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

RESUMO

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.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Sistema Respiratório/diagnóstico por imagem , Anormalidades Craniofaciais/diagnóstico por imagem , Faringe/diagnóstico por imagem , Sistema Respiratório/anatomia & histologia , Nariz/diagnóstico por imagem , Imageamento Tridimensional
2.
Forensic Sci Int ; 306: 110095, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31841934

RESUMO

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.


Assuntos
Pontos de Referência Anatômicos , Tomografia Computadorizada de Feixe Cônico , Nariz/diagnóstico por imagem , Grupo com Ancestrais do Continente Africano , Antropologia Forense , Humanos , Imageamento Tridimensional , Nariz/anatomia & histologia , Reprodutibilidade dos Testes , África do Sul
4.
Int. j. morphol ; 37(4): 1272-1279, Dec. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1040124

RESUMO

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.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Palato/anatomia & histologia , Nariz/anatomia & histologia , Tomografia Computadorizada de Feixe Cônico , Palato/diagnóstico por imagem , Fatores Sexuais , Nariz/diagnóstico por imagem , México
5.
J Craniofac Surg ; 30(7): 2099-2101, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31574783

RESUMO

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.


Assuntos
Nariz/diagnóstico por imagem , Fraturas Cranianas/diagnóstico por imagem , Criança , Feminino , Humanos , Masculino , Radiografia , Ultrassonografia/métodos
6.
J Craniofac Surg ; 30(7): 2202-2206, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31403514

RESUMO

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.


Assuntos
Cavidade Nasal/diagnóstico por imagem , Nariz/diagnóstico por imagem , Adulto , Cefalometria/métodos , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Hipofaringe , Masculino , Orofaringe , Software
7.
Am J Orthod Dentofacial Orthop ; 156(2): 257-265, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375236

RESUMO

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.


Assuntos
Fenda Labial/patologia , Fissura Palatina/patologia , Tomografia Computadorizada de Feixe Cônico/métodos , Hidrodinâmica , Laringe/anatomia & histologia , Nariz/anatomia & histologia , Tonsila Faríngea/anatomia & histologia , Pontos de Referência Anatômicos , Criança , Fenda Labial/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Epiglote/anatomia & histologia , Epiglote/diagnóstico por imagem , Feminino , Humanos , Osso Hioide/anatomia & histologia , Imageamento Tridimensional/métodos , Laringe/diagnóstico por imagem , Má Oclusão de Angle Classe I , Nasofaringe/anatomia & histologia , Nasofaringe/diagnóstico por imagem , Nariz/diagnóstico por imagem , Respiração , Apneia Obstrutiva do Sono
9.
Plast Reconstr Surg ; 144(3): 378e-385e, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31461007

RESUMO

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.


Assuntos
Ligamentos/cirurgia , Microcirurgia/métodos , Nariz/anatomia & histologia , Rinoplastia/métodos , Prevenção Secundária/métodos , Estética , Feminino , Seguimentos , Humanos , Ligamentos/anatomia & histologia , Masculino , Microcirurgia/efeitos adversos , Nariz/diagnóstico por imagem , Nariz/cirurgia , Fotografação , Recidiva , Reoperação/estatística & dados numéricos , Rinoplastia/efeitos adversos , Resultado do Tratamento
10.
J Forensic Sci ; 64(6): 1640-1645, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31150115

RESUMO

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.


Assuntos
Antropologia Forense/métodos , Nariz/anatomia & histologia , Nariz/diagnóstico por imagem , Adolescente , Adulto , Idoso , Brasil , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Imageamento Tridimensional , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Software , Dimensão Vertical , Adulto Jovem
11.
BMJ Case Rep ; 12(6)2019 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-31229987

RESUMO

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.


Assuntos
Epistaxe/etiologia , Hemangioma/complicações , Nariz/patologia , Idoso , Aneurisma , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/patologia , Angiografia por Tomografia Computadorizada/métodos , Angiografia por Tomografia Computadorizada/estatística & dados numéricos , Diagnóstico Diferencial , Feminino , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Humanos , Nariz/irrigação sanguínea , Nariz/diagnóstico por imagem , Resultado do Tratamento
12.
J Appl Clin Med Phys ; 20(6): 184-193, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31120615

RESUMO

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).


