ObjectiveTo investigate the technique and the effectiveness of digital three-dimensional (3-D) titanium mesh in repairing skull defect under the temporalis and reconstructing temporal muscle attachment points. MethodsBetween January 2009 and December 2012, 58 patients with skull defect after decompressive craniectomy at the frontal temporal region were treated. Of 58 patients, 33 were male and 25 were female, aged 17-62 years (mean, 36.2 years). The disease duration was 15 weeks to 25 months (mean, 5.8 months). The size of skull defect ranged from 8 cm×6 cm to 15 cm×12 cm. The patients underwent skull impairment patch surgery with digital 3-D titanium mesh and reconstruction of the temporal muscle attachment points at titanium mesh temporal corresponding position. ResultsThe operation time was 60-100 minutes (mean, 87 minutes). After operation, 2 cases had slight red swelling with little exudation at skin incision margin, which was cured after symptomatic treatment; 2 cases had symptom of headache, which disappeared after incision healing; primary healing of incision was obtained in the other patients. Fifty-eight patients were followed up 6-24 months (mean, 16 months). The patients were satisfied with shaping, and had no chewing pain. Head CT after operation showed good fixation of titanium mesh and titanium nail, and satisfactory skull shape symmetry; no postoperative complication of subcutaneous effusion, intracranial bleeding, titanium mesh loosening, or titanium mesh exposure occurred. ConclusionThe surgery technique of digital 3-D titanium mesh to repair skull defect in frontal temporal region and to reconstruct temporal muscle attachment points at the corresponding position of titanium mesh, basically can obtain anatomical reduction of the skull, frontal temporal, and each layer of scalp. It has the advantages of less complication, less titanium nail, and satisfactory shape.
ObjectiveTo investigate the expression of ErbB3 and Flotillin-2 in osteosarcoma biopsies and possible clinical pathology significance. MethodsThe tissue biopsies were harvested from 38 osteosarcoma patients and 13 osteochondroma patients between September 2009 and March 2014 for immunohistochemical staining. The ErbB3 and Flotillin-2 expressions were observed in osteosarcoma and osteochondroma biopsies, and the correlation and the relationship to the clinical and pathological features were analyzed. ResultsThe expression levels of ErbB3 and Flotillin-2 in osteosarcoma were significantly higher than those in osteochondroma (P<0.05). The high expressions of ErbB3 and Flotillin-2 had good consistency in osteosarcoma (Kappa=0.434, P=0.000). The high expression of ErbB3 was positively correlated to the clinical stages and lung metastasis (P<0.05), but it was not associated with gender, age, tumor location, and size (P>0.05). The high expression of Flotillin-2 had no correlation with clinical and pathological features (P>0.05). The influence factors of patients' overall survival included clinical stages, lung metastasis, high expression of ErbB3, and tumor size (P<0.05). Only lung metastasis and high expression of ErbB3 were independent factor affecting overall survival (P<0.05). ConclusionThe ErbB3 and Flotillin-2 express highly in osteosarcoma and the high expression has good consisitency. Besides, the high expression of ErbB3 is associated with the clinical stages and lung metastasis, indicating a poor prognosis for osteosarcoma.