Open-Source 3D Morphing Software for Facial Plastic Surgery and Facial Landmark Detection Research and Open Access Face Data Set Based on Deep Learning (Artificial Intelligence) Generated Synthetic 3D Models.

Background: The scarcity of 3D facial models presents a significant hurdle for researchers and educators. Gathering such data demands substantial resources. Objective: To introduce an open-source 3D morphing software to generate 3D facial data sets for research and to provide a large sample data set that is based on synthetically generated 3D models. Methods: Software is developed to morph 3D facial models in bulk by altering landmark locations. Twenty synthetic 3D facial models are generated utilizing deep learning tools and 28 landmarks located on each. The measurements of synthetic models are confirmed to be realistic by comparing them with facial statistics. Several facial deformities and types are simulated at various magnitudes on 3D models to generate a large data set. Results: An open-source software and an open-access data set of 980 3D facial models, each with 28 landmark locations, are provided. Since the data set is based on synthetically generated 3D models, no institutional review board approval is required. Conclusion: The 3D morphing software and the large 3D data set are expected to benefit researchers and educators in the field of facial surgery and facial landmark detection.

Three-dimensional (3D) area and volume measurements for rhinoplasty.

BACKGROUND: Morphometric changes achieved in rhinoplasty are mostly analyzed on two-dimensional (2D) images. However, most of these alterations are amenable to three-dimensional (3D) analysis. OBJECTIVES: Objective measurements for rhinoplasty are currently done on 2D photographic analyses. We believe that newer techniques will develop. This is a study to help define new parameters. METHODS: Landmarks that are widely used in the literature were used to define the boundaries of these measurements. They comprised certain parts of the nose (tip, dorsum, radix, etc.). Measurements were done on a generic face (GF) 3D model. The model's nose was then morphed using the free, open-source 3D modeling software (Blender) to generate seven different deformed noses and to perform the area and volume measurements. RESULTS: Each nose with a different type of deformity demonstrated significant area and volume differences. For example, comparing area measurements to GF-Pleasant nose, GF-Snub nose showed a significant difference at the tip (43.3% reduction). Volume measurements were found to be mostly parallel to the area measurements; however, some incongruences were noted. CONCLUSIONS: We show that new area and volume measurements can be reliably developed for 3D-scanned images. These measurements can be utilized and will enrich the facial analysis and evaluation of the outcomes of rhinoplasty.

Facial Surface Anthropometric Features and Measurements With an Emphasis on Rhinoplasty.

BACKGROUND: Facial features and measurements are utilized to analyze patients' faces for various reasons, including surgical planning, scientific communications, patient-surgeon communications, and post-surgery evaluations. OBJECTIVES: There are numerous descriptions regarding these features and measurements scattered throughout the literature, and the authors did not encounter a current compilation of these parameters in the medical literature. METHODS: A narrative literature review of the published medical literature for facial measurements used for facial analysis in rhinoplasty was conducted through the electronic databases MEDLINE/PubMed and Google Scholar, along with a citation search. RESULTS: A total of 61 facial features were identified: 45 points (25 bilateral, 20 unilateral), 5 lines (3 bilateral, 2 unilateral), 8 planes, and 3 areas.A total of 122 measurements were identified: 48 distances (6 bilateral, 42 unilateral), 57 angles (13 bilateral, 44 unilateral), and 17 ratios. Supplemental figures were created to depict all features and measurements utilizing a frontal, lateral, or basal view of the face. CONCLUSIONS: This paper provides the most comprehensive and current compilation of facial measurements to date. The authors believe this compilation will guide further developments (methodologies and software tools) for analyzing nasal structures and assessing the objective outcomes of facial surgeries, in particular rhinoplasty. Moreover, it will improve communication as a reference for facial measurements of facial surface anthropometry, in particular rhinoplasty.

Surgical Algorithms in Rhinoplasty: A Scoping Review of the Current Status.

BACKGROUND: Algorithms define a sequence to approaching a subject. This study represents a scoping review seeking to define the role of surgical algorithms in rhinoplasty. METHODS: A scoping review was conducted. Pubmed/MEDLINE, Web of Science, and Google Scholar, as well as a citation searching was performed to find eligible studies for review. Eligibility criteria included studies published in English, human subjects ≥ 15 years old, and all included surgical algorithms were for primary cosmetic rhinoplasty. RESULTS: In total, 514 studies included the key search terms. Thirty-nine studies were evaluated for data extraction. The majority of the algorithms were from USA-based publications (22/39). Flow-chart type algorithm was used in 23 and text-based algorithms in 15 of the 39 studies. Algorithms related to tip shape and/or position were most frequent (19/39), followed by those for crooked nose and dorsal height. Only 7 of the algorithms described outcomes for utilizing the algorithm. CONCLUSIONS: Very few surgical algorithms have been published for cosmetic rhinoplasty. A minority of these studies have published outcomes. This study provides a description and summary of these algorithms and also shows that future studies could be done to further develop surgical algorithms for rhinoplasty and evaluate outcomes. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com.

