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Biomedical subjects

Lai Gui

Publications and source records attributed to Lai Gui.

30 records · Page 2Linked to original sources

[Chin augmentation with bone transplantation from the mandible].

OBJECTIVE: To explore a new method for mentoplasty. METHODS: The bilateral prominent mandibular angle or outer lamina was resected through the intraoral approach. The resected bone fragments were shaped and rigid fixed to the chin with miniplates and screws. RESULTS: A total of 30 patients (28 females, 2 males) accepted chin augmentation with this method. The mandibular angle bone was used in 20 cases and the mandibular outer lamina was used in 10 cases. The operative results were satisfactory, and the patient's facial contour was improved substantially. CONCLUSION: No rejection reaction was found after this procedure. Chin augmentation with autogenous mandibular bone is an ideal method for genioplasty.

Adult↗

[Applications of autogenous outer table of the calvarial and mandibular bone in posttraumatic deformities of the nose].

OBJECTIVE: To study the applications of bone grafts from the cranium or mandible in the repair of posttraumatic deformities of the nose. METHODS: From 1997 to 2002, a total of 44 patients, who presented with secondary nose deformity as well as facial fractures, were reconstructed by autogeneous outer table grafts of the calvarial or mandibular bone after facial skeleton reposition. In this series, 32 cases used the calvarial bone, 12 cases used the mandible bone, which was harvested through a coronal incision and an oral approach respectively. RESULTS: The surgical incisions healed primarily in all patients with minimal scar. The facial appearance was greatly improved. No implant infection, extrusion and shift were observed in the postoperative follow-up of 6 months to 2 years. There was not obvious bone resorption, nor donor site morbidity. CONCLUSION: Autogeneous calvarial and mandibular bone was an ideal material of bone graft in reconstruction of severe posttraumatic deformities of the nose. Compared with other autogeneous and alloplastic materials, the outer table of the calvarial and mandibular bone produced less morbidity of the donor site, invisible scar, no rejection and less resorption.

Adolescent↗

[Surgical treatment of orbital and periorbital fibrous dysplasia].

OBJECTIVE: To explore the surgical approaches to obtain good aesthetic and functional results in the management of orbital and periorbital fibrous dysplasia and related deformities. METHODS: Ten cases of orbital and periorbital fibrous dysplasia were treated surgically. The location, extension and shape of the lesions were identified based on X-ray examination and two and three dimensions CT examinations preoperatively. According to the type of the lesion, different approaches were used to excise the lesion and to reconstruct the orbit. The lesions were radically or partially excised through bicoronal, intraoral and subciliary approach; the orbit was reconstructed with autogenous outer or inner table of calvarium, outer table of mandible, Medpor and prefabricated individual titanic implants. RESULTS: In 10 cases treated surgically, radical excision was employed in 4 cases and partial excision in 6 cases. Autogenous inner table of calvarium was used in 2 cases, Medpor in 2 cases, outer table of mandible in 1 case, and titanic meshwork and prefabricated individual titanic implants in 4 cases to reconstruct the orbit. After the treatment, all patients obtained satisfactory aesthetic and functional results. CONCLUSIONS: Carefully planed surgical approaches with methods for preventing the complications can be used for the treatment of orbital and periorbital fibrous dysplasia and obtaining satisfactory aesthetic and functional results.

Adolescent↗

[Intro-extro cranial approach treat serious post fronto-orbital fracture deformities].

OBJECTIVE: To explore the method of treating serious secondary fronto-orbital fracture deformities through intro-extra cranial approach. METHODS: The fronto-orbital fracture was divided into two types according to whether there were any large scale fronto-orbital bone defects: type I: Large scale fronto-orbital bone defect; type II: Concave fronto-orbital fracture deformity without large scale bone defect. Both types were treated through intro-extra cranial approach to expose the fracture site. For type I deformity, the bone defects were repaired and reconstructed with outer table of cranial bone and artificial bone. For type II, the deformity was repaired by osteotomy, bone reposition and internal rigid fixation. RESULTS: 18 cases were treated from June 1998 to October 2000, include type I, 12 cases, and type II, 6 cases. All the patients recovered well and the post-operative appearance were greatly improved. CONCLUSIONS: Intro-extra cranial approach can expose the fractured site better than the simple extrocranio approach, and make the operation more easily done. Combined with the technique of cranio maxillo facial surgery, the treatment can be more complete and the results can be more satisfactory.