Assuntos
Algoritmos , Elétrons/uso terapêutico , Método de Monte Carlo , Imagens de Fantasmas , Planejamento da Radioterapia Assistida por Computador/métodos , Osso e Ossos/diagnóstico por imagem , Mama/diagnóstico por imagem , Feminino , Humanos , Pulmão/diagnóstico por imagem , Nariz/diagnóstico por imagem , Aceleradores de Partículas , Doses de Radiação , Software
13.
J Craniofac Surg ; 30(3): e254-e255, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31048621

RESUMO

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.


Assuntos
Coloboma , Pálpebras/anormalidades , Nariz/anormalidades , Coloboma/diagnóstico por imagem , Pálpebras/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional , Lactente , Nariz/diagnóstico por imagem , Tomografia Computadorizada por Raios X
15.
Ann Otol Rhinol Laryngol ; 128(9): 811-818, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31014074

RESUMO

OBJECTIVE: Total laryngectomy (TL) results in complete abolition of nasal airflow, with notable pathologic alterations of the intranasal mucosa, mucociliary clearance, and nasal cycle. Despite these observed morphological changes, it remains unclear whether this subpopulation of patients experiences clinically significant sinonasal disease. The goal of this study was to identify rhinosinusitis in TL patients using radiographic imaging. METHODS: An Institutional Review Board-approved retrospective review (January 2005-July 2017) identified 50 patients who underwent radiographic imaging before and after TL. The Lund-Mackay Staging System (LM) was applied to 197 surveillance computed tomography scans. Surveyed patients also underwent investigation of current sinonasal symptomatology using the SNOT-22 questionnaire. Simple linear regression was modeled to LM scores; tests of statistical significance were estimated via the method of Kenward and Roger. RESULTS: The mean age was 62.4 years, with a 5:1 male-to-female ratio. The mean SNOT-22 score was 27.4 (range, 5-33). A median of 3 scans was obtained, 49% within 12 months after TL. The mean (± standard deviation) postoperative LM score was 2.7 ± 3.97 points (range, 0-19). For every 1 month after TL, postoperative LM was +0.01 point (P = .49). Conversely, for every +1 point in preoperative LM, postoperative LM was +1.08 points (P < .001). Two patients required functional endoscopic sinus surgery after TL for persistent sinonasal disease. CONCLUSIONS: Preoperative sinonasal disease burden likely plays an important role in the development of clinically significant rhinosinusitis in TL patients. Correlating radiographic findings to validated outcome measures remains a critical aspect of determining optimal surgical candidates; this arena is still under investigation in this unique patient cohort.


Assuntos
Laringectomia/efeitos adversos , Nariz/diagnóstico por imagem , Seios Paranasais/diagnóstico por imagem , Complicações Pós-Operatórias , Rinite , Sinusite , Tomografia Computadorizada por Raios X/métodos , Endoscopia/métodos , Feminino , Humanos , Laringectomia/métodos , Masculino , Pessoa de Meia-Idade , Depuração Mucociliar , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Ventilação Pulmonar , Rinite/diagnóstico , Rinite/etiologia , Rinite/fisiopatologia , Sinusite/diagnóstico , Sinusite/etiologia , Sinusite/fisiopatologia
16.
BMJ Case Rep ; 12(3)2019 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-30852512

RESUMO

Extranodal natural killer (NK-)/T cell lymphoma, nasal type (ENKL), 1 is a rare disease that often mimics rheumatological and infectious conditions and can therefore be difficult to diagnose. The authors present a case of a 55-year-old Vietnamese woman who was misdiagnosed with severe atrophic rhinitis and chronic sinus osteitis. Over a period of 8 months from initial referral, she underwent multiple biopsies and was treated with various antimicrobial regimens until the histopathological diagnosis of ENKL was finally made. Her presentation was complicated by bacterial dacrocystitis, preseptal cellulitis and a retrobulbar extraconal phlegmon requiring surgical drainage. She also subsequently developed a naso-oral fistula on treatment. This case highlights the importance of repeated biopsies, in particular from non-necrotic regions of the sinonasal tract when a patient does not respond to therapy and clinical suspicion of neoplastic pathology remains. This is the first case of ENKL to describe significant orbital complication.


