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Purpose: The nasal foramen is located in the nasal bone and for vessels passage to supply the nasal area. This project aimed to establish reliable references for the nasal foramina for future clinical applications. Methods: The 72 dried skulls, 46 from the Division of Anatomy, University of Phayao, Thailand, and 26 from the Tulane University School of Medicine, USA, were collected and examined. The location, number, and sizes of nasal foramina were noted. The distances from each nasal foramen to the internasal suture, frontonasal suture, nasomaxillary suture, nasion, and rhinion were also recorded and used in the statistical analytical programs. Results: The most common type of nasal foramen in all skulls was type II (one external opening) at 65.97%, followed by type I (no foramen opening) at 20.83%, type III (two external openings) at 11.11% and type IV at 2.08% (three external openings). Nasal foramen subtypes in many of the Thai and American skulls were type IIb and type IIa. The diameter of a connecting nasal foramen was significantly larger than that of a non-connecting. Results from embalmed confirmed the passage of the external nasal artery through the nasal cavity. Conclusion: The study shows no significant difference in nasal foramen morphometry between Thai and American. It illustrates recent data on type and subtype classifications and the location of a vascular passage through the nasal foramen. This is the first study of NF variations and their respective classifications. [ABSTRACT FROM AUTHOR]

To date South African forensic anthropologists are only able to successfully apply a metric approach to estimate population affinity when constructing a biological profile from skeletal remains. While a non-metric, or macromorphoscopic approach exists, limited research has been conducted to explore its use in a South African population. This study aimed to explore 17 cranial macromorphoscopic traits to develop improved methodology for the estimation of population affinity among black, white and coloured South Africans and for the method to be compliant with standards of best practice. The trait frequency distributions revealed substantial group variation and overlap, and not a single trait can be considered characteristic of any one population group. Kruskal-Wallis and Dunn's tests demonstrated significant population differences for 13 of the 17 traits. Random forest modelling was used to develop classification models to assess the reliability and accuracy of the traits in identifying population affinity. Overall, the model including all traits obtained a classification accuracy of 79% when assessing population affinity, which is comparable to current craniometric methods. The variable importance indicates that all the traits contributed some information to the model, with the inferior nasal margin, nasal bone contour, and nasal aperture shape ranked the most useful for classification. Thus, this study validates the use of macromorphoscopic traits in a South African sample, and the population-specific data from this study can potentially be incorporated into forensic casework and skeletal analyses in South Africa to improve population affinity estimates. [ABSTRACT FROM AUTHOR]

Introduction: The facial bones are prone to severe injuries due to high exposure and the labile nature of the bones, and they are injured in a significant proportion of trauma patients. Varying from simple, common nasal fractures to communited fractures of the face, management of such injuries can be extremely challenging due to fact that these injuries involve a highly vascular zone with proximity to the airway. In spite of being very well trained in surgeries of face and head neck area, with the exception of nasal bones, not many ENT surgeons in India perform facial bone fracture surgeries. Objective: This questionnaire-based study was planned to explore this key issue to understand as why many ENT surgeons do not perform facial trauma surgeries. Method: A cross-sectional questionnaire-based study was conducted over a period of 2 months Responses were obtained from ENT surgeons across various social groups on a Google Form-based questionnaire. The answers were collected and analysed. Result: A total of 240 valid responses were obtained. Most (56.7%) of the ENT surgeons had more than 15 years of practice. Around half (52%) of surgeons never did facial trauma surgery, and 65% of respondents replied that the main reason for their lack of involvement in facial trauma surgery was that they had no exposure to it during postgraduate training. The majority (65%) also wanted to enter this subspeciality if given a chance. Conclusion: To develop facial trauma management as a subspeciality in ENT, more and more ENT departments in medical colleges should include these surgeries as part of their training programmes. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Successful treatment by miniscrew‐assisted rapid expansion and clinical aligner therapy for an adult diagnosed with maxillary transverse deficiency (MTD) by clinical examinations and Yonsei transverse analysis. Adult orthodontic diagnosis and treatment with maxillary transverse deficiency (MTD) is challenging. Miniscrew‐assisted rapid palatal expansion (MARPE) is a fast and low‐risk method to expand the width of maxillary basal bone. This case report describes a 23‐year‐old female with mandible deviation and bilateral posterior teeth crossbite. She was diagnosed as MTD by the clinical examinations and Yonsei transverse analysis, and treated by the MARPE and clinical aligner therapy. After 26 months' treatment, cone‐beam computed tomography (CBCT) images showed that the width of maxillary basal bone increased by 3.8 mm, that of zygomatic arch and nasal bone increased by 1.0 and 1.9 mm, respectively, and the bilateral posterior teeth crossbite was corrected. Furthermore, the dental midline of lower arch was consistent with that of upper arch and face, the molars arrived Angle Class II and canines was Class I relationships, the profile was maintained, the facial asymmetry was improved. The results of seventeen‐month follow‐up showed that the effect of orthodontic treatment is very stable. This case report demonstrates that MARPE is the effective approach for patients with MTD and facial asymmetry, which provide the alternative for the treatment of similar cases. [ABSTRACT FROM AUTHOR]

This retrospective case study aimed to evaluate the efficacy of collagen matrix (DuraGen®) in preventing subcutaneous emphysema, a common complication following dorsal rhinotomy. Six client-owned dogs diagnosed with nasal masses using computed tomography were included in this study. Dorsal rhinotomy was performed, and a collagen matrix was used to seal bone defects before fixation of the nasal bone flap. Following collagen matrix application, all dogs recovered without notable complications. These findings suggest that the collagen matrix is a reliable and safe intervention for mitigating subcutaneous emphysema after dorsal rhinotomy. [ABSTRACT FROM AUTHOR]

Objective: To document the successful surgical reconstruction of a composite nasomaxillary and superior labial defect using a fascia lata graft, titanium mesh and angularis oris axial pattern flap in a dog. Case summary: An estimated 2-year-old female intact mixed-breed dog was presented with a composite (hard and soft tissue) nasomaxillary defect, suspected to be caused by a chemical burn. Physical examination revealed nasal discharge, exposed bilateral maxilla and nasal bone, nasomaxillary fistula with air movement, and intrinsic discoloration of the left maxillary canine tooth. The soft tissue lesion extended from the nasal planum rostrally to the medial canthus of the left eye distally and from the right maxillary bone to include a full thickness loss of the left maxillary labium laterally. Computed tomographic images of the head showed chronic osteomyelitis of the maxilla, zygomatic and nasal bones with nasomaxillary fistula and numerous exposed roots of the left maxillary premolars. Staged surgical procedures to address the dentition and nasomaxillary defect were planned. The first procedure consisted of the extraction of periodontally compromised left maxillary premolars, and standard root canal therapy of bilateral maxillary canine teeth. The second procedure consisted of debridement of the non-vital soft and hard tissues and surgical reconstruction of the nasomaxillary defect after virtual surgical planning. Head computed tomography performed 5 months post-operatively revealed a decrease in the size of the osseous defect as well as the resolution of rhinitis. Clinical relevance: This case demonstrates the feasibility of using a combination of soft tissue graft, titanium mesh, and axial pattern flap in managing nasomaxillary defects. Such defects can lead to chronic rhinitis, infection, discomfort, and long-term morbidity. This case report provides a novel but practical approach for managing defects in the nasomaxillary region in dogs. [ABSTRACT FROM AUTHOR]

