6)分]、3个月[(85.6±8.7)分vs.(78.2±11.4)分]、6个月[(87.6±5.1)分vs.(82.5±7.8)分]、末次随访[(88.6±5.4)分vs.(84.3±3.9)分]患者生活质量评分均提升,差异有统计学意义(P<0.001)。结论切开复位内固定手术治疗胸骨骨折合并肋软骨骨折可缓解疼痛,促进肺功能恢复,缩短总住院时间及术后骨痂形成时间,降低术后肺部感染的发生率,改善患者的生活质量。展开更多
Pollution in the coastal areas negatively affects biochemical indicators of seawater, human health and marine organisms. Hai Phong is a coastal city of Vietnam with the development of socio-economic activities, repres...Pollution in the coastal areas negatively affects biochemical indicators of seawater, human health and marine organisms. Hai Phong is a coastal city of Vietnam with the development of socio-economic activities, representing through an increasing number of industrial zones. This study is to evaluate the pollution of large industrial zones in Hai Phong city using numerical models. The numerical simulation (MIKE 21 SW, FM, ECO Lab) models were applied to simulate the wave propagation, hydraulic regime, water quality in coastal Hai Phong area. The MIKE 21 ECO Lab model was used to evaluate sources of waste from the large coastal industrial zones to some aquaculture zones. The calibration and validation results of wave propagation and the hydrodynamic models were resonably good, with Nash coefficient ranging from 0.65 to 0.90 and a percent bias (PBIAS) from 5.6% to 9.4%. The simulation results of water quality and concentration of pollutants (DO, BOD<sub>5</sub>, COD, TSS, Fe, and Coliform) in 2023 at the aquaculture locations show that the BOD<sub>5</sub>, COD, and TSS concentrations were higher than the allowable limits stated in the national technical regulation on surface water quality (QCVN 08:2023/BTNMT) and lower than the allowable limits stated in the national technical regulation on marine water quality (QCVN 10:2023/BTNMT). The outcomes of this study will provide more information to support managers to come up with a better socio-economic development plan for Hai Phong city to achieve sustainable development.展开更多
基金This work was supported by Key Clinical Projects of Peking University Third Hospital(No.BYSYZD2019013)the Scientific Research Staring Foundation for the Returned Overseas Chinese Scholars,Peking University Third Hospital(No.BYSYLXHG2019001).
文摘Background The corresponding author's experience and recent methods employed in autologous costal cartilage grafts combined with expanded polytetrafluoroethylene(ePTFE)in Asian rhinoplasty were presented in this study.Objectives The purpose of this study was to assess the outcomes of rhinoplasty performed on patients using autogenous costal cartilage grafts combined with an ePTFE implant.Methods Seventy-five rhinoplasty cases with autologous costal cartilage grafts and an ePTFE implant were retrospectively reviewed.Graft types,complications associated with the graft itself or graft harvesting,surgical outcomes,and patient satisfaction were assessed.Results The mean follow-up time post-operation was 13.5 months.A total of 42/75 patients underwent revision surgeries.Graft-related complications were found in 8%of cases,including two warped graft and four infection cases.Three individuals with infections had mild graft resorption.One patient with an infection removed the implant.Graft exposure,mobility,and substantial resorption were not recorded.A total of two cases underwent revision procedures for infection and perforation,respectively.Chest incision lengths for graft harvesting averaged 2.1 cm.No pneumothorax or significant donor-site pain was found.Donor-site scars were negligible,although two cases had hypertrophic chest scars.In general,functional and esthetic outcomes were mostly satisfactory among the assessed patients.Conclusions Rhinoplasty using autologous rib cartilage provides adequate support and sufficient cartilage amounts for correcting nasal contouring.Meanwhile,ePTFE alone for nasal dorsum augmentation safely achieves satisfactory outcomes.Rib cartilage rhinoplasty performed by an experienced surgeon yields excellent,long-lasting results with minimal risk;however,the potential for infection should be considered following revision surgery.
文摘Objective To investigate the application effect and manufacturing skills of autologous costal cartilage scaffold in ear reconstruction for microtia.Methods From January 2016 to January 2019,41 patients with microtia reconstruction in our hospital were selected,all of whom were type II or type III pediatric deformities.All patients underwent auricle reconstruction and retroauricular skin expansion and autologous costal cartilage stent.The first stage of the operation is to insert a skin dilator behind the residual ear and inject water to expand.The second stage of the operation is to carve and repair the soft ribs(usually 6 or 7 ribs)from the body,make a three-dimensional auricle support for auricle reconstruction,place a negative pressure drainage tube,and follow up for 3 to 6 months to observe the three-dimensional shape of the reconstructed auricle and the formation of cranioauricular angle.Results 41 patients with microtia had good three-dimensional shape of auricle reconstruction,normal auricle position,moderate cranioauricular angle,good helix and triangular fossa structure,and good bilateral symmetry.Patients and their families were satisfied with the effect of auricle reconstruction.Conclusion Autologous costal cartilage is a good scaffold for auricle reconstruction.It is through efficient and elaborate carving and splicing that a good three-dimensional auricle structure can be formed.Combined with early flap expansion,a good postoperative appearance effect can be obtained,which is the appropriate method for auricle reconstruction at present.
