Jiajie Xu

Peking Union Medical College Hospital, Peping, Beijing, China

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Publications (12)17.35 Total impact

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    ABSTRACT: Background The clinical characteristics of craniomaxillofacial fibrous dysplasia (FD) have not been clearly identified. The objective of this meta-analysis is to assess the predominance of the monostotic form of FD using an evidence-based review. Furthermore, we examined the laterality and sex dominance of FD in patients from international study populations. Methods We performed a systematic search of PubMed, Embase, Cochrane Central Register of Systematic Reviews, Cochrane Central Register of Controlled Trials and EBSCO for trials published through August 2013. Data extracted from the literature were analysed with Review manager 5.0.24. Results The results of this study showed that unilateral FD occurred more frequently than bilateral FD (RR, 12.37; 95% CI, 2.92-61.24; P = 0.008, N = 263 patients). For unilateral FD, there was no significant difference between cases involving the left or right side of the face (RR, 0.98; 95% CI, 0.66-1.44; P = 0.91; N = 201 patients). There were no significant sex-dependent differences for monostotic and polyostotic forms of craniomaxillofacial FD. Conclusion There is a significantly higher percentage of the unilateral form than the bilateral form in the craniomaxillofacial FD studies analysed, and an almost equal distribution of left- and right-sided unilateral FD. These proportions were maintained among males and females and there were nearly equal frequencies of monostotic and polyostotic FD.
    Journal of Cranio-Maxillofacial Surgery 10/2014; · 1.61 Impact Factor
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    ABSTRACT: Purpose To develop a novel technique for narrowing the wide midface in Asians using virtual surgical planning (VSP) and two bent plate fixation. Materials and Methods A total of 19 patients with wide midface underwent midface narrowing by VSP and two bent plate fixation between 2009 and 2013. In each case, a three-dimensional spiral CT scan of the skull was obtained before surgery. The CT data were imported into the SurgiCase software and VSP was performed. VSP was used to direct the amount of adduction and advancement during midface narrowing surgery. During the actual surgery, we combined zygomatic arch osteotomy and I-shaped osteotomy of the zygomatic body, and moved the zygomatic complex upward and inward following these preoperative data. We then reset the free zygomatic complex to a target position and fixed it with two bent plates. The correction effectiveness was then evaluated through 3D-CT as well as pre-and post-surgical standard facial photographs. Results Most patients were satisfied with the results and suffered no severe complications. No cases of nonunion or permanent facial nerve injury were reported. Conclusion VSP can provide precise data to guide modified reduction of a zygomatic arch protrusion. The bent plate fixation method can provide sufficient support and ideal mid-facial contours. Our technique is recommended for narrowing wide midface which caused by lateral prominent zygomatic arch.
    Journal of Oral and Maxillofacial Surgery 06/2014; · 1.28 Impact Factor
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    ABSTRACT: Hemimandibular hyperplasia (HH) is a developmental asymmetry characterized by three-dimensional enlargement of one half of the mandible. The hyperplastic side usually involves the condyle, condylar neck, ramus, and body, with the anomaly terminating abruptly at the symphysis. The malformation results in the clinical presentation of ipsilateral enlargement of the mandible and tilted occlusal plane, associated with a deviated chin to the contralateral side. Since the first case report of HH in the English literature in 1836, various terminology and classifications were used. In this study, the authors classified the patients into typical and atypical types of HH on the basis of clinical and radiologic observations in an effort to achieve a simplified and efficient surgical management on the basis of the severity of deformity. Accordingly, surgical treatments are designed respectively on the basis of the authors' classification and treatment algorithm. In addition, in view of potential complications arising from condylectomy, none of the patients had undergone condylectomy as part of the surgical treatment. The authors present their experience on the basis of this proposed classification and treatment algorithm with functional and aesthetic outcomes as the end points of this study.
    The Journal of craniofacial surgery 01/2014; · 0.81 Impact Factor
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    ABSTRACT: The purpose of this study was to determine the changes in teeth and hard tissues after preoperative modeling and bimaxillary anterior subapical osteotomy for the treatment of bimaxillary protrusion. Cephalometric analysis was used to evaluate the aesthetic effects and occlusal relationships obtained. The subjects included 19 women and 1 man (aged 19-41 years; average, 29 years) with bimaxillary protrusion who underwent anterior subapical osteotomy of both the maxilla and mandible, with simultaneous genioplasty, if required. Based on a preoperative computer-aided manufacturing/design-assisted and model surgical design and an occlusal guide plate, new occlusal relationships were established for the patients. In addition, the preoperative and postoperative cephalometric radiographs were systematically analyzed. In all patients, the surgical incisions underwent primary healing, with no infection or osteonecrosis. Significant differences were observed in the preoperative and postoperative values of all hard tissue and teeth parameters, except for SGn-FH degrees and Co-MP. The most obvious significant differences were seen in L1-OP°, Id-Pog-Go°, IIA°, U1E-Apog, L1E-Apog, U1E-NA, and L1-NA° (P < 0.001). Postoperative follow-up lasted for 12 to 36 months. All patients eventually achieved normal jaw relationships, tooth arch forms, and Spee curves. No evident irregularities of teeth arrangement or abnormal occlusal relationships were observed. All patients were satisfied with their postoperative facial appearance, except for 1 patient, who underwent repeat surgery because of relapse. With the use of a precise preoperative model surgical design, orthognathic surgery, a simple and time-saving technique, can be used to correct bimaxillary protrusion with satisfactory postoperative occlusal relationship and facial aesthetic appearance and minimal postoperative complications.