Allergic Rhinitis (AR), a prevalent condition in otorhinolaryngology, is mediated by Type 1 hypersensitivity through IgE, characterized by Type 2 inflammatory response and eosinophil infiltration in the nasal mucosa. Since AR disease exhibits significant heterogeneity in symptom severity, an objective assessment of AR severity may facilitate better individualized treatment. To explore the changes in peripheral blood IL-9, Th9, and BAFF levels of allergic rhinitis (AR) in patients and the clinical significance associated with it. A retrospective study selected 80 AR patients admitted from January 2022 to October 2022 as the case group, dividing them into mild and moderate-to-severe groups based on symptom scores. Concurrently, 50 patients without AR, who were treated for nasal bone fractures or underwent septoplasty, were selected as the group for comparison. Alterations in the expression levels of peripheral blood IL-9, Th9, and BAFF were analyzed and compared among the different groups. The diagnostic value of serum BAFF for the severity of AR was analyzed using the receiver operating characteristic (ROC) curve. Noticeable variations were observed in clinical variables among the three groups such as, total IgE levels, peripheral blood eosinophil count and proportion, TNSS, and VAS (P< 0.05), while no statistically significant differences were observed in other variables (P> 0.05). The comparison of IL-9, Th9, and BAFF among the three groups revealed statistically significant differences (P< 0.05). Analysis using multivariate logistic regression revealed that IL-9 (OR = 2.365), Th9 (OR = 2.186), BAFF (OR = 2.307) were influencing factors of moderate-to-severe AR (P< 0.05). The ROC curve indicated that the AUC for the diagnosis of moderate-to-severe AR by IL-9, Th9, BAFF were 0.770, 0.734, 0.761, respectively, and the combined detection AUC was 0.888, an area under the curve higher than individual testing. Changes in peripheral blood IL-9, Th9, and BAFF levels in AR patients may function as indicators to assess the level of severity in diagnostic procedures. [ABSTRACT FROM AUTHOR]

Background Development of malocclusion can be promptly recognized through an understanding of the optimal position of the bone structures in the orofacial system and their relationship to the cranial base and jaw base. The aim of this study was to assess the relationship between the cranial base, mandible, and hyoid bone in different anteroposterior skeletal malocclusions. Materials and Methods This retrospective study evaluated 120 lateral cephalometric radiographs of individuals aged between 15 and 30 years. The subjects were classified using Burstone's analysis into three groups based on the N perpendicular to point A and N perpendicular to point B. The collected lateral cephalograms of the selected individuals were analyzed using Nemoceph v.12 software (Nemotec, Spain). The nasion-sella-articulare (NSAr), hyoidale angle (C3HyD), sella-articulare-hyoid angle (SArHy), and nasion-sella-hyoid (NSHy) angles were measured and compared among all the three groups. Results In the present study, considering the various angles among the three study groups, a statistically significant difference was observed for the SArHy angle (p < 0.05). However, the saddle angle (NSAr) and hyoidale angle (C3HyD) showed no statistically significant difference between the three study groups. Post hoc Bonferroni test was applied to compare the differences between two groups. A statistically significant difference (p < 0.05) was observed between class I and class II and between class II and class III groups. Conclusion Though the findings of the present study concluded that there is no variation in saddle angle among the three groups, the significant association of SArHy angle among class I, class II, and class III skeletal relationships, suggests an adaptation of the hyoid bone position in various skeletal patterns. We also suggest that the posterior positioning of the hyoid bone is related to skeletal class II malocclusion, whereas a forward positioning of the hyoid bone is related to skeletal class III malocclusion. [ABSTRACT FROM AUTHOR]

Objective: To explore the optimal reconstruction algorithm for volume rendering imaging (VR), improving the diagnostic efficacy of linear fractures of nasal bone area. Methods: Adult CT images of the nasal bone from August 2022 to August 2023 were retrospectively included, and 100 patients with linear fracture and 35 patients without fracture in the nasal region were randomly selected and underwent post-processing of VR with Smooth, Standard, Sharp, and Bone algorithms, respectively. Two radiologists scored the VR with and without fracture, the display of the nasal foramen, and the image quality in a double-blind method. The CT phantom was used for measuring the noise power spectrum (NPS), task transfer function (TTF) and detectability index \begin{document}$(d') $\end{document} of the CT images of different reconstruction algorithms using the same scanning protocol. Results: The diagnostic efficacy for linear nasal fractures varied between VR_Standard, VR_Sharp, and VR_Bone, with higher scores for the display of the nasal foramen in VR_Sharp than in VR_Standard and higher image quality scores in VR_Sharp than in VR_Standard and VR_Bone. As the sharpness of the reconstruction algorithm increased, the amount of noise and spatial resolution gradually increased. The NPSpeak and TTF50% for the Standard, Sharp, and Bone groups were (225.85 HU2·mm2, 0.42), (416.67 HU2·mm2, 0.53), and (1888.20 HU2·mm2, 0.8), respectively. The Sharp group had the highest \begin{document}$d' $\end{document} value when the diameter of the target to be measured was 1 mm. Conclusion: VR_Sharp has the best diagnostic efficacy for linear fractures in the nasal region, which better utilizes the value of VR in aiding diagnosis.

For surgical craniofacial reconstruction, preoperative planning may be limited by missing 3D skeletal geometry. In forensic sciences, 'reconstruction' models the 3D facial structure from skull geometries using soft-tissue depth mapping. This work investigates 'reverse engineering' the forensics' TD Morpheus model to infer the bony shape from 3D facial surfaces by subtracting tissue depths inwards along the normal vectors. This approach using Euclidean tissue depths successfully estimated the upper and outermost skeletal regions (i.e. frontal, zygoma, and nasal bones) in 24 head CT scans, but concave skeletal surfaces were inaccurately evaluated where the face is convex yielding misshapen anatomy around the orbits and zygomatic arches. A perpendicular tissue depth algorithm was developed to probe inwards along the face's normal vectors until contacting bone, demonstrating superior performance to the Euclidean depth approach. Accurate regional tissue depths achievable with this approach may provide a useful bridge to connect the 3D face and underlying skull geometry, with the potential for application in craniofacial reconstruction. [ABSTRACT FROM AUTHOR]

