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1.
Int. j. morphol ; 38(2): 423-426, abr. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1056457

RESUMEN

The aim of this investigation was to define the volume and area of the airway in subjects with Class II and Class III skeletal deformity. A cross-sectional study was designed including subjects with facial deformity defined by Steiner's analysis in subjects with indication of orthognathic surgery who presented diagnosis by cone beam computerised tomography. We determined the measurements of maximum area, minimum area and volume of the airway. The data were compared using Spearman's test, with statistical significance defined as p<0.05. 115 subjects were included: 61.7 % Class II and 38.3 % Class III, mean age 27.8 years (± 11.6). A significant difference was observed in the area and volume measurements in the groups studied, with significantly smaller measurements found in Class II (p=0.034). The minimum area was 10.4 mm2 smaller in Class II patients than in Class III, while the general volume of the airway was 4.1 mm3 smaller in Class II than in Class III. We may conclude that Class II subjects present a smaller airway volume than Class III subjects.


El objetivo de esta investigación de definir el volumen y área de vía aérea en sujetos con deformidad esqueletal clase II y III. Se diseñó un estudio de corte transversal incluyendo sujetos con deformidad facial definida según análisis de Stainer en sujetos con indicación de cirugía ortognática que presentaran una tomografía computadorizada de haz cónico como elemento diagnóstico; en este examen se determinaron medidas de área mayor, menor de vía aérea y volumen presente; los datos fueron comparados utilizando pruebas estadísticas con el test de spearman considerando el valor de p<0,05 para definir significancia estadística. 115 sujetos fueron incluidos, siendo 61,7 % de tipo clase II y 38,3 % de sujetos clase III, con una edad promedio de 27,8 años (± 11,6). Se observó una diferencia significativa en mediciones de area y volumen en los grupos estudiados, siendo el grupo de clase II significativamente menor (p=0,034). El área de menor tamaño fue 10,4 mm2 en pacientes clase II que en pacientes clase III, mientras que el volumen general de la vía área fue 4,1 menor en los clase II que en los clase III. Es posible concluir que los sujetos de clase II presentan menor volumen de vía área que los sujetos clase III.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Sistema Respiratorio/diagnóstico por imagen , Anomalías Craneofaciales/diagnóstico por imagen , Faringe/diagnóstico por imagen , Sistema Respiratorio/anatomía & histología , Nariz/diagnóstico por imagen , Imagenología Tridimensional
2.
Plast Reconstr Surg ; 145(5): 1223-1236, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32332542

RESUMEN

BACKGROUND: Primary rhinoplasty has not been universally adopted because the potential for nasal growth impairment remains an unsolved issue in cleft care. This study's purpose was to assess the long-term effects of primary rhinoplasty performed by a single surgeon in a cohort of patients with a unilateral cleft lip nose deformity. METHODS: Three-dimensional nasal morphometric measurements (linear, angular, proportional, surface area, and volume) were collected from consecutive patients (cleft group, n = 52; mean age, 19 ± 1 year) who had undergone primary rhinoplasty with the use of the Noordhoff approach between 1995 and 2002 and reached skeletal maturity. Normal age-, sex-, and ethnicity-matched subjects (control group, n = 52) were identified for comparative analyses. RESULTS: No significant differences (all p > 0.05) were observed for most measures, including nasal height, alar width, nasal dorsum angle, columellar angle, columellar-labial angle, nasal tip/height ratio, nasal index, alar width/intercanthal distance ratio, nasal surface area, and nasal volume. The cleft group displayed significantly (all p < 0.05) lower nasal bridge length and nasal tip projection, and greater nasal protrusion, tip/midline deviation, nasal tip angle, nasal tip protrusion width index, and alar width/mouth ratio values than the control group. CONCLUSIONS: Primary rhinoplasty does not interfere with nasal growth as measured by three-dimensional photogrammetric analysis. Further imaging studies are required for the assessment of development in other anatomical nasal structures. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Asunto(s)
Labio Leporino/cirugía , Imagenología Tridimensional , Nariz/crecimiento & desarrollo , Fotogrametría , Rinoplastia/efectos adversos , Adolescente , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Voluntarios Sanos , Humanos , Masculino , Nariz/anomalías , Nariz/diagnóstico por imagen , Nariz/cirugía , Estudios Retrospectivos , Rinoplastia/métodos , Programas Informáticos , Resultado del Tratamiento , Adulto Joven
3.
J Craniofac Surg ; 31(2): 367-371, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049908