Fracture Fixation, Internal↗

[Secondary reconstruction of post-fracture deformities in the nasal-orbital ethmoid region].

OBJECTIVE: To study the surgical reconstruction of secondary fracture deformities of the nasal-orbital ethmoid area. METHODS: Typical bicoronal and subciliary incisions or the adjacent scar incision were employed to expose the fractured area. The flattened nasal bone was narrowed by curved osteotomy along the medial orbital rims and trimed with a bur. 2-3 pieces of cranial outer table were used to reconstruct the nasal framework, which were fixed to the frontal bone with mini-plates. After the medial orbital wall and orbital floor were exposed, the herniated orbital contents were released and reduced to the orbital cavity. The fractured orbital walls were repaired precisely with autogenous cranial outer table or Medpor. The medial canthal tendons were anchored superior-posteriorly to the lacrimal fossa with transnasal wires. RESULTS: From December 1996 to December 2001, 34 cases of severe nasal-orbital ethmoid fracture deformities were repaired with this technique. Of them, 12 cases had combined orbital-zygomatic fracture, 4 cases had fontal sinus fracture, 1 case had Le Fort II and 1 case had Le Fort III fracture. All the patients recovered well and their facial appearance improved greatly. CONCLUSIONS: The key points for surgical reconstruction of the periorbital post-fracture deformities are narrowing the flattened nasal root by curved osteotomy, the nasal framework reconstruction with autogenous bone graft, the orbital wall repair to correct enophthalmos, and most importantly, the medial canthal tendon reduction and canthal plasty.

Adolescent↗

[Analysis of the complications following correction of mandibular angle prominence].

OBJECTIVE: To investigate the causes and the prophylactic measures for the complications following correction of mandibular angle prominence. METHODS: From 1996 to 2001, a total of 203 patients with mandibular angle prominence underwent mandibular angle osteotomy. RESULTS: Of them, 9 patients had postoperative complications, which included bleeding, hematoma, infection, mental nerve injury, labia scar, asymmetry, and steep mandibular angle. CONCLUSION: The correction of mandibular angle prominence should be designed and performed precisely. Care must be taken to avoid severe complications like condyle fracture.

Cicatrix↗

[The experimental study of bioabsorbable mini-plate for rigid fixation on rabbits].

OBJECTIVE: To study the biodegradation process of the bioabsorbable mini-plate (LactoSorb) and its influence on bone healing. METHODS: 15 mature New Zealand White Rabbits were selected as the experimental animals. The bilateral zygomatic arch were fractured using a fissure bur. One side was fixed with the bioabsorbable mini-plate and the other side was fixed with Titanium mini-plate as a control. 5 animals were killed after 4, 12, and 24 weeks post operation respectively for radiographic and histologic study. RESULTS: At 4 weeks, the absorbable plate changed from transparent to opaque and its dimensions was enlarged. The bone gaps of both groups were filled with new bone. No inflammatory cells were found in both groups. At 12 weeks, the absorbable plate broke to small pieces or particles, its dimensions reduced greatly but the outline could still been recognized. The bone continuity had been reestablished in both groups. At 24 weeks, the absorbable plate was resorbed completely. Only the residual screw could be seen in the screw hole. Complete bone healing was seen in both groups. No histological differences of bone healing were found at this stage. CONCLUSION: The absorbable plate demonstrates excellent biocompatibility. No adverse local inflammatory reactions were found during the plate was absorbed gradually. In the non-weight baring area, the absorbable plate provides the same fixation stability as that of the metal plate.

Absorption↗

[Surgical management of bilateral mandibular angle prominence associated with microgenia].

OBJECTIVE: A surgical procedure was developed to improve the operative results for bilateral mandibular prominence with microgenia. METHODS: Through an oral approach the bilateral prominent mandibular angles were resected using the technique of continuous curve-line ostectomy with the masseteric muscle intact. Meanwhile, the chin was elongated and moved forward by horizontal osteotomy. The distal part of the chin was rigid fixed with miniplates and screws, and the bone gaps were filled with autogenous bone of the resected mandibular angle. RESULTS: From November 1996 to August 1999, 20 cases of bilateral mandibular angle prominence with microgenia were corrected with this procedure. The postoperative appearance was improved greatly after 3-6 months. The lower face was not only narrowed but elongated, and consequently in harmony with the upper and middle face. CONCLUSION: Bilateral continuous curve-line mandibular angle ostectomy together with chin osteotomy and autogenous bone graft is a good procedure for the management of the above-mentioned deformities.