Fetal chromosomal abnormalities are the main cause of adverse pregnancy outcomes and are the focus of invasive prenatal diagnosis. Recent studies have demonstrated that various techniques have distinct advantages. Achieving high-resolution and effective prenatal chromosomal abnormality diagnosis requires a multi-technology integration strategy. Based on retrospective samples from a single center, we propose that integrating CNVseq and karyotype analysis is an effective strategy for prenatal diagnosis of chromosomal abnormalities. In this study, 13.80% of the pregnant women (347/2514) were found to have likely pathogenic or pathogenic fetal chromosomal abnormalities using this integrated approach. Among these cases, 53.89% (187/347) had consistent chromosomal abnormalities detected by both CNV-seq and karyotyping analysis, while 19.02% (66/347) and 27.09% (94/347) of cases were diagnosed solely by CNV-seq or karyotyping, respectively. Fetal chromosomal abnormalities were identified in 18.39% of samples with abnormal ultrasound, which was significantly higher than the percentage found in samples with normal ultrasound (p < 0.001). Samples with multiple ultrasound abnormalities and single-indicator ultrasound abnormalities such as nasal bone dysplasia, renal dysplasia, or echogenic fetal bowel also had higher rates of chromosomal abnormalities (p < 0.05) compared to normal samples. Analyzing samples with Trio family data (N = 521) revealed that about 94% of variants of uncertain significance were inherited from parents and were nonpathogenic. Overall, integrating CNV-seq and karyotype analysis is an effective strategy for prenatal diagnosis of chromosomal abnormalities. This study provides valuable insights for correlating prenatal screening indicators with chromosomal abnormalities. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the prevalence of submicroscopic chromosomal abnormalities found on single nucleotide polymorphism array (SNP array) in pregnancies with either an absent or hypoplastic nasal bone. Methods: This retrospective study included 333 fetuses with either nasal bone hypoplasia or absence identified on prenatal ultrasound. SNP array analysis and conventional karyotyping were performed in all the subjects. The prevalence of chromosomal abnormalities was adjusted for maternal age and other ultrasound findings. Fetuses with either an isolated nasal bone absence or hypoplasia, those that had additional soft ultrasound markers, and those where structural defects were found on ultrasound were divided into three groups: A, B, and C, respectively. Results: Among the total cohort of 333 fetuses, 76 (22.8%) had chromosomal abnormalities, including 47 cases of trisomy 21, 4 cases of trisomy 18, 5 cases of sex chromosome aneuploidy, and 20 cases of copy number variations of which 12 were pathogenic or likely pathogenic. The prevalence of chromosomal abnormalities in group A (n = 164), B (n = 79), and C (n = 90) was 8.5%, 29.1% and 43.3%, respectively. The incremental yields by SNP-array compared with karyotyping in group A, B, and C were 3.0%, 2.5% and 10.7%, respectively (p > 0.05). Compared to karyotype analysis, SNP array detected an additional 2 (1.2%), 1 (1.3%), and 5 (5.6%) pathogenic or likely pathogenic CNVs in groups A, B, and C, respectively. In the 333 fetuses, the prevalence of chromosomal abnormalities in women with advanced maternal age (AMA) was significantly higher than that in non-AMA women, (47.8% vs. 16.5%, p < 0.05). Conclusion: In addition to Down's syndrome, many other chromosomal abnormalities are present in fetuses with abnormal nasal bone. SNP array can improve the prevalence of chromosomal abnormalities associated with nasal bone abnormalities, especially in pregnancies with non-isolated nasal bone abnormalities and advanced maternal age. [ABSTRACT FROM AUTHOR]

Ultrasonography, a radiation-free and cost-effective modality, stands out as a promising tool for evaluating nasal bone fractures. Despite limited literature on its pediatric application, there is an increasing recognition of its potential to enhance diagnostic precision. To evaluate the diagnostic efficacy of ultrasound in detecting pediatric nasal bone fractures. Employing established guidelines, a systematic review and meta-analysis were conducted through a comprehensive literature search in PubMed, Scopus, Web of Science, and Embase databases until December 5, 2023. Inclusion criteria encompassed studies reporting diagnostic accuracy measures of ultrasound in pediatric patients with nasal bone fractures. Data extraction and analysis were undertaken for the selected studies. Involving four studies with 277 patients, ultrasound demonstrated a pooled sensitivity of 66.1% (95% CI: 35.1-87.5%) and specificity of 86.8% (95% CI: 80.1-91.4%) in diagnosing pediatric nasal fractures. The area under the receiver operating characteristic curve (AUC) was 0.88 (95% CI: 0.72–0.93). After excluding an outlier study, sensitivity and specificity increased to 78.0% (95% CI: 65.6-86.9%) and 87.8 (95% CI: 78.1-93.6%), respectively, with an AUC of 0.79 (95% CI: 0.75–0.94). Pooled positive and negative likelihood ratios were 5.11 (95% CI: 2.12–9.15) and 0.40 (95% CI: 0.14–0.77) before exclusion and 6.75 (95% CI: 3.47–12.30) and 0.26 (95% CI: 0.15–0.40) after exclusion of an outlier study, respectively. This study highlighted ultrasonography's utility in diagnosing pediatric nasal bone fractures with high accuracy and specificity. However, caution is advised in relying solely on ultrasound due to suboptimal overall diagnostic performance, evident in likelihood ratios. [ABSTRACT FROM AUTHOR]

Objectives: To describe findings from an otolaryngology-specific needs assessment tool in Zimbabwe. Methods: Surveys were developed and shared with Low-Middle Income Country (LMIC) hosting institutions in Zimbabwe and to High-Income Country surgical trip participants (HIC). Respondents were otolaryngologists identified online and through professional networks who had participated in a surgical trip. Results: The most common procedures Zimbabwe otolaryngologists reported treating were adenotonsillectomy (85.7%), chronic rhinosinusitis (71.4%), chronic otitis (57.1%), and head and neck tumor intervention (57.1%). The most common untreatable conditions that host physicians wanted to treat were skull base surgery (71.4%), flap reconstructions (57.1%), and laryngotracheal reconstruction (57.1%). The largest discrepancy between host desires and visiting team offerings were flap reconstruction (57.1%), nasal bone deformities (37.1%), and laryngotracheal reconstruction (17.1%). Perceptions of shortterm surgical trips (STST) were recorded for host and visiting teams, and important differences between the public and private sectors of care in Zimbabwe were also identified. Conclusion: The surveys utilized in this study served as a bidirectional needs assessment of the requirements and care goals of host institutions and visiting teams in Zimbabwe. Differences between public and private sectors of care, particularly regarding infrastructure, resources, and surgical goals, were revealed, and the results can be utilized as part of efforts to maximize efforts within global surgical partnerships. [ABSTRACT FROM AUTHOR]

Background: The oral and maxillofacial complex is subject to a range of traumas. Injuries to the region are devastating and have a great impact on social health outcomes. This review intends to investigate the aetiologies of maxillofacial trauma across Australia. Methods: This review was written in accordance with the PRISMA‐ScR. Comprehensive searches of CINAHL, MEDLINE, Ovid, Scopus, and Web of Science databases were conducted to identify potentially relevant literature. Quantitative observational epidemiological studies were sought and were required to include at least one aetiology to the maxillofacial region in their data set. A total of 31 eligible studies were included. Results: The greatest recorded causes of maxillofacial injuries included inter‐personal violence (34.98%) falls (20.87%), sports (15.62%), and motor‐vehicle accidents (14.31%). These four aetiologies cumulatively accounted for more than 85% of maxillofacial injuries. From all sustained injuries (n = 7661), the orbit was the most prevalent site of fracture (31.85%), followed by the zygoma (22.01%), mandible (21%), nasal bone (12.45%), maxilla (10.04%), dentoalveolus (1.84%), antrum (<1%), and frontal bone (<1%). Conclusion: Violence was an unprecedented cause of trauma—additional research is recommended to further characterize the correlation between the two variables. Research is also recommended specifically in regional/rural communities, where data was particularly limited. © 2024 Australian Dental Association. [ABSTRACT FROM AUTHOR]

The American Institute of Ultrasound in Medicine (AIUM) has released a revised practice parameter for conducting standard diagnostic obstetric ultrasound examinations. This parameter provides recommendations for healthcare professionals on how to perform high-quality ultrasounds during pregnancy. It covers various types of ultrasounds, including those done in the first trimester, second or third trimester, limited ultrasounds, and specialized ultrasounds. The parameter also outlines the qualifications and responsibilities of personnel involved in performing these examinations. It emphasizes the importance of proper documentation, the need for a valid medical reason to perform the ultrasound, and adherence to safety protocols. The guidelines were developed collaboratively by several professional organizations in the field. [Extracted from the article]