RESUMEN

OBJECTIVES: The aim of this pilot study was to illustrate the feasibility of a full digital workflow to design and manufacturing a consecutive series of customized nasoalveolar molding (NAM) appliances in advance for presurgical unilateral and bilateral cleft lip and palate (CLP) treatment. METHODS: The full digital workflow consisted of acquisition of 3D image data of an infant's maxilla by using intraoral scanner (TRIOS; 3Shape, Copenhagen, Denmark); the initial data were imported into an appropriate computer-aided design (CAD) software environment, the digital model was virtual modified to achieve a harmonic alveolar arch, and generated a consecutive of digital models of each movement stage; the digital model of NAM appliance was designed based on the virtual modified model; bio-compatible material MED610 was used to manufacturing the real NAM appliances by 3D printing. A consecutive series of NAM appliances was delivered to CLP infant before lip surgery. RESULTS: Intraoral scanning was harmless and safer than conventional impression technique for CLP infants. The CAD/3D printing procedures allowed a series of NAM appliances to be designed and manufactured in advance. The clinical results showed that this full digital workflow was efficient, viable and able to estimate the treatment objective. By the end of presurgical NAM treatment, the malposition alveolar segments had been aligned normally, the surrounding soft tissues repositioned. CONCLUSIONS: The full digital workflow presented has provided the potential for presurgical NAM treatment of infants with cleft lip and palate. Intraoral scanning served as a starting point, so subsequent virtual treatment planning and CAD/3D printing procedures could realize the full digital workflow, a whole series of customized NAM appliances was manufactured in advance. This method brings the benefits of safety, affectivity and time-saving.


Asunto(s)
Labio Leporino/diagnóstico por imagen , Fisura del Paladar/diagnóstico por imagen , Nariz/diagnóstico por imagen , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/cirugía , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Diseño Asistido por Computadora , Humanos , Maxilar/cirugía , Nariz/cirugía , Proyectos Piloto , Impresión Tridimensional , Programas Informáticos , Flujo de Trabajo
4.
Ann Otol Rhinol Laryngol ; 129(7): 645-648, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32100546

RESUMEN

OBJECTIVES: To discuss the presentation and management of infants with arhinia or congenital absence of the nose. METHODS: This case report describes an infant with arhinia that was diagnosed prenatally. In addition to a discussion of the case, a review of the literature was completed to define appropriate postnatal work-up and management. RESULTS: The patient is a term male infant, diagnosed with arhinia on ultrasound and magnetic resonance imaging (MRI) performed at 21-weeks gestational age. Upon birth, the patient was subsequently intubated, followed by tracheostomy due to complete nasal obstruction. Through a genetics evaluation, the patient was found to be heterozygous for the SMCHD1 gene, with hypomethylation at the D4Z4 locus. Plans for reconstruction will be based on future imaging and the development of any nasal patency, however, the patient's family plans to utilize a prosthetic nose until the patient is older. CONCLUSION: Arhinia is a rare condition causing respiratory distress in the neonatal period. While stabilization of the airway is the first priority, further management is not clearly defined given the rarity of the malformation. This case discusses stabilization of the airway with a review of treatment and reconstructive options.


Asunto(s)
Anomalías Craneofaciales/diagnóstico por imagen , Nariz/anomalías , Manejo de la Vía Aérea , Proteínas Cromosómicas no Histona/genética , Anomalías Craneofaciales/genética , Anomalías Craneofaciales/terapia , Manejo de la Enfermedad , Humanos , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Mutación Missense , Nariz/diagnóstico por imagen , Diagnóstico Prenatal , Prótesis e Implantes , Procedimientos Quirúrgicos Reconstructivos , Tomografía Computarizada por Rayos X , Traqueostomía , Ultrasonografía Prenatal
5.
J Craniofac Surg ; 31(1): e32-e35, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31449205

RESUMEN

The authors present a case of a 33-year-old male patient with obstructive sleep apnea syndrome who was treated with a mandibular advancement device with excellent results. The aim of this study is to underline the importance of new instruments that allow evaluating the upper airway with greater precision, such as cone beam tomography. Given the diagnosis and treatment, the upper airway was assessed using cone beam tomography; an increase in UA volume of 22% was observed (initial volume 22,962 mm), along with a 28% increase in area (initial area 971 mm). The evaluation of the UA using teleradiography also showed an increase in the points evaluated, with the midpoint of the soft palate presenting the greatest increase.