Assuntos
Celulite (Flegmão)/etiologia , Linfoma Extranodal de Células T-NK/complicações , Linfoma Extranodal de Células T-NK/patologia , Nariz/diagnóstico por imagem , Fístula Bucal/complicações , Grupo com Ancestrais do Continente Asiático/etnologia , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/cirurgia , Quimiorradioterapia , Dacriocistite/diagnóstico , Dacriocistite/etiologia , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Humanos , Linfoma Extranodal de Células T-NK/tratamento farmacológico , Linfoma Extranodal de Células T-NK/radioterapia , Pessoa de Meia-Idade , Nariz/patologia , Fístula Bucal/induzido quimicamente , Tomografia por Emissão de Pósitrons , Doenças Raras , Resultado do Tratamento
17.
Medicine (Baltimore) ; 98(10): e14832, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30855511

RESUMO

The nasopharyngeal airway is an important equipment in airway management, a correct placement is crucial for its effectiveness. We measured the nares-to-epiglottis distance (NED) and examined the correlations of the optimal insertion length (NED-1) with patient characteristics and various external facial measurements. We aimed to develop a simple method for estimating the optimal insertion length and to help select an appropriate nasopharyngeal airway.Two hundred patients of ASA grade I & II aged >20 years undergoing elective surgery under general anesthesia were enrolled. We measured nares-to-ear tragus distance (NTD), nares-to-mandibular angle distance (NMD), philtrum-to-ear tragus distance (PTD), and philtrum-to-mandibular angle distance (PMD). The NED was measured by fiber-optic bronchoscope. All measurements were obtained in centimeters. NED-1 (cm) was defined as the optimal insertion length. The patient's sex, age, body weight, body height, and body mass index were recorded.The NED-1 significantly correlated with body weight, body height, NTD, NMD, PTD, and PMD. Backward stepwise multiple linear regression analysis yielded the formula for predicting NED-1: 0.331 - 0.018 × BW + 0.061 × BH + 1.080 × NMD - 1.256 × PMD + 0.697 × PTD (r = 0.640, P < .001). The regression lines of the optimal insertion length versus PTD showed the best fit to the equality line. The measurements of PTD showed the minimal differences from NED-1 and with the most patients showing <1 cm differences from NED-1.The optimal insertion depth of nasopharyngeal airway can easily be predicted by the distance from philtrum-to-ear tragus, and a nasopharyngeal airway of an appropriate size can be selected accordingly.


Assuntos
Manuseio das Vias Aéreas/métodos , Epiglote/anatomia & histologia , Modelos Biológicos , Nariz/anatomia & histologia , Adulto , Idoso , Manuseio das Vias Aéreas/instrumentação , Anestesia , Estatura , Peso Corporal , Broncoscopia , Procedimentos Cirúrgicos Eletivos , Epiglote/diagnóstico por imagem , Feminino , Tecnologia de Fibra Óptica , Humanos , Masculino , Mandíbula/anatomia & histologia , Pessoa de Meia-Idade , Nariz/diagnóstico por imagem , Tamanho do Órgão , Adulto Jovem
18.
Med Oral Patol Oral Cir Bucal ; 24(2): e243-e253, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30818318