Background: Dentofacial malformation is a common condition that affects a significant portion of the population, resulting in functional and aesthetic defects. Orthognathic surgeries, such as LeFort I osteotomy, are performed to correct these abnormalities. However, the impact of these surgeries on nasal profile changes remains unclear. Additionally, the role of anterior nasal spine (ANS) reduction in maxillary advancement surgeries of 3–5 mm range is yet to be determined. This study aims to investigate the effect of ANS reduction on soft tissue profile changes following LeFort I osteotomy with a maxillary advancement range of 3–5 mm in class III skeletal patients. The hypothesis is that the changes in nasolabial angle and upper lip length will not significantly differ between patients who undergo LeFort I osteotomy with and without ANS reduction. Method and design: This study is designed as a randomized controlled trial. A total of 26 class III skeletal patients with maxillofacial abnormalities will be recruited from the maxillofacial clinic of Bu-Ali and Farahikhtegan Hospitals in Tehran, Iran. Patients meeting the inclusion criteria will be randomly assigned to two groups: one group will undergo LeFort I osteotomy with ANS reduction, and the other group will undergo LeFort I osteotomy without ANS reduction. The soft tissue profile changes, specifically the nasolabial angle and upper lip length, will be evaluated and compared between the two groups. Discussion: Achieving facial harmony through orthognathic surgery requires careful planning and consideration of the impact on surrounding soft tissue. The primary objective is to predict and plan for the effects on the nasolabial region. LeFort I osteotomy is a common procedure used to correct dentofacial deformities, particularly in class III patients. Maxillary advancement during this surgery can lead to changes in nasal tip position, width, and rotation, potentially due to repositioning of the anterior nasal spine and soft tissue dissection. In this study, soft tissue changes will be assessed in non-growing class III patients using cephalometric radiographs. The impact of reducing the anterior nasal spine (ANS) on nasal profile changes will be investigated for maxillary advancements of 3–5 mm. Objective measurements and patient-reported outcomes will be evaluated to gain insights into the aesthetic outcomes of orthognathic surgery. The findings will provide valuable guidance for treatment decisions and alternative options based on expected nasal profile changes. Trial registration: This project was registered at The Iranian Registry of Clinical Trials (Identifier No. IRCT20210928052625N1, Website: https://www.irct.ir/trial/59171) and Open Science Framework (OSF) (Registration https://doi.org/10.17605/OSF.IO/X3HD4). 2021-06-09. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D) anatomical extraction techniques could help the forensic anthropologist in a precise and inclusive assessment of biological phenotypes for the development of facial reconstruction methods. In this research, the nose morphology and the underlying hard tissue of two South African populations were studied. To this end, a 3D computer-assisted approach based on an automated landmarking workflow was used to generate relevant 3D anatomical components, and shape discrepancies were investigated using a data set of 200 cone-beam computer tomography (CBCT) scans. The anatomical landmarks were placed on the external nose and the mid-facial skeleton (the nasal bones, the anterior nasal aperture, the zygoma, and the maxilla). Shape differences related to population affinity, sex, age, and size were statistically evaluated and visualised using geometric morphometric methods. Population affinity, sexual dimorphism, age, and size affect the nasal complex morphology. Shape variation in the mid-facial region was significantly influenced by population affinity, emphasising that shape variability was specific to the two population groups, along with the expression of sexual dimorphism and the effect of ageing. In addition, nasal complex shape and correlations vary greatly between white and black South Africans, highlighting a need for reliable population-specific 3D statistical nose prediction algorithms. Significance: • 3D anatomical structures were acquired and extracted from 200 CBCT scans of modern South Africans. • Geometric morphometric methods were applied. • Soft- and hard-tissue nasal complex morphology vary across South African groups. [ABSTRACT FROM AUTHOR]

Trisomy 13 syndrome is a lethal chromosomal disorder characterized by severe congenital anomalies. We report a case of trisomy 13 syndrome with semilobar holoprosencephaly, cyclopia, proboscis, omphalocele, and an absent nasal bone, prenatally diagnosed by first‑trimester ultrasonography. The diagnosis was confirmed by chromosomal analysis. The pregnancy was eventually terminated at 14 weeks of gestation. The poor prognosis of trisomy 13 syndrome and holoprosencephaly prompts the demand for early prenatal diagnosis. We present this case to introduce some of the typical features of semilobar holoprosencephaly, including an anteriorly fused ventricle with partially fused thalami and absent falx, and to sensitize physicians to similar sonographic findings in the future. [ABSTRACT FROM AUTHOR]

Aim: In this study, we compared the ratio of second trimester fetal biometric measurements to nasal bone length (NBL) in fetuses with normal karyotype and trisomy 21 to determine their diagnostic prognostic value. Materials and Methods: The study included 148 pregnant women who obtained second‐trimester ultrasonographic fetal anatomy and had amniocentesis (AS) for fetal karyotyping. The fetal karyotype results divided the groups into normal and trisomy 21 fetuses. Age, obstetric history, first and/or second trimester screening test risk ratios, fetal biometric measurements, and NBL mm, median (MoM) multiples, and percentile values were recorded and compared between groups. Results: BPD/NBL ratios above 9.26 predict trisomy 21 in fetuses with 77.6% sensitivity and 86.1% specificity (p = 0.001). HC/NBL ratios above 34.50 predict trisomy 21 in fetuses with 77.8% sensitivity and 88.8% specificity (p = 0.001). FL/NBL ratios above 6.02 predict trisomy 21 in fetuses with 69.6% sensitivity and 72.2% specificity (p = 0.001). HL/NB ratios above 6.56 predict trisomy 21 in fetuses with 95.5% sensitivity and 47.2% specificity (p = 0.001). The NBL MoM value demonstrated a high diagnostic accuracy for normal‐karyotype fetuses (p = 0.021). Conclusion: We found that BPD/NBL, HC/NBL, FL/NBL, and HL/NBL ratios differed between fetuses with a normal karyotype and those with trisomy 21, specifically the HC/NBL ratio, which predicted trisomy 21 with good diagnostic accuracy. In identifying normal‐karyotype fetuses, the NBL MoM was highly accurate. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to estimate the incidence of posterior fossa anomalies (PFA) and assess the associated outcomes in King Abdulaziz Medical City (KAMC), Riyadh. All fetuses diagnosed by prenatal ultrasound with PFA from 2017 to 2021 in KAMC were analyzed retrospectively. PFA included Dandy–Walker malformation (DWM), mega cisterna magna (MCM), Blake's pouch cyst (BPC), and isolated vermian hypoplasia (VH). The 65 cases of PFA were 41.5% DWM, 46.2% MCM, 10.8% VH, and 1.5% BPC. The annual incidence rates were 2.48, 2.64, 4.41, 8.75, and 1.71 per 1000 anatomy scans for 2017, 2018, 2019, 2020, and 2021, respectively. Infants with DWM appeared to have a higher proportion of associated central nervous system (CNS) abnormalities (70.4% vs. 39.5%; p-value = 0.014) and seizures than others (45% vs. 17.9%; p-value = 0.041). Ten patients with abnormal genetic testing showed a single gene mutation causing CNS abnormalities, including a pathogenic variant in MPL, C5orf42, ISPD, PDHA1, PNPLA8, JAM3, COL18A1, and a variant of uncertain significance in the PNPLA8 gene. Our result showed that the most common PFA is DWM and MCM. The autosomal recessive pathogenic mutation is the major cause of genetic disease in Saudi patients diagnosed with PFA. [ABSTRACT FROM AUTHOR]