Asunto(s)
Laringe/diagnóstico por imagen , Nariz/diagnóstico por imagen , Ferulas Oclusales , Apnea Obstructiva del Sueño/terapia , Adulto , Tomografía Computarizada de Haz Cónico , Humanos , Masculino , Avance Mandibular , Apnea Obstructiva del Sueño/fisiopatología
6.
Anesth Analg ; 130(4): 1018-1025, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31162158

RESUMEN

BACKGROUND: Preformed nasal endotracheal tubes (NETs) come with a predefined insertion depth due to their curved design. While size indication refers to internal diameter, there is a considerable variability in the corresponding lengths and proportions of same-sized tubes of different manufacturers which is probably based on the lack of data of nasolaryngeal distances (NLDs) in the adult population. Choosing the best-fitting NET is therefore difficult and carries the risk of endobronchial intubation or, on the contrary, cuff inflation at the vocal cord level. The aim of this study was to develop a prediction model for NLD and a selection guide to choose the appropriate NET based on a radiographic description of NLD in comparison to the measurements of available NETs of several manufacturers. METHODS: After institutional ethics board review, 388 computed tomography (CT) scan images of head, neck, and upper thorax in a heterogeneous adult cohort were included. Mean distances from the nares to the lower border of the thyroid cartilage were measured. NETs from different manufacturers were measured and compared to the NLD derived from the radiographic analysis. The patients' sex, body height, and weight were considered as possible covariates in quantile regression models for predicting the NLD. RESULTS: Data from 200 patients were analyzed. NLD was associated with sex, body height, and weight. A simple quantile regression model using the body height as the only covariate sufficed to achieve accurate predictions of NLD. Validation on independent test data showed that 92.8% of the NLD predictions were closer than ±20 mm to the observed NLD values. Measurements of equal-sized NETs varied considerably in outer diameter, proportion, the nasopharyngeal part, and guide marks. Length differences of the bend-to-cuff distance, containing the anatomically NLD, ranged between 218 and 270 mm at same sizes. CONCLUSIONS: A reliable prediction of NLD can be obtained simply by body height, using the formula (Equation is included in full-text article.). As manufacturers' tube lengths vary substantially, additional information about the bend-to-cuff distance as corresponding tube section would allow for more accurate tube selection.


Asunto(s)
Intubación Intratraqueal/instrumentación , Laringe/anatomía & histología , Nariz/anatomía & histología , Adulto , Anciano , Anciano de 80 o más Años , Estatura , Peso Corporal , Estudios de Cohortes , Diseño de Equipo , Femenino , Humanos , Laringe/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Nasofaringe/anatomía & histología , Nasofaringe/diagnóstico por imagen , Nariz/diagnóstico por imagen , Valores de Referencia , Reproducibilidad de los Resultados , Caracteres Sexuales , Cartílago Tiroides/anatomía & histología , Cartílago Tiroides/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto Joven
7.
Forensic Sci Int ; 306: 110095, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31841934