RESUMO

BACKGROUND: To evaluate the accuracy between actual outcomes and virtual surgical planning (VSP) in orthognathic surgery regarding the use of three-dimensional (3D) surface models for registration using iterative closest point (ICP) algorithm and generated color maps. MATERIAL AND METHODS: Construction of planning and postoperative 3D models in STL files format (M0 and M1, respectively) from CBCT of 25 subjects who had been submitted to bimaxillary orthognathic surgery was performed. M0 and M1 were sent to Geomagic software in semi-automatic alignment surface mesh order of M0 and M1 for registration using ICP algorithm to calculate mean deviation (MD, MD+, MD-, SD) and root mean square (RMS - 3D Error). Color maps were generated to assess qualitative congruence between M0 and M1. From deviation analysis, 3D Error was defined as accuracy measurement. To assess the reproducibility, the workflow was performed by two evaluators multiple times. t-tests were used to assess whether all means of MD, MD+, MD-, SD and 3D Error values would be ≤ - 2 mm and ≥ 2 mm. RESULTS: High intra and inter evaluators correlation were found, supporting the reproducibility of the workflow. t-tests proved that all MDs and 3D Error values were > - 2 mm and < 2 mm. CONCLUSIONS: 3D error mean was within the standards of clinical success lower than 2 mm. ICP algorithm provided a reproducible method of alignment between 3D models and generated color maps to evaluate 3D congruence but did not answer all methodological parameters regarding the assessment of accuracy in orthognathic surgery.


Assuntos
Algoritmos , Cirurgia Ortognática/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Cirurgia Assistida por Computador/métodos , Adulto , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Nariz/diagnóstico por imagem , Planejamento de Assistência ao Paciente , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento
19.
BMJ Case Rep ; 12(2)2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30796077

RESUMO

A 59-year-old man presented with unilateral nasal congestion and discharge. Clinical examination revealed a mass in the floor of the nasal cavity. Sinus CT indicated a retained tooth or a dermoid cyst. It was removed by endoscopic surgery. Histology confirmed the diagnosis of a retained tooth. At follow-up, the patient reported no nasal symptoms. A retained nasal tooth is rare, and the symptoms are variable. It can resemble other diseases such as chronic rhinosinusitis. Surgical removal is recommended to confirm the diagnosis and eliminate symptoms.


Assuntos
Endoscopia/métodos , Obstrução Nasal/diagnóstico por imagem , Nariz/diagnóstico por imagem , Dente Supranumerário/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Obstrução Nasal/cirurgia , Nariz/patologia , Tomografia Computadorizada por Raios X , Dente Supranumerário/complicações , Dente Supranumerário/cirurgia , Resultado do Tratamento
20.
J Plast Surg Hand Surg ; 53(3): 130-137, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30782083

RESUMO

The dysplastic maxilla and retracted zygoma characterize Apert's syndrome. The relationship between the cranial base and facial development is believed to be influential and substantial. The purpose of this study is to explore the temporal relationships of maldevelopment of these structures to identify potential influence patterns. Fifty-four CT scans (unoperated Apert's, n = 18; control, n = 36) were included and divided into three age subgroups (0-6 months, 6 months-2 years, and 2-6 years). All measurements were analyzed by Materialize software. Cephalometrics relating to midface and cranial base were collected. In anteroposterior direction, prior to 6 months, the zygoma was markedly retruded by 12% in Apert's, followed by persistent retrusive shape into adulthood, averaging 17% shorter compared to controls. The maxillary anteroposterior dimension was 22% shorter than normal before 6 months of age, thereafter, it maintained at least an 18% deficiency into adulthood. In the horizontal direction, the transverse width of the zygoma increased 39% between 6 months and 2 years of age, and it was 14% wider on average overall into adulthood. The maxilla had normal growth in transverse and vertical directions. The zygoma is the most severely deformed anatomic facial structure in early infancy, in both positional relation and geometric shape in Apert's syndrome. This may develop as a 'bridge', influencing the structure, transmitting malformation stresses, caused by premature fused coronal and peri-zygomatic sutures, into facial structures and the maxilla.


Assuntos
Acrocefalossindactilia/complicações , Maxila , Zigoma , Adolescente , Estudos de Casos e Controles , Cefalometria , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Maxila/anormalidades , Maxila/diagnóstico por imagem , Nariz/anormalidades , Nariz/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem , Zigoma/anormalidades , Zigoma/diagnóstico por imagem
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