Background/Aim: This study aimed to assess the incidence and pattern of maxillofacial fractures and related demographic data in the victims of rollover crashes. Patients and Methods: This retrospective study was based on medical records of patients who sustained maxillofacial injuries following rollover accidents. Investigated data included age, gender, accident date and time, accident cause, seat belt usage, airbag deployment, road type, anatomical location of the facial fracture, and treatment approach. Results: Among the 147 patients who met the inclusion criteria, the most prevalent age groups were 20–30 (36.7%) and 30–40 (32.7%) years, with a mean age of 33.6 ± 9.7 years. The male‐to‐female ratio was 6:1. Most crashes occurred in March, August, and July. These accidents involved 69.4% light vehicles and 39.6% heavy vehicles. The leading causes of rollover crashes were speeding (58.5%) followed by distracted driving (21.1%) and traffic rule violations (13.6%). The most prevalent injuries were fractures of the maxillary sinus wall (40.8%), nasal bones (39.5%), zygomaticomaxillary complex (36.1%), and the mandible (32.6%). Surgical intervention was necessary for 44.2% of patients, while 12.9% of cases underwent close reduction, and 42.9% did not require any surgical intervention. The occurrence of nasal bone fractures was significantly lower in cases where seat belts were worn and zygomatic arch fractures were less frequent in incidents with airbag deployment. Conclusions: In rollover crashes, the midface is the most vulnerable anatomical location. Utilization of seat belts and airbag deployment has the potential to prevent nasal bone and zygomatic arch fractures. [ABSTRACT FROM AUTHOR]

La tuberculosis aún es un problema de salud pública mundial. La infección causada por Mycobacterium tuberculosis se manifiesta de forma principal a nivel pulmonar. Sin embargo, alrededor del 20 % de los casos se presentan en otras localizaciones anatómicas y solo el 2 % tiene afectación del tracto respiratorio superior. Se presenta el caso de una mujer de 75 años, reconsultante al servicio de otorrinolaringología por epistaxis, lesiones postillosas en cavidad nasal y hallazgo de masa nasal. Posterior a la resección quirúrgica de la lesión, se logró la comprobación microbiológica de infección por M. tuberculosis. Se realizan estudios para descartar compromiso pulmonar y de otras localizaciones. Posterior al inicio de tratamiento antituberculoso se logró resolución completa de la lesión y no recurrencia de los síntomas. Las formas extrapulmonares de la infección por M. tuberculosis y, en especial las que afectan la región de la cabeza y el cuello, requieren un alto índice de sospecha para su diagnóstico. Los métodos de diagnóstico como la prueba de PCR y los cultivos de tejidos permiten un óptimo inicio del manejo médico de acuerdo con la epidemiología local y las condiciones del paciente.

Background: Pathogenic (P) copy number variants (CNVs) may be associated with second-trimester ultrasound soft markers (USMs), and noninvasive prenatal screening (NIPS) can enable interrogate the entire fetal genome to screening of fetal CNVs. This study evaluated the clinical application of NIPS for detecting CNVs among fetuses with USMs in pregnant women not of advanced maternal age (AMA). Results: Fetal aneuploidies and CNVs were identified in 6647 pregnant women using the Berry Genomics NIPS algorithm.Those with positive NIPS results underwent amniocentesis for prenatal diagnosis. The NIPS and prenatal diagnosis results were analyzed and compared among different USMs. A total of 96 pregnancies were scored positive for fetal chromosome anomalies, comprising 37 aneuploidies and 59 CNVs. Positive predictive values (PPVs) for trisomy 21, trisomy 18, trisomy 13, and sex chromosome aneuploidies were 66.67%, 80.00%, 0%, and 30.43%, respectively. NIPS sensitivity for aneuploidies was 100%. For CNVs, the PPVs were calculated as 35.59% and false positive rate of 0.57%. There were six P CNVs, two successfully identified by NIPS and four missed, of which three were below the NIPS resolution limit and one false negative. The incidence of aneuploidies was significantly higher in fetuses with absent or hypoplastic nasal bone, while that of P CNVs was significantly higher in fetuses with aberrant right subclavian artery (ARSA), compared with other groups. Conclusions: NIPS yielded a moderate PPV for CNVs in non-AMA pregnant women with fetal USM. However, NIPS showed limited ability in identifying P CNVs. Positive NIPS results for CNVs emphasize the need for further prenatal diagnosis. We do not recommend the use of NIPS for CNVs screening in non-AMA pregnant women with fetal USM, especially in fetuses with ARSA. [ABSTRACT FROM AUTHOR]

To compare the pain scores in closed reduction of nasal bone fractures under local anaesthesia (LA) and general anaesthesia (GA), and to outline the blocks that should be used for the same based on their nerve supply. A prospective study was conducted with 40 patients with Class 1 and 2 nasal bone and septal fracture. 20 patients underwent the procedure under LA and 20 under GA. The local blocks that should be used based on the complete nerve supply of the nose has been tabulated. Pain scores were recorded immediately after the procedure and 6 h later. Additionally, all the patients undergoing reduction under LA were asked, if given the choice again, if they would prefer to undergo the procedure under LA or GA. The overall difference in the pain scores calculated by T-test showed a p-value of 0.08807 (the result was not significant at p <.05) in the immediate post operative period. At the 6 h post operative period, overall difference in the pain scores showed a p-value of 0.384972 (not significant at p <.05). Of the patients who underwent the procedure under LA, 18 of 20 (90%) said that if given a choice again, they would undergo the procedure under LA, while 2 said they would prefer GA. Based on the pain score in the La vs. GA groups, there is no significant difference in the pain scores whether closed reduction is done under local or general anaesthesia. If all the blocks are given keeping the nerve supplies in mind, and both externally, and with pledgets, the entire nerve supply of the nose can be blocked. [ABSTRACT FROM AUTHOR]

Among many contributions to the world of art and science, Renaissance artist Leonardo da Vinci created the technique known as sfumato. In this technique, da Vinci considered that the regions to be highlighted should be lit up, while the regions to be hidden should be darkened. Drawing parallel with the face, we can work on the anatomical structures underlying the skin and create a favorable surface anatomy for the entire face, including the nose. However, to achieve the ideal hourglass shape of the nose, the bones must be shaped, and a variety of osteotomies are described and used to achieve this. The new and innovative Fish Bone technique, described in this article, allows for the bony nasal pyramid to be shaped and adapted to the hourglass shape, resulting in a harmonious contour, with smooth transitions and preservation airway. [ABSTRACT FROM AUTHOR]

This study aims to identify the epidemiology and effects of facial fractures on return to play (RTP) in Major League Soccer (MLS) and the English Premier League (EPL). A total of 39 MLS players and 40 EPL players who sustained facial fractures from 2007 to 2019 were identified. Data on player demographics, the injury, and the impact of their injury on RTP were collected. Elbow-to-head was the most common mechanism of injury (20.3%). The most common fracture involved the nasal bone (48.3%). Most players (90%) RTP the same season. Players who sustained nasal fractures missed significantly fewer games (p < 0.001) than those who suffered other craniofacial fractures. Players treated surgically missed significantly more games (3.21 vs. 0.71, p = 0.006) and days (30.1 vs. 8.70, p = 0.002) than those managed nonoperatively. Significantly more EPL players who sustained facial fractures wore headgear upon RTP compared to MLS players (82% vs. 56%, p <0.01). Most professional soccer players who sustain a facial fracture RTP the same season, but their recovery time can vary depending on the type of fracture, injury management, or injury severity. Our findings can help inform future craniofacial injury management as well as guidelines on player safety and fracture prevention. [ABSTRACT FROM AUTHOR]