RESUMEN

Manual landmarking is used in several manual and semi-automated prediction guidelines for approximation of the nose. The manual placement of landmarks may, however, render the analysis less repeatable due to observer subjectivity and, consequently, have an impact on the accuracy of the human facial approximation. In order to address this subjectivity and thereby improve facial approximations, we are developing an automated three-dimensional (3D) method based on an automatic dense landmarking procedure using non-rigid surface registration. The aim of this study was to validate the automatic landmarking method by comparing the intra-observer errors (INTRA-OE) and inter-observer errors (INTER-OE) between automatic and manual landmarking. Cone beam computed tomography (CBCT) scans of adult South Africans were selected from the Oral and Dental Hospital, University of Pretoria, South Africa. In this study, the validation of the automatic landmarking was performed on 20 3D surfaces. INTRA-OE and INTER-OE were analyzed by registering 41 craniometric landmarks from 10 hard-tissue surfaces and 21 capulometric landmarks from 10 soft-tissue surfaces of the same individuals. Absolute precision of the landmark positioning (both on the samples as well as the template) was assessed by calculating the measurement error (ME) for each landmark over different observers. Systematic error (bias) and relative random error (precision) was further quantified through repeated measures ANOVA (ANOVA-RM). The analysis showed that the random component of the ME in landmark positioning between the automatic observations were on average on par with the manual observations, except for the soft-tissue landmarks where automatic landmarking showed lower ME compared to manual landmarking. No bias was observed within the craniometric landmarking methods, but some bias was observed for capulometric landmarking. In conclusion, this research provides a first validation of the precision and accuracy of the automatic placement of landmarks on 3D hard- and soft-tissue surfaces and demonstrates its utilization as a convenient prerequisite for geometric morphometrics based shape analysis of the nasal complex.


Asunto(s)
Puntos Anatómicos de Referencia , Tomografía Computarizada de Haz Cónico , Nariz/diagnóstico por imagen , Grupo de Ascendencia Continental Africana , Antropología Forense , Humanos , Imagenología Tridimensional , Nariz/anatomía & histología , Reproducibilidad de los Resultados , Sudáfrica
9.
Int. j. morphol ; 37(4): 1272-1279, Dec. 2019. tab, graf
Artículo en Español | LILACS | ID: biblio-1040124

RESUMEN

La morfología y dimensiones de ciertas estructuras anatómicas varían de población a población, así como de individuo a individuo; el canal nasopalatino (CNP) es una de estas estructuras, este se encuentra ubicado en la línea media del paladar y aloja el nervio nasopalatino y la rama terminal de la arteria nasopalatina. El propósito de este estudio es determinar la morfología y dimensiones promedio del CNP en la población mexicana mediante tomografía computarizada de haz cónico (CBCT). Se analizaron 120 CBCT de manera coronal, transversal y sagital; y se clasificaron siguiendo los parámetros de Bornstein. Para el análisis estadístico se determinó la normalidad de las variables empleando la prueba de Shapiro Wilk y la significancia estadística mediante la prueba de UMann Whitney. Los resultados mostraron diferencias estadísticas significativas en las variables analizadas del canal nasopalatino entre hombres y mujeres. De acuerdo con los datos obtenidos se puede establecer que la morfología del CNP es muy variable y se recomienda realizar un estudio morfológico y dimensional antes de cualquier intervención quirúrgica relacionada con esta zona.


Certain human structures present different dimensions and morphologies in each population and individual, the nasopalatine canal being one of these. It is located in the midline of the palate, and it contains the nasopalatine nerve and the terminal branch of the nasopalatine artery. The purpose of this study was to analyze and record measurements of the nasopalatine duct in Mexican population by Cone Beam Computed Tomography (CBCT). A total of 120 CBCT coronal, transversal and sagittal views were analyzed. The data were classified according to Bornstein´s parameters. The normality of the variables was determined with the Shapiro Wilk test and the statistical significance was determinate by U-Mann Whitney test. A statistically significant difference was found in the evaluated variables of the nasopalatal canal between men and women. The data obtained determined that the morphology of the nasopalatine canal is variable and a morphological and dimensional analysis before any surgical intervention related with the area is recommended.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Paladar (Hueso)/anatomía & histología , Nariz/anatomía & histología , Tomografía Computarizada de Haz Cónico , Paladar (Hueso)/diagnóstico por imagen , Factores Sexuales , Nariz/diagnóstico por imagen , México
11.
J Craniofac Surg ; 30(7): 2099-2101, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31574783

