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Background: Considering the importance of the nose in the beauty of the face, accurate and systematic three-dimensional nasal analysis of the nose before the procedure is essential. The radix, and so the nasofrontal and nasofacial angles, play an essential role in forming an aesthetically pleasing nose because they influence the length and projection of the nose. We aimed to measure information about the pre-operative radix position in our region. Method: Pre-operative images were taken from our cases in the profile view. A checklist including radix location and projection, nasofrontal angle, and nasofacial angle were extracted from these images. Results: Overall, 200 (100 males and 100 females) cases were enrolled. Thirty-two male cases and 48 females had abnormal radix position. Radix projection were normal in only 36 male cases and 18 females. The mean nasofrontal angle in the male and female groups was 119.2 and 128.2 respectively. The mean nasofacial angle was 29.8 in the female groups and 32.6 in the male group. Conclusion: The reality of the current society of Iranian patients can be very different from the predictions of surgeons and can be far away from the statistics mentioned in western books. We tried to notify surgeons to thoroughly examine the patients prior to surgical operation by measuring parameters such as projection and position of the radix and nasofrontal and nasofacial angles.
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Background: We aimed to determine the prevalence of pre-existing asymmetry in our patients and investigate the impact of age and sex on upper facial asymmetry. Methods: We collected images from 155 patients who were undergoing upper eyelid blepharoplasty and MRD1 (marginal reflex distance 1), TPS (tarsal plate show), and BFS (brow fat span) measurements were extracted by ImageJ software. The relationship between asymmetry and age and gender was assessed by comparing the mean differences of these metrics. A generalized linear model (GLM) was used to compare the outcomes of the study. P-value < 0.05 was considered significantly different in all tests. Results: Pre-operative asymmetry was present in 112 (72%) patients. Among the cases, 61 (39%), 40 (26%), and 24 (15.5%) patients had more than 1mm of asymmetry in BFS, TPS, and MRD1, respectively. Males under 50 years old had the most asymmetry in the preorbital area. Comparing men under 50 years old with the other groups showed that the mean ± SD of absolute differences of TPS was significantly higher in this group (all P< 0.00), but pairwise comparison for MRD1 and BFS indicated no significant correlation between age, gender, and the mean asymmetry of these parameters (overall test P = 0.70 for MDR1 and P = 0.45 for BFS). Conclusion: Most patients have asymmetry before surgery without being aware of it. Awareness of this asymmetry and the relationship between facial asymmetry and age and gender is essential to prevent dissatisfaction due to the probable post-operative asymmetry and unrealistic expectations.
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Mucocele is a benign soft tissue mass that could occur in all accessory glands. Mucocele can also occur in paranasal sinuses. It is mostly placed in the frontal sinus and barely grows larger than 1.5 centimeters(cm). Based on the affected site, it could cause facial pain and headache. Analgesics like opioids could relieve and potentially make patients ignore the headache and cause giant frontal mucocele. This article discusses a patient with giant frontal sinus mucocele (7×8×8 cm) and opium addiction that presented with severe and intolerable pain. A 32 yr old man came to Rajaee Trauma Hospital, Shiraz, Iran with a severe headache and a large swelling of the face frontal region that developed gradually. In physical examination, the mass was non-tender, non-pulsatile, and free from the overlying normal skin. Computed tomography (CT) scan and magnetic resonance imaging (MRI) demonstrated a frontal sinus mucocele. The operation was planned, and the patient was discharged after two days. Subsequently, the 6-month follow-up of the patient was normal. Two different hypotheses are declared in this article. First, the potential role of opium addiction as a risk factor for giant mucoceles was noted, then the analgesic non-responsiveness of sinus mucoceles was described. The latter hypothesis is more likely. So, we should consider that if the patient had an analgesic-resistant headache, one differential diagnosis could be sinus mucocele. Moreover, the pos sible psychological effect of addiction on discounting face beauty was acknowledged.
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Background: COVID-19, caused by SARS-CoV-2, is a global pandemic that particularly affects immunocompromised individuals, leading to secondary bacterial and fungal infections. Mucormycosis, caused by Mucorales fungi, is a severe infection primarily affecting immunocompromised individuals. The COVID-19 pandemic has seen a surge in mucormycosis cases worldwide, with India experiencing a significant increase. Various factors, including diabetes mellitus, contribute to the risk of mucormycosis. This study investigated head and neck mucormycosis in patients with prior COVID-19 infection. Methods: Data from 45 patients were analyzed, with diabetes being the most common risk factor. Visual symptoms, ethmoid bone involvement, and orbital bone involvement were also identified as significant factors. Results: The COVID-19 pandemic has led to an increase in mucormycosis cases, particularly in the head and neck region, with high mortality. Successful management involves addressing underlying factors, surgical debridement, and antifungal therapy. Conclusion: Timely debridement reduces morbidity and mortality.