    The Journal of craniofacial surgery 11/2013; 24(6):1980-6. · 0.81 Impact Factor
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    ABSTRACT: Over the past 20 years, there has been an increase in the use of bioresorbable fixation system in orthognathic surgery, but concerns remain about the stability of fixation. This review is to seek evidence for the effectiveness of bioresorbable fixation systems compared to titanium systems used for orthognathic surgery. A systematic review of the scientific literature listed on PubMed, Embase, Cochrane Central Register of Systemic Reviews and Cochrane Central Register of Controlled Trials was performed, up to December 2012. Twenty articles were selected based on inclusion and exclusion criteria: five RCTs and fifteen prospective. We compared these studies, published between 1997 and 2012 and involving 1092 participants examining skeletal stability of bioresorbable fixation in orthognathic surgery. This review found that the published data have shown that bioresorbable fixation systems produce reliable skeletal stability.
    Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery 09/2013; · 1.25 Impact Factor
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    ABSTRACT: Parry-Romberg syndrome (PRS) is a rare craniofacial disorder whose etiology has not been well understood. The objective of this study was to evaluate the sex difference and the scope of female predominance in PRS. The study used meta-analysis to examine 838 diverse patients from 26 articles. The result of the study showed a significantly higher risk in women in the PRS study populations; the pooled female ratio was 2.23 (95% confidence interval, 1.77-2.80; P < 0.00001; N = 838 patients). There was no significant difference in the association between laterality of PRS and sex, wherein female and male patients have almost the same distribution of left- and right-sided PRS.
    The Journal of craniofacial surgery 07/2013; 24(4):1195-1200. · 0.81 Impact Factor
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    ABSTRACT: Lip-vermilion reconstruction is part of the comprehensive treatment of progressive hemifacial atrophy. In this study, we described a two-stage reconstruction procedure to address the defect of the upper lip in patients with hemifacial atrophy, using a modified cross-lip vermilion flap with the pedicle specifically positioned at the commissure for functional and aesthetic purposes. During the first stage of surgery, a pre-determined mucosal flap from the lower lip with a vascular pedicle containing an inferior labial artery and the surrounding orbicularis oris muscle cuff were raised and transposed to reconstruct the upper-vermilion defect. Additional manoeuvres include simultaneous creation of the central tubercle of the upper lip with a segment of de-epithelised vermilion flap. At the second stage, the pedicle was divided 10-14 days later to complete the reconstruction. The patients achieved satisfactory results without compromising the shape of the commissure and the donor-site scar was inconspicuous. During the period prior to the division of the pedicle, this technique also overcomes the discomfort and pain during eating and speaking that could occur with the traditional cross-lip vermilion-flap transfer whereby the pedicle is centrally located. To the best of our knowledge, this is the first report of such a technique specifically applied to address the unilateral upper-lip vermilion defect in patients with hemifacial atrophy.
    Journal of Plastic Reconstructive & Aesthetic Surgery 02/2013; · 1.44 Impact Factor
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    ABSTRACT: The use of titanium during maxillofacial fixation is limited due to its palpability, mutagenic effects and interference with imaging, which lead to the requirement for subsequent removal. The use of a biologically absorbable fixation material will potentially eliminate these limitations. In this meta-analysis, we analyzed the complications of absorbable fixation in maxillofacial surgery. We performed a systematic search of PubMed, Embase, Cochrane Central Register of Systematic Reviews and Cochrane Central Register of Controlled Trials for trials published through December 2012. Data extracted from literature were analyzed with Review manager 5.0.24. Relevant data was extracted from 20 studies (1673 participants) and revealed that patients in the absorbable group had significantly more complications than those in the titanium group (RR = 1.20; 95% CI: 1.02-1.42; P = 0.03) in all enrolled maxillofacial surgeries. For bimaxillary operation subgroup, the absorbable fixation group did not have a significant increase in complications when compared with the titanium group (RR = 1.89; 95% CI: 0.85-4.22; P = 0.12). There was no significant difference observed between the absorbable and titanium groups receiving a bilateral sagittal split ramus osteotomy (BSSRO) (RR = 1.45; 95% CI: 0.84-2.48; P = 0.18) and Le Fort I osteotomy (RR = 0.65; 95% CI: 0.34-1.23; P = 0.18). The combined results of the five trials revealed that the absorbable group had a significantly lower rate of complications compared to the titanium group (RR = 0.71; 95% CI: 0.52-0.97; P = 0.03) in fracture fixation. This meta-analysis shows that absorbable fixation systems used for fixation in maxillofacial surgery do not have adequate safety profiles. Subgroup indicated the safety of absorbable fixation systems was superior during fracture fixation. The absorbable fixation systems tend to have a similar favorable safety profile as titanium fixation during Le Fort I, bimaxillary operation and BSSRO.