This article discusses the use of a novel nasoseptal mucosal flap for the reconstruction of skull base and oropharyngeal defects. The traditional nasoseptal flap design may not be sufficient for large defects, so modified designs have been proposed. The study measured the dimensions of the standard and novel flap designs using computed tomography scans and found that the novel flap had a significantly larger usable area and increased length compared to the standard flap. The authors conclude that the novel nasoseptal flap is a viable option for reconstructing skull base and oropharyngeal defects. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, explores a novel approach called contralateral nasofrontal trephination (CNT) for accessing the petrous apex (PA) during surgery. The study conducted experiments on cadaveric heads to evaluate the feasibility and anatomical aspects of this approach. The results showed that the CNT portal reduced the distance to the target PA and increased the angle between instruments, providing a greater area of surgical freedom compared to traditional approaches. However, it is important to note that this study was conducted on cadavers and further research is needed to determine the clinical applicability of the CNT approach. [Extracted from the article]

Few existing reports have investigated the copy number variants (CNVs) in fetuses with central nervous system (CNS) anomalies. To gain further insights into the genotype–phenotype relationship, we conducted chromosomal microarray analysis (CMA) to reveal the pathogenic CNVs (pCNVs) that were associated with fetal CNS anomalies. We enrolled 5,460 pregnant women with different high-risk factors who had undergone CMA. Among them, 57 subjects with fetal CNS anomalies were recruited. Of the subjects with fetal CNS anomalies, 23 were given amniocentesis, which involved karyotype analysis and CMA to detect chromosomal abnormalities. The other 34 cases only underwent CMA detection using fetal abortive tissue. In this study, we identified five cases of chromosome aneuploid and nine cases of pCNVs in the fetuses, with a chromosomal aberration detection rate of 24.56% (14/57). In the 23 cases that were given both karyotype and CMA analysis, one case with trisomy 18 was detected by karyotyping. Moreover, CMA revealed a further three cases of pCNVs, including the 1p36.33p36.31, 7q11.23, and 1q21.1q21.2 microdeletions, with a 13.04% (3/23) increase in CMA yield over the karyotype analysis. Additionally, three cases of trisomy 13, one case of trisomy 21, and six cases of pCNVs were detected in the other 34 fetuses where only CMA was performed. Furthermore, a higher chromosomal aberration detection rate was observed in the extra CNS anomaly group than in the isolated CNS anomaly group (40.91% vs 14.29%). In conclude, several pathogenic CNVs were identified in the fetuses with CNS anomalies using CMA. Among the detected CNVs, ZIC2, GNB1, and NSUN5 may be the candidate genes that responsible for fetal CNS anomalies. Our findings provides an additional reference for genetic counseling regarding fetal CNS anomalies and offers further insight into the genotype–phenotype relationship. [ABSTRACT FROM AUTHOR]

Background: Epiphyseal, Vertebral, Ear, and Nose (EVEN)‐PLUS syndrome is a rare condition characterized by the involvement of the Epiphyses, Vertebrae, Ears, and Nose, plus other associated findings, due to pathogenic variants in the HSPA9 gene. Due to the sparse number of patients, the clinical phenotypic spectrum is not clear. Methods: We report two patients with pathogenic HSPA9 variants from a Chinese family. Besides the core clinical features of EVEN‐PLUS syndrome, the two cases had seizures, developmental delay, and basal ganglia lesions in cerebral MRI. We also reviewed the previously published reports of patients with biallelic pathogenic HSPA9 variants. Results: Together with the presented cases, 12 cases (9 females) were identified from 6 relevant research items for analysis. All patients had synophrys or arched eyebrows, hypoplastic or dysplastic ears, hypoplastic nasal bone, and dysplastic femoral head. Other specific craniofacial features (such as triangular nares), abnormal skeletal presentations (such as bifid femur, dysplastic epiphyses at the knee, dysplastic acetabula, delayed ossification, short stature, vertebral clefting, scoliosis, and dislocated patellae), congenital heart defects, and renal alterations are common clinical features. Two patients had seizures and basal ganglia lesions in cerebral MRI. Infrequent features, such as aplasia cutis, short thorax and sternum, and widely spaced nipples, are also observed in the syndrome. Thirteen variants associated with EVEN‐PLUS syndrome have been reported. Conclusions: HSPA9 gene mutations should be suspected in all cases with specific craniofacial features, abnormal skeletal presentations, congenital heart defects, and renal alterations. Seizures and basal ganglia lesions are a new phenotype of EVEN‐PLUS syndrome. [ABSTRACT FROM AUTHOR]

Objective: To determine the outcomes of early versus delayed reduction of nasal bone fractures in terms of patient satisfaction and postoperative pain. Study Design: Comparative study. Study Setting & Duration: Department of Otorhinolaryngology, at Rawalpindi Teaching Hospital, Rawalpindi. The duration of the study was 6 months after approval by the Ethical Committee from February 2023 to July 2023. Materials and Methods: A total of 96 patients were selected. The study participants were individuals who, according to operational definitions, had nasal bone fractures and presented for evaluation at the Department of Otorhinolaryngology, Head & Neck Surgery at Rawalpindi Teaching Hospital, Rawalpindi. Patients were divided into two groups. Patients who underwent early reduction (within 2 weeks of trauma) were included in Group A while those who underwent delayed reduction (more than 2 weeks) were included in Group B. They also met all inclusion and exclusion criteria requirements and these requirements were strictly adhered to to control confounders and bias. Patients were chosen via a series of nonprobability sampling. SPSS 28 was used to determine the frequencies in the data. Results: A total of 96 patients were included in this study. Out of which 52(54.17 %) were males and 44(45.8 %) were females. Patients who underwent early reduction had higher mean satisfaction scores on the seventh and fourteenth postoperative day (4.22 ± 0.75 and 4.60 ± 0.49 respectively) than those who underwent Delayed reduction (2.41± 0.82 and 2.93 ± 0.80 respectively). Patients who underwent early reduction had a better mean Pain Intensity score at 0(2.37 ± 0.81)3rd (1.37 ± 0.81), and 7th-day (0.58 ± 0.49) than the Delayed reduction, at 0(5.83 ± 1.20), 3rd (5.08 ± 0.67), and 7th-day (4.31 ± 0.58). Patient discomfort was more intense in the delayed reduction group than in the early reduction group. Early reduction led to higher patient satisfaction and a better mean pain intensity score. Conclusion: The results of nasal fractures between the early and delayed reduction groups did differ statistically significantly. Early reduction decreased pain intensity and increased patient satisfaction. [ABSTRACT FROM AUTHOR]

Tuberculosis is still a global public health burden. Infection caused by the bacillus Mycobacterium tuberculosis (M. Tuberculosis) manifests mainly in the lungs. However, around 20 % of cases occur in other anatomical locations and only 2 % have upper respiratory tract involvement. We present the case of a 75-year-old female patient, who returned to the otorhinolaryngology service due to epistaxis and postillomous lesions in the nasal cavity with a finding of a nasal mass. After surgical resection of the lesion, microbiological confirmation of M. tuberculosis infection is achieved. Studies are performed to rule-out lung involvement, as well as other locations. After the initiation of tuberculosis treatment, complete resolution of the lesion and no recurrence of symptoms is documented. Extrapulmonary forms of M. tuberculosis infection, and especially those involving the head and neck region, require a high index of suspicion for their diagnosis. Diagnostic methods such as PCR testing and tissue cultures allow optimal initiation of medical management according to local epidemiology and patient conditions. [ABSTRACT FROM AUTHOR]