基金supported by Sichuan Science and Technology Program(2020YFH0008)National Natural Science Foundation of China(No.81771351)+1 种基金Joint Research Fund Liaoning-Shenyang National Laboratory for Materials Science(2019JH3/30100022)National Key R&D Program of China(2017YFA0105802).
文摘On account of the poor biocompatibility of synthetic prosthesis,millions of rhinoplasty recipients have been forced to choose autologous costal cartilage as grafts,which suffer from limited availability,morbidity at the donor site and prolonged operation time.Here,as a promising alternative to autologous costal cartilage,we developed a novel xenogeneic costal cartilage and explored its feasibility as a rhinoplasty graft for the first time.Adopting an improved decellularization protocol,in which the ionic detergent was substituted by trypsin,the resulting decellularized graft was confirmed to preserve more structural components and better mechanics,and eliminate cellular components effectively.The in vitro and in vivo compatibility experiments demonstrated that the decellularized graft showed excellent biocompatibility and biosecurity.Additionally,the functionality assessment of rhinoplasty was performed in a rabbit model,and the condition of grafts after implantation was comprehensively evaluated.The optimized graft exhibited better capacity to reduce the degradation rate and maintain the morphology,in comparison to the decellularized costal cartilage prepared by conventional protocol.These findings indicate that this optimized graft derived from decellularized xenogeneic costal cartilage provides a new prospective for future investigations of rhinoplasty prosthesis and has great potential for clinical application.
文摘Autologous costal cartilage is an excellent source of graft in rhinoplasty due to its rich supply,durability,versatility,and functionality.For a long time,rhinoplasty surgeons have been critical of using autologous costal cartilage based on the potential for associated complications including donor site morbidities,postoperative pain,warping,and long operation time.Even with this criticism,costal cartilage is still a gra昀material of choice in cartilage depleting revision rhinoplasty.Recently,there has been a steady increase in costal cartilage use even in primary augmentation rhinoplasty,especially in Asian.
文摘Asian rhinoplasty is a very common cosmetic procedure.Many Asians desire a higher nasal bridge,for which they undergo several procedures,including filler injections,implantations and insertion of threads.Surgeons encounter many patients who have had several procedures done on them previously.In this paper,we introduce the use of autologous grafts for Asian rhinoplasty(primary and secondary),and discuss the rib carving techniques and difficulties encountered during harvesting,carving and placements of grafts and how to overcome these problems and prevent complications.
文摘Aim: To assess the safety profile and practice trend of autologous costal cartilage harvest by facial plastic surgeons in the United States (US).Methods: A 10-question online survey was distributed by the American Academy of Facial Plastic and Reconstructive Surgery to its members.Results: Of the 2,639 members, 2,379 received the survey with 137 (5.76%) members responded. The majority (33.6%)of the respondents were expert facial plastic surgeons. One hundred and nine (79.6%) of the respondents performed rib harvest with 49.6% of them performing the procedure at a hospital facility. Among them, 21.5% exclusively performed their surgery at an ambulatory surgical center not physically attached to a hospital while 6.67% of them at the in-office accredited operating room. When comparing techniques, 64.7% performed only full-thickness rib grafts vs. 12.0%harvesting partial-thickness rib grafts. Most used an incision length between 2.1 and 4 cm (64.4%) while 2 surgeons used < 1 cm incision. The occurrence of pneumothorax after autologous rib harvest remained low (< 1%) in most (73.1%).Regarding safety practices of the surgeons, only 24.6% would order a chest X-ray post-operatively while 54.5% would not. In addition, 58.7% of respondents never kept their patients overnight for observation after autologous rib grafting while 15.0% always would. For pain management, most respondents (50.4%) did not utilize any additional analgesia protocol besides oral pain medications.Conclusion: Two thirds of the US facial plastic surgeons performed autologous costal cartilage harvest in a hospital setting. Routine chest imaging or overnight observation post-operatively was not warranted as the percentage of pneumothorax remained low and pain control was adequate.