RESUMEN

BACKGROUND: Nasal fractures are the most commonly encountered facial fracture in children presenting to emergency departments. Though plain radiographs have long been used to aid the diagnosis of fractures, its limited diagnostic accuracy has led to the increasing use of ultrasound. Ultrasound offers a cheap, safe, and readily available imaging modality. Evidence in the adult population has shown ultrasound to be far more accurate in identifying nasal fractures. The efficacy of ultrasound in the pediatric setting though remains uncertain. METHODS: A systematic review of the Pubmed and EmBase databases was undertaken. The search terms (nose OR nasal) AND (fracture) AND (ultrasound OR ultrasonography OR sonography) and associated MeSH terms were searched. The search was limited to those <18 years of age. RESULTS: Following review and exclusion, 3 papers met the inclusion criteria. All 3 studies showed ultrasound was able to detect nasal fractures in children. Two studies showed that ultrasound diagnosed fractures with a greater accuracy than plain radiographs. One study used ultrasound alone and reported a sensitivity of 75% and specificity as 92.3%. CONCLUSION: With the limited evidence to date in the pediatric population, ultrasound appears to offer a more accurate radiological investigation in nasal fractures. It could be considered diagnostically superior to plain radiographs and reduces radiation exposure in children. Further work is required to better determine its true utility and improve its diagnostic accuracy.


Asunto(s)
Nariz/diagnóstico por imagen , Fracturas Craneales/diagnóstico por imagen , Niño , Femenino , Humanos , Masculino , Radiografía , Ultrasonografía/métodos
12.
J Craniofac Surg ; 30(7): 2202-2206, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31403514

RESUMEN

PURPOSE: To propose a three-dimensional cephalometric analysis of upper airway (UA) related to its functionality, defining normal reference values in healthy individuals and the relationship between nostril, nasal valve, and minimal cross-sectional area (MCS) in functional upper airway. MATERIALS AND METHODS: The UAs of 20 Class I patients were analyzed with CBCT using Nemoceph 3D-OS and HOROS software, determining linear distances, volumes and cross-sectional areas, including MCS. RESULTS: MCS was mostly located in the middle-upper oropharynx and high hypopharynx. MCS showed moderate correlation with the area of both nares (BNA) (r = 0.60, P = 0.004) and high correlation with the area of both internal nasal valves (BNV) (r = 0.66, P = 0.0016). BNA and BNV showed a moderate correlation (r = 0.445, P = 0.049). A total upper airway (TUA) and functional upper airway (FUA) volumes were established. TUA and FUA showed the strongest statistical correlation (r = 0.82, P = 0.00). A paired samples t test compared the measurement as absolute values of MCS with BNA (t = 0.781, P = 0.44), with BNV (t = -0.12, P = 0.90); and BNA with BNV (t = -0.76, P = 0.45), showed no significant differences. CONCLUSIONS: A functional cephalometric analysis of the UA with stable parameters in cervical spine and normal reference values has been proposed. BNA and BNV could be used as reference to establish the MCS compatible with respiratory health.


Asunto(s)
Cavidad Nasal/diagnóstico por imagen , Nariz/diagnóstico por imagen , Adulto , Cefalometría/métodos , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Hipofaringe , Masculino , Orofaringe , Programas Informáticos
13.
Am J Orthod Dentofacial Orthop ; 156(2): 257-265, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375236

RESUMEN

INTRODUCTION: Children with unilateral cleft lip and palate (UCLP) exhibit snoring and mouth breathing. They are also reported to show obstructive sleep apnea syndrome. However, their upper airway ventilation condition is not clearly understood. Therefore, this study was performed to evaluate upper airway ventilation condition in children with UCLP with the use of computational fluid dynamics. METHODS: Twenty-one children (12 boys, 9 girls; mean age 9.1 years) with UCLP and 25 children (13 boys, 12 girls; mean age 9.2 years) without UCLP who required orthodontic treatment underwent cone-beam computed tomography (CBCT). Nasal resistance and upper airway ventilation condition were evaluated with the use of computational fluid dynamics from CBCT data. The groups were compared with the use of Mann-Whitney U tests and Student t tests. RESULTS: Nasal resistance of the UCLP group (0.97 Pa/cm3/s) was significantly higher than that of the control group (0.26 Pa/cm3/s; P < 0.001). Maximal pressure of the upper airway (335.02 Pa) was significantly higher in the UCLP group than in the control group (67.57 Pa; P < 0.001). Pharyngeal airway (from choanae to base of epiglottis) pressure in the UCLP group (140.46 Pa) was significantly higher than in the control group (15.92 Pa; P < 0.02). CONCLUSIONS: Upper airway obstruction in children with UCLP resulted from both nasal and pharyngeal airway effects.