Mobile technology for recording surgical procedures.

Mobile technology has been advancing in countless directions, and in particular medicine has been an attractive place for mobile technology innovators. The recording of surgical procedures, however, has not been one of those directions, possibly because there is a lack of software specifically designed for recording open surgical procedures. Using an iPhone SE as the device to record video along with an app devised by one of the authors, five cases of various neck surgeries (two submandibular gland resections, two neck dissections, one neck dissection and supraglottic laryngectomy) were recorded. The authors were able to completely record four out of the five cases. One case was not recorded due to storage insufficiency on the device. The recorded images were evaluated by a jury comprised of three people, and according to their findings the image quality was of an acceptable level. The authors conclude that, with a specifically devised app and a smartphone with sufficient storage capacity, surgical video recordings are possible. Specific precautions will need to be taken to ensure the privacy of these medical records. Once that is done, it is possible to use a smartphone to provide a convenient and affordable way of recording surgical procedures.

Sialendoscopic Pneumatic Lithotripsy for Salivary Calculi: A New Technique and a Long-term Clinical Experience.

We report our results comprising a series of 34 cases of sialolithiasis that were approached sialendoscopically with conventional instruments (ie, basket and/or forceps) and for which stone removal was unsuccessful and so were thereafter treated with pneumatic lithotripsy. Intraductal pneumatic lithotripsy was able to fragment 30 of 34 (88%) salivary calculi in total. No major complications occurred. All 30 treated glands returned to normal function without any symptoms. We believe that the success of sialendoscopy is closely related to the success of salivary stone fragmentability.

An effective method for videorecording the nasal-dorsal part of a rhinoplasty - a multiple case study.

Rhinoplasty is a difficult procedure to record for several reasons which include the narrow, dark and deep surgical field cluttered with many instruments, and the heads and hands of the surgical team often blocking the view. This study discusses 13 rhinoplasty cases that were recorded using the authors' technique. A three-minute, unedited segment was extracted from the mid-portion of each surgical case, and that footage was evaluated by three specialist examiners. Results indicate that the authors' technique can offer a effective solution in the video recording of the nasal-dorsal part of a rhinoplasty.

The comparison of cephalometric characteristics in nonobese obstructive sleep apnea subjects and primary snorers cephalometric measures in nonobese OSA and primary snorers.

The objective of the study is to evaluate the cephalometric characteristics and investigate the measurement differences between habitual snorers and subjects with obstructive sleep apnea (OSA) in nonobese Turkish male population. The study design is prospective and nonrandomized. The setting is sleep-snoring center of referral hospital. Total of 60 male subjects constituted OSA (n = 20), habitual snorer (n = 20) and control group (n = 20). Clinical evaluation, Epworth sleepiness scale scoring, flexible nasopharyngoscopy, polysomnography, Tweed and Delaire analysis on cephalometric images were performed. The main outcome measures include cranial base maxillary angle (SNA), cranial base mandibular angle (SNB), posterior airway space (PAS), mandibular plane and hyoid distance (MPH), soft palate length, soft palate thickness, cranial height ratio (C2/C1), cranial base angle (C1⊥C3), and craniofacial angle (C3⊥F1) parameters were compared. In comparison of OSA and habitual snorers, PAS at palatal and tongue base level (p = 0.037, p = 0.001), MPH (p = 0.07), C3⊥F1 (p = 0.001) were found statistically different. In comparison of controls with OSA and habitual snorers PAS at palatal level (p < 0.001, p = 0.01), MPH (p < 0.001, p = 0.015), soft plate length (p < 0.001, p < 0.001) and thickness (p < 0.001, p = 0.056) were found statistically different. The soft palate length, PAS, C3⊥F1 and MPH were detected as the most effective four parameters in discriminating three groups. In conclusion, this study increased MPH, soft palate length and decreased PAS were identified as the determinant characteristics in OSA and habitual snoring group. PAS and MPH values reported were higher in OSA as compared to habitual snorers. The selected cephalometric data may be used as a complementary to endoscopic examination, sleep tests and imaging techniques to determine anatomic site, management plan and follow-up of outcome in habitual snorers and OSA subjects.