Adolescent↗

[Correction of prominent malar complex by L-type osteotomy].

OBJECTIVE: To present a new method for correction of prominent malar complex by L-shaped osteotomy through an intraoral incision. METHODS: Based on the anatomical characteristics of the malar complex, we designed a new L-shaped osteotomy for malar eminence reduction. The procedure includes oblique incision of the upper part of the mala, vertical incision of the anterior part of the mala and "greenstick" fracture of the zygomatic arches. According to the severity of malar prominence, we resect part of the anterior-inferior part of the mala and lower the malar complex. RESULTS: This method was used in 39 patients with prominent malar complex. Of them, 32 were symmetrical and 7 were unsymmetrical. All the patients obtained good results. CONCLUSION: L-shaped osteotomy for correction of prominent malar complex is a relatively ideal surgical method with the advantages of simpler manipulation, fewer complications, better result, and ensuring the intactness of the structural characteristics of the malar complex.

Adult↗

[The surgical management of late complex posttraumatic enophthalmos].

OBJECTIVE: To study the surgical management of late complex posttraumatic enophthalmos. METHOD: According to the X-ray film and CT examination, the displaced orbital bone fragments was repositioned after osteotomy and rigid fixed by mini-plate and screws, then the orbital walls were repaired. RESULT: From July 1996 to June 2001, 42 cases were treated and the enophthalmos were obviously corrected or improved. CONCLUSION: The late complex posttraumatic enophthalmos can be corrected or obviously improved through reconstruction of the normal shape and volume by the reduction of displaced bone fragments and precise orbit wall repair.

Adolescent↗

Intraoral one-stage curved osteotomy for the prominent mandibular angle: a clinical study of 407 cases.

BACKGROUND: Many Oriental people have a square face with a prominent mandibular angle. This article presents a good osteotomy method for the prominent mandibular angle (PMA). METHODS: Two modifications of the conventional procedures have been made. The first is a one-stage curved osteotomy for the mandibular angle. The second is nonresection of the masseter muscle. The surgical procedure has been performed using an intraoral approach with a direct field of vision. RESULTS: From October 1996 to December 2002, a total of 407 patients with PMA underwent surgery using this method with satisfactory results. The PMA osteotomy procedure was performed for only 248 patients. In addition, 29 patients received concurrent zygomatic reduction osteotomy, 38 patients underwent concurrent genioplasty, 41 patients had concurrent chin augmentation with excised PMA bone fragment, 2 patients received concurrent submental liposuction, and 39 patients underwent concurrent buccal fat pad resection. CONCLUSION: The described method is a very simple procedure with fewer complications for the surgical treatment of PMA.

Adolescent↗

Remediation of DNAPL source zones with granular iron: laboratory and field tests.

Degradation of dissolved chlorinated solvents using granular iron is an established in situ technology. This paper reports on investigations into mixing iron and bentonite with contaminated soil for in situ containment and degradation of dense nonaqueous phase liquid source zones. In the laboratory, hypovials containing soil, water, bentonite, iron, and free-phase trichloroethene (TCE) were assembled. Periodic measurement of TCE, chloride, and degradation products showed progressive degradation of TCE to nondetectable levels. Subsequently, a demonstration was conducted at Canadian Forces Base Borden near Alliston, Ontario, Canada, where, in 1991, a portion of the surficial aquifer was isolated and free-phase tetrachloroethene (PCE) was introduced. Using a drill rig equipped with large-diameter mixing blades, three mixed zones were prepared containing 0%, 5%, and 10% granular iron by volume. The bentonite was added to serve as a lubricant to facilitate injection of the iron and to isolate the contaminated zone. Analysis of core samples showed reasonably uniform distributions of iron through the mixed zones. Monitoring over a 13-month period following installation showed, relative to the control, a decline in PCE concentrations to virtually nondetectable values. Reaction rates in the laboratory tests were similar to those reported in the literature, while the rate in the field test was substantially lower. The lower rate may be a consequence of mass transfer limitations under the static conditions of the field test. Results indicate that mixing iron and bentonite into source zones may be an effective means of source-zone remediation, with the particular advantage of being relatively immune to effects of geologic heterogeneity.

Bentonite↗