Asunto(s)
Labio Leporino/patología , Fisura del Paladar/patología , Tomografía Computarizada de Haz Cónico/métodos , Hidrodinámica , Laringe/anatomía & histología , Nariz/anatomía & histología , Tonsila Faríngea/anatomía & histología , Puntos Anatómicos de Referencia , Niño , Labio Leporino/diagnóstico por imagen , Fisura del Paladar/diagnóstico por imagen , Epiglotis/anatomía & histología , Epiglotis/diagnóstico por imagen , Femenino , Humanos , Hueso Hioides/anatomía & histología , Imagenología Tridimensional/métodos , Laringe/diagnóstico por imagen , Maloclusión de Angle Clase I , Nasofaringe/anatomía & histología , Nasofaringe/diagnóstico por imagen , Nariz/diagnóstico por imagen , Respiración , Apnea Obstructiva del Sueño
14.
Plast Reconstr Surg ; 144(3): 378e-385e, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31461007

RESUMEN

BACKGROUND: Nasal hump relapse and its probable reasons or mechanisms have been less discussed after dorsal preservation rhinoplasty. In this article, the authors would like to share their experiences and offer solutions regarding this subject. METHODS: Five hundred twenty patients who underwent primary rhinoplasty between the years 2016 and 2018 were included in the study. The push-down method was used for noses with a hump less than 4 mm and the let-down procedure was performed for others. Hump height was measured from profile photographs. The cases were evaluated in terms of nasal dorsal problems and their probable mechanisms. RESULTS: Five hundred twenty patients, 448 with a straight nose and 72 with a deviated nose, were enrolled in this study. Mean follow-up was 13 months (range, 9 to 16 months). Visible dorsal hump recurrence was observed in 63 patients, and they appeared at 1 to 4 months postoperatively. Forty-one of these had a dorsal hump more than 4 mm preoperatively. Hump recurrence was not more than 2 mm in 34 patients, and they did not wish to have any revision intervention because of cosmetic satisfaction. In 11 cases, the height of the hump recurrence was 2 to 3 mm. These patients were treated with only minimal rasping. The remaining 18 patients had a hump recurrence with a height of 3 to 4 mm. They underwent secondary surgery using let-down rhinoplasty. CONCLUSION: The authors recommend subperichondrial/subperiosteal dissection, subdorsal excision of cartilaginous and bony septum, scoring the resting upper part of the septum just below the keystone area, and performing lateral keystone dissection and preferring let-down procedure for kyphotic noses to prevent hump relapse after dorsal preservation rhinoplasty. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Asunto(s)
Ligamentos/cirugía , Microcirugia/métodos , Nariz/anatomía & histología , Rinoplastia/métodos , Prevención Secundaria/métodos , Estética , Femenino , Estudios de Seguimiento , Humanos , Ligamentos/anatomía & histología , Masculino , Microcirugia/efectos adversos , Nariz/diagnóstico por imagen , Nariz/cirugía , Fotograbar , Recurrencia , Reoperación/estadística & datos numéricos , Rinoplastia/efectos adversos , Resultado del Tratamiento
16.
J Forensic Sci ; 64(6): 1640-1645, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31150115

RESUMEN

Forensic facial approximation is an auxiliary method for human identification and allows facial recognition. The midface, that includes the nose, is vital for the recognition of a familiar face. The purpose of this study was to set hard tissue parameters to estimate nasal width, to test the method to estimate nasal width of Brazilians, and to analyze the relationship between nasal profile and facial type. A total of 246 computed tomography scans (183 females and 63 males) of adults were analyzed in Horos. Bone tissue measurements and facial type classification were performed on the skull scan. Nasal profile morphology was accessed through the tool 3D surface rendering. There was a difference around 3 mm from real to predicted nose through the method to estimate nasal width in Brazilians. So, the method may be used in forensic practice. Straight nose was associated with long face type.