    PLoS ONE 01/2013; 8(6):e67449. · 3.53 Impact Factor
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    ABSTRACT: Repair of a large, trauma-induced partial-thickness vermilion defect is considered a challenging task. Ideally, such defects should be corrected by methods that use tissues similar in colour and texture to the normal vermilion. When the length of a defect is greater than half that of the vermilion and the width of the defect is greater than 1.5 cm, however, effective repair is not always achieved using the traditional mucosal V-Y advancement flap. In this article, a modified mucosal V-Y advancement flap containing the orbicularis oris muscle is described. This flap possesses the mobility sufficient to serve as the pedicle for the transfer and repair of large vermilion defects. Between August 2006 and January 2009 vermilion reconstruction using this modified flap was performed on eight patients, with satisfactory cosmetic and functional outcomes obtained in all cases. This simple and useful approach to vermilion reconstruction provides excellent outcomes with minimal injury to the donor site.
    Journal of Plastic Reconstructive & Aesthetic Surgery 04/2011; 64(4):472-6. · 1.44 Impact Factor
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    ABSTRACT: From January 2000 to May 2008, 50 patients with facial contour deformities underwent soft tissue augmentation with 51 anterolateral thigh (ALT) adipofascial flaps. Fifty flaps survived with no complications; partial fat necrosis occurred in one flap. Mean follow-up was 16 months. Flaps ranged from 10 x 6 cm to 20 x 12 cm. Perforators were found in 50 flaps, 43 musculocutaneous perforators (84.3%) and 7 septocutaneous perforators (13.7%), with a mean of 2.5 perforators per flap. In one flap (2.0%), no perforator was found. In this case, we used an anteromedial thigh adipofascial flap using the medial branch of the descending branch of lateral circumflex femoral artery as the vascular pedicle. Relatively symmetric facial contour was achieved in 20 cases. In 30 cases, adjunctive procedures including flap debulking, fat injection, and resuspension were necessary, and 23 patients achieved satisfactory outcomes. We conclude that the ALT adipofascial flap can be successfully elevated and transplanted for the correction of soft tissue facial defects. This flap can provide tissue to fill large defects, and posses the qualities of pliability, an excellent blood supply, ease of suspension and fixation, and minimal morbidity at the donor site.
    Microsurgery 07/2010; 30(5):368-75. · 1.62 Impact Factor
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    ABSTRACT: We performed simultaneous facial scar repair and oral aperture open with a windowed, bilateral, bipedicled deep inferior epigastric perforator flap (DIEP flap) in a 20-year-old male patient who had suffered from severe postburn scar of the face and neck in association with serious cicatricial microstomia. DIEP flap is a typical perforator flap that has less donor site morbidity because of a minimal sacrifice of muscles. Since bipedicled DIEP flap can provide the largest skin territory in the lower abdominal wall and ensure a sufficient blood supply to zone IV, it is very suitable for the repair of massive defects of the face and neck. From our challenging case, we learned that bilateral, bipedicled DIEP flap is an excellent option for the repair of large faciocervical defects. Bilateral, bipedicled DIEP flap, which can produce an excellent esthetic and functional outcome, has reliable blood perfusion, provides soft and pliable tissue, and causes the minimal donor-site morbidity.
    Annals of plastic surgery 10/2009; 63(6):616-20. · 1.29 Impact Factor
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    ABSTRACT: Treatment of hemifacial atrophy presents a challenge for reconstructive surgeons. Previous studies have described numerous methods for the correction of facial asymmetry. We present our experience with treatment of hemifacial atrophy using a microsurgical anterolateral thigh adipofascial flap procedure and other adjunctive measures. This method is similar to that used for the free anterolateral thigh flap, but only the deep fascia of the anterolateral thigh and subcutaneous fatty tissue above the fascia were harvested. This flap procedure was used in 32 patients with moderate or severe hemifacial atrophy. In the first stage, the anterolateral thigh adipofascial flap procedure was used in all the patients, of whom eight accepted a porous polyethylene implant along with the anterolateral thigh adipofascial flap to reconstruct the skeleton. In the second stage, ancillary procedures including porous polyethylene implantation, liposuction debulking, fat injection and flap re-suspension were performed to refine the outcome in 28 patients. The anterolateral thigh adipofascial flap is advantageous in that it can provide a reliable vascular pedicle with relatively thin, pliable soft tissue and direct primary closure of the donor site.
    Journal of Plastic Reconstructive & Aesthetic Surgery 08/2009; 63(7):1110-6. · 1.44 Impact Factor