文摘Rhinoplasty and septal reconstruction often require the use of cartilage grafts.Complete nasal septal reconstruction may be required in very specific situations like difficult secondary septoplasty or severely deformed post traumatic noses.Usually in these cases the septal cartilage or bone is insufficient for septal reconstruction.The authors hereby describe a new technique of complete septal reconstruction by using the 7th rib(costal)cartilage combined with author’s ingenious technique to prevent warping.
文摘目的探讨切开复位内固定手术治疗胸骨骨折合并肋软骨骨折的疗效。方法回顾性分析2013年10月—2021年9月联勤保障部队第九〇九医院心胸外科收治的胸骨骨折合并肋软骨骨折患者78例,男性43例,女性35例;年龄18~60岁,平均42.0岁。胸骨角骨折14例,胸骨体骨折64例;单侧肋软骨骨折42例,双侧肋软骨骨折36例;患者均合并纵隔挫伤。受伤至手术时间0~2d,平均1.1d。根据胸部固定方式不同分为治疗组(46例)和对照组(32例),治疗组行骨折切开复位内钢板固定手术,对照组行胸部护板胸壁外固定术。比较术前5min和术后1~7d静息和咳嗽咳痰时疼痛数字评分量表(numerical rating scale,NRS)评分,相应时间点第一秒用力呼气容量(forced expiratory volume in the first second,FEV1)和FEV1占用力肺活量百分比(forced expiratory volume in the first second/forced vital capacity,FEV1%),疼痛持续时间,总住院时间,骨痂形成时间,术后肺部感染并发症发生率以及术前5min及术后1、3、6个月和末次随访健康状况调查简表(short-form 36 health survey scale,SF-36)评分。结果患者均获随访12个月,两组患者术前5min静息时NRS评分[(8.8±0.3)分vs.(8.7±0.4)分],咳嗽咳痰时NRS评分[(9.0±0.5)分vs.(9.1±0.4)分],差异无统计学意义(P>0.05)。术后1~7d静息和咳嗽咳痰时NRS评分比较差异有统计学意义(P<0.001)。两组患者术前5minFEV1[(1.8±0.2)L vs.(1.7±0.3)L],FEV1%[(56.3±7.7)%vs.(55.6±8.5)%]比较差异无统计学意义(P>0.05)。术后1~7d相应时间点FEV1、FEV1%比较差异有统计学意义(P<0.001)。治疗组较对照组疼痛持续时间短[(7.9±0.8)d vs.(16.9±0.5)d],总住院时间短[(7.5±1.8)d vs.(10.7±1.9)d],骨痂形成时间短[(2.5±0.4)周vs.(3.2±0.8)周],术后肺部感染发生率低(6.5%vs.21.8%),差异有统计学意义(P<0.001)。两组术前5min SF-36评分[(53.3±2.7)分vs.(54.6±3.5)分],差异无统计学意义(P>0.05)。与对照组比较,治疗组术后1个月[(73.4±10.9)分vs.(64.7±11.6)分]、3个月[(85.6±8.7)分vs.(78.2±11.4)分]、6个月[(87.6±5.1)分vs.(82.5±7.8)分]、末次随访[(88.6±5.4)分vs.(84.3±3.9)分]患者生活质量评分均提升,差异有统计学意义(P<0.001)。结论切开复位内固定手术治疗胸骨骨折合并肋软骨骨折可缓解疼痛,促进肺功能恢复,缩短总住院时间及术后骨痂形成时间,降低术后肺部感染的发生率,改善患者的生活质量。
文摘Pollution in the coastal areas negatively affects biochemical indicators of seawater, human health and marine organisms. Hai Phong is a coastal city of Vietnam with the development of socio-economic activities, representing through an increasing number of industrial zones. This study is to evaluate the pollution of large industrial zones in Hai Phong city using numerical models. The numerical simulation (MIKE 21 SW, FM, ECO Lab) models were applied to simulate the wave propagation, hydraulic regime, water quality in coastal Hai Phong area. The MIKE 21 ECO Lab model was used to evaluate sources of waste from the large coastal industrial zones to some aquaculture zones. The calibration and validation results of wave propagation and the hydrodynamic models were resonably good, with Nash coefficient ranging from 0.65 to 0.90 and a percent bias (PBIAS) from 5.6% to 9.4%. The simulation results of water quality and concentration of pollutants (DO, BOD<sub>5</sub>, COD, TSS, Fe, and Coliform) in 2023 at the aquaculture locations show that the BOD<sub>5</sub>, COD, and TSS concentrations were higher than the allowable limits stated in the national technical regulation on surface water quality (QCVN 08:2023/BTNMT) and lower than the allowable limits stated in the national technical regulation on marine water quality (QCVN 10:2023/BTNMT). The outcomes of this study will provide more information to support managers to come up with a better socio-economic development plan for Hai Phong city to achieve sustainable development.