Asunto(s)
Antropología Forense/métodos , Nariz/anatomía & histología , Nariz/diagnóstico por imagen , Adolescente , Adulto , Anciano , Brasil , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Imagenología Tridimensional , Modelos Lineales , Masculino , Persona de Mediana Edad , Programas Informáticos , Dimensión Vertical , Adulto Joven
17.
BMJ Case Rep ; 12(6)2019 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-31229987

RESUMEN

The majority of epistaxes are anterior in nature, resolve with simple first aid measures and require no further follow-up. However, some cases pose more of a diagnostic challenge and prove resistant to standard investigation and treatment. We present a case of recurrent epistaxis, refractory to multiple treatment modalities and with CT imaging suggestive of a vascular aetiology which was ultimately disproved. The case highlights the shortcomings of CT imaging and importance of thorough examination technique. Nasal haemangiomas are a rare but recognised cause of epistaxis and should be considered in refractory cases.


Asunto(s)
Epistaxis/etiología , Hemangioma/complicaciones , Nariz/patología , Anciano , Aneurisma , Arteria Carótida Interna/diagnóstico por imagen , Arteria Carótida Interna/patología , Angiografía por Tomografía Computarizada/métodos , Angiografía por Tomografía Computarizada/estadística & datos numéricos , Diagnóstico Diferencial , Femenino , Hemangioma/diagnóstico por imagen , Hemangioma/cirugía , Humanos , Nariz/irrigación sanguínea , Nariz/diagnóstico por imagen , Resultado del Tratamiento
18.
J Appl Clin Med Phys ; 20(6): 184-193, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31120615

RESUMEN

The RayStation treatment planning system implements a Monte Carlo (MC) algorithm for electron dose calculations. For a TrueBeam accelerator, beam modeling was performed for four electron energies (6, 9, 12, and 15 MeV), and the dose calculation accuracy was tested for a range of geometries. The suite of validation tests included those tests recommended by AAPM's Medical Physics Practice Guideline 5.a, but extended beyond these tests in order to validate the MC algorithm in more challenging geometries. For MPPG 5.a testing, calculation accuracy was evaluated for square cutouts of various sizes, two custom cutout shapes, oblique incidence, and heterogenous media (cork). In general, agreement between ion chamber measurements and RayStation dose calculations was excellent and well within suggested tolerance limits. However, this testing did reveal calculation errors for the output of small cutouts. Of the 312 output factors evaluated for square cutouts, 20 (6.4%) were outside of 3% and 5 (1.6%) were outside of 5%, with these larger errors generally being for the smallest cutout sizes within a given applicator. Adjustment of beam modeling parameters did not fix these calculation errors, nor does the planning software allow the user to input correction factors as a function of field size. Additional validation tests included several complex phantom geometries (triangular nose phantom, lung phantom, curved breast phantom, and cortical bone phantom), designed to test the ability of the algorithm to handle high density heterogeneities and irregular surface contours. In comparison to measurements with radiochromic film, RayStation showed good agreement, with an average of 89.3% pixels passing for gamma analysis (3%/3mm) across four phantom geometries. The MC algorithm was able to accurately handle the presence of irregular surface contours (curved cylindrical phantom and a triangular nose phantom), as well as heterogeneities (cork and cortical bone).


Asunto(s)
Algoritmos , Electrones/uso terapéutico , Método de Montecarlo , Fantasmas de Imagen , Planificación de la Radioterapia Asistida por Computador/métodos , Huesos/diagnóstico por imagen , Mama/diagnóstico por imagen , Femenino , Humanos , Pulmón/diagnóstico por imagen , Nariz/diagnóstico por imagen , Aceleradores de Partículas , Dosis de Radiación , Programas Informáticos
20.
J Craniofac Surg ; 30(3): e254-e255, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31048621

RESUMEN

Proboscis Lateralis is a rare congenital anomaly composed of an accessory tubular appendage with possible associated craniofacial anomalies. Computed tomography scan is essential for evaluation of the anomaly and proposing a plan of management. Treatment is complex and should be individualized. The authors present the case of an 18-month old female with left proboscis lateralis associated with left heminasal hypoplasia and coloboma of the left upper eyelid.


Asunto(s)
Coloboma , Párpados/anomalías , Nariz/anomalías , Coloboma/diagnóstico por imagen , Párpados/diagnóstico por imagen , Femenino , Humanos , Imagenología Tridimensional , Lactante , Nariz/diagnóstico por imagen , Tomografía Computarizada por Rayos X
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