A 5 yr old castrated male domestic longhair was examined because of left-sided facial swelling and epistaxis. Head computed tomography with contrast identified a mass within the left nasal cavity and multifocal regions of nasal bone osteolysis. Histopathology of nasal mass biopsies and cytology of the facial swelling revealed pyogranulomatous inflammation due to Blastomyces dermatitidis. The cat experienced resolution of clinical signs following 8 mo of treatment with itraconazole. Although rare, clinicians should include blastomycosis on the differential diagnoses list of infectious causes for feline nasal disease if within an endemic area. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Veterinaria Brasilica is the property of Acta Veterinaria Brasilica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Augmentation rhinoplasty sometimes is required for patients with saddle nose deformity caused by failed rhinoplasty or facial trauma; finding appropriate grafting material remains a significant problem for this procedure. We investigated hyaluronic acid matrix as an allograft for dorsal augmentation rhinoplasty in a rabbit model. We performed an osteotomy on the nasal bones of eight rabbits. Four animals were sham operated as the control group and four were administered a mixture of saline-gelled hyaluronic acid matrix and sliced cartilage. Ultrasonography and three-dimensional reconstruction tomography were performed at the end of the experimental period. After sacrifice of the animals, nasal tissues were examined for histopathology, and both collagen scores and number of capillaries were compared between the two groups. Increased collagen and capillaries were apparent in the hyaluronic acid matrix group compared to controls. The median collagen score was significantly greater for the hyaluronic acid matrix group than for the control group. Although the number of capillaries for the hyaluronic acid matrix group was greater than for the control group, the difference was not statistically significant. Three weeks is sufficient for adhesion of ends of fractures in clinical practice; however, we found no ossification at this time in either group. A hyaluronic acid matrix may be a useful alternative supplement for dorsal augmentation rhinoplasty. Development of collagen was commensurate with membranous ossification; however, assessment of complete ossification requires a longer experimental period. [ABSTRACT FROM AUTHOR]

Cleft palate and lip develop as a result of any disruption in the formation of palate and lip during the first 12 weeks of embryonic development. Besides the heredity, there also are cases suggesting that this deformation was caused by the problems, which the mother has experienced during the pregnancy period. In addition to the nutritional problems, this defect causes many other problems such as dental problems and infectious and psychological disorders. This defect is not a very commonly observed palaeopathological finding in studies carried out on archeological human skeletal remains. Cleft palate and lip were detected on the skull of a male constituting the study material, which was labeled with the number 1178 and dated to the Ottoman period. In literature, the first cleft palate and lip found in Anatolian archeological human skeletal remains were found in this individual. Computed Tomography (CT) images were taken for the skull, on which cleft palate and lip were found, and the analyses were conducted by obtaining the 3D image by making use of a 3D laser scanner. For the control group consisting of 20 individuals from the same community, 22 metric measurements were performed on the skulls by making use of the Materialise MiniMagics software. In this individual, nasal septum deviation has developed because of the effects of cleft palate and lip defects. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the outcomes of closed reduction of different types of nasal bone fractures depending on time between onset of injury and reduction and comparing the outcomes of early closed reduction (within 6 h) of nasal bone fracture with late closed reduction (after 2 weeks). A hospital based Prospective cohort type of study was conducted among cases of nasal bone fracture attending the outpatient department of Otorhinolaryngology at Chettinad Hospital and Research Institute, Chennai during the months of August 2021 to January 2022. A total of 54 participants were included in the study. Primary outcome was to assess the effectiveness of closed reduction of different types of nasal bone fractures postoperatively. The second objective was to compare the outcomes of early closed reduction (within 6 h) of nasal bone fracture with late closed reduction (after 2 weeks). Using chi square test, the association of factors such as age, sex, mode of injury, external framework deformity, type of fracture and treatment was analyzed with outcome measures such as post op degree of deviation, arch irregularity, malalignment, bony irregularity, bony displacement, olfactory disturbances and result. We analyzed the sample data statistically and measured the outcomes which showed that post operatively after undergoing closed reduction, some degree of deviation was present in 17(31.48./.), arch irregularity present in 12(22.2./.), malalignment in 11(20.37./.), bony irregularity in 24(44.44./.), bony displacement in 19(35.19./.), olfactory disturbances in 2(3.70./.). Comparing the outcome factors between early and late reduction, we found that the outcome was better in early closed reduction when compared with late closed reduction. Among the 54 patients studied, the results of closed reduction were found to be excellent in 27(50./.), Fair in 16(29.63./.), Good in 10(18.52./.) and poor in 1(1.85./.) We could thus conclude from this study that early closed reduction of nasal bone fracture gave better results than a late closed reduction in terms of post operative deformity, arch irregularity, malalignment, bony irregularity, bony displacement and olfactory disturbances. [ABSTRACT FROM AUTHOR]

Aims: To determine the best technique to repair anterior skull base defects using various grafts. Materials & Methods: This Ambi-directional cohort study was carried out at a tertiary care hospital from May 2019 to October 2021. A total of 17 patients who underwent Endoscopic Repair of Anterior Skull Base Defects using various grafts were included in the study. Detailed history and clinical evaluation followed by Diagnostic Nasal Endoscopy, Biochemical and Radiological investigations were done for all patients with postoperative follow-up for at least 6 months. Results: Most common site of anterior skull base defect in our study group was the posterior wall of the sphenoid sinus. Various graft materials used in our study were fascia lata, thigh fat, Hadad flap, Septal cartilage, nasal septal bone chip, septal mucosal free flap, surgicel and fibrin glue. The most commonly used sequence of graft materials used is the fat(underlay) - fascia lata - fat(overlay). Various complications that occurred were nasal bleeding, residual CSF leak, localized collection of pus in the Septal region, cerebral oedema and Alar trauma. Conclusions: The success of Anterior skull base defect repair depends on watertight Dural closure with multiple layers of grafts to prevent postoperative CSF leak. Although dependent on the Surgeon's preference, usually the sequence of an underlay fat - fascia lata - overlay fat followed by glue/gel foam/Hadad flap works well. Even after discharging the patient, regular follow-up and evaluation ensure that the graft is in situ and there is no CSF leak or other complication. [ABSTRACT FROM AUTHOR]

Background: The clinical characteristics of pediatric nasal fractures can vary depending on the child's age, social activities, and environment. Therefore, this study aimed to analyze these characteristics in different age groups. Methods: We retrospectively reviewed of a series of patients aged under 12 years who received treatment between 2013 and 2021. The initial study design involved dividing the patients into four age groups, corresponding to different developmental ages, but there were no cases in infants aged 0 to 1 year. Therefore, the patients were divided into three groups: group I, between 2 and 5; group II, between 6 and 9; and group III, between 10 and 12 years of age. The following parameters were evaluated: sex, age, etiology, fracture type and severity, and the incidence of septal injuries. Results: In total, 98 patients were included in this study. In group III, the ratio of boys to girls was 3.88:1, exceeding the overall ratio of 1.97:1. The most common cause varied with age: slipping down in group I, bumping accidents in group II, and sports accidents in group III. Concomitant septal injuries were present in 4.17% of patients in group I, 5.71% of patients in group II, and 28.21% of patients in group III. Conclusion: Increasing age was accompanied by a greater tendency for male predominance and a higher prevalence of sports-related causes and septal injuries. Violence was infrequent but started to become a contributing factor during school age. These varying environmental factors across age groups can offer valuable insights into the epidemiology and clinical characteristics of pediatric nasal bone fractures. [ABSTRACT FROM AUTHOR]

Treacher Collins syndrome (TCS) should be suspected if the triad of micrognathia, glossoptosis, and posterior cleft palate, and deformed external ears are observed during prenatal ultrasonography, excepting Pierre Robin sequence. Visualization of the fetal zygomatic bone and down‐slanting palpebral fissures are conducive to differentiation. Molecular genetics testing can establish a definite diagnosis. A 28‐year‐old pregnant Chinese woman was referred for systematic ultrasound examination at 24 weeks. Two‐dimensional and three‐dimensional ultrasound showed polyhydramnios, micrognathia, absence of nasal bone, microtia, secondary cleft palate, mandibular hypoplasia, glossoptosis, and normal limbs and vertebrae. Pierre Robin sequence was misdiagnosed with the triad of micrognathia, glossoptosis, and posterior cleft palate. Final diagnosis of TCS was confirmed by whole‐exome sequencing. Visualization of the fetal zygomatic bone and down‐slanting palpebral fissures can facilitate a differential diagnosis between Pierre Robin sequence and TCS, with the triad of micrognathia, glossoptosis, and posterior cleft palate. Synopsis: Ultrasonographic features of Treacher Collins syndrome include hypoplastic zygomatic bone, down‐slanting palpebral fissures, and the triad of micrognathia, glossoptosis, and posterior cleft palate. [ABSTRACT FROM AUTHOR]

Nasal bone fractures are the most common fractures of the facial skeleton and are often accompanied by bony, cartilaginous, and soft tissue injuries. These injuries are often complex, and when untreated or inadequately treated, can lead to posttraumatic nasal deformity. The most common deformities are the crooked nose and the saddle nose. Both deformities may result in significant cosmetic and functional concerns. The treatment of these deformities can be complex, requiring careful evaluation of the nose and thoughtful planning to correct the cosmetic deformity and restore functional integrity. The rhinoplasty surgeon will benefit from having a large repertoire of techniques to achieve these repairs. In this article, we discuss the options and concepts for the management of nasal bone fractures as well as complicated posttraumatic nasal deformity. Level of evidence is not available. [ABSTRACT FROM AUTHOR]

Nasal bone fracture is more common because it is a prominent structure on the face. It can occur as an isolated injury or in combination with other soft tissue and bony facial injuries. While isolated fractures are more common, they can also be associated with fractures of the zygomatic-orbital-maxillary complex and the skull base. Typically, nasal bone fractures are treated with closed reduction or open reduction and fixation. This involves internal fixation using nasal packing and external fixation using plaster splinting. However, in this technique, we utilised an internal teflon splint and an external thermoplastic splint for the fixation of comminuted nasal bone fractures. One advantage of this technique is that it keeps the nostrils open, allowing for unobstructed breathing. Additionally, the internal splint helps lift the nasal bone back into its anatomical position. The present case report presents the management of a 40-year-old male patient who sustained nasal and maxillary dentoalveolar fractures as a result of a road traffic accident. The fractures were further managed using intranasal teflon splints, an external thermoplastic splint, and Kirschner’s wires. This splint pattern prevents displacement and promotes healing in the desired alignment. This technique employs a logical tripod arrangement of a rigid support system that incorporates all these elements into one interconnected unit, providing support, stability, and tension for optimal results. It focuses on the keystone area of the nose, which requires the most support. [ABSTRACT FROM AUTHOR]

Calcifying odontogenic cysts (COCs) are rare developmental odontogenic cysts with characteristic "ghost" epithelial cells and a propensity to calcify. The COC can occur anywhere in the oral cavity, but the majority are found to affect the anterior jaws. In this case report, we aim to emphasize the transnasal vestibular endoscopic management of such a pathology with a resultant reduced surgical morbidity. [ABSTRACT FROM AUTHOR]

The correct reconstructive technique following dermoid cyst removal is critical for treatment and aesthetics. This article will discuss the management of nasal dermoid sinus cysts. A mixture of "Turkish-delight" crushed cartilage with Fibrin-based tissue adhesives and non-crushed septal cartilage was used for the primary reconstruction of the nasal dorsum. Nasal dermoid cysts: Nasal dermoid sinus cysts are rare midline abnormalities that can occur on the nasal dorsum, typically between the glabella and the columella. Surgical intervention is usually necessary to prevent complications and ensure complete removal of the cyst. Surgical approaches: Various surgical approaches can be used for the treatment of nasal dermoid cysts, including excision with primary closure, midline vertical incision, transverse incision, lateral rhinotomy, inverted-U incision, and external rhinoplasty. The choice of approach depends on factors such as the size, location, and extent of the cyst, as well as the patient's condition and the surgeon's preference. Importance of complete excision: Complete excision of nasal dermoid cysts is crucial to prevent complications such as recurrence, nasal deformity, infection, meningitis, and intracranial abscesses. Proper surgical management aims to remove the cyst and associated sinus tracts while restoring normal nasal anatomy and function. Surgical technique: In a case study involving a 73-year-old male patient with a nasal dermoid cyst, an inverted T-shaped incision was made on the nasal dorsum. The entire cystic mass was carefully removed along the midline, and any eroded nasal dorsum bones were drilled to create a single common cavity. The defect on the nasal dorsum was repaired using a combination of crushed septal cartilage mixed with Fibrin-based tissue adhesives and small cartilaginous palisade grafts for aesthetic reconstruction. Successful outcome: The patient underwent successful surgery with no recurrence observed during the one-year follow-up. The wound site healed completely, and the patient maintained a pleasing profile. This case highlights the effectiveness of the surgical technique in managing nasal dermoid cysts while minimizing defects and achieving aesthetic and functional outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVE- To study histopathological patterns of nasal cavity and paranasal sinuses lesions, to categorize them and to correlate them with age and gender and sociodemographic data. METHODOLOGY: Hospital based observational study was conducted in Department of Pathology,Dr. S.N. Medical College, Jodhpur on Paraffin block of cases that fulfilled the inclusion criteria. Patient name, age, gender, registration number, path number, type of biopsy specimen and its gross feature was noted. The specimens were received in 10% formalin along with requisition form which also included the clinical data. The material was processed as routine histopathological examination, special stains were done wherever required. RESULTS :-Total 74 cases were analyzed, and lesions were classified as neoplastic and non neoplastic (inflammatory) and neoplastic were further classified as benign and malignant. Tumor were of nasal cavity and paranasal sinus were classified according to WHO classification and observation compared with other studies. . Nasal cavity(61.18%) was more effected by non neoplastic and neoplastic lesions than paranasal sinus (38.82%), Nasal obstruction was the most common presenting symptoms followed by nasal masses. 71.19% of the cases showed a unilateral presentation as the most common side.Most common non neoplastic lesion was nasal polyp with 43 cases which includes 95.65% of all nasal masses. Nasal polyps were most common in the third decade of life and showed an M:F ratio of 1:1.03.Allergic polyp were much more common then non allergic polyp. The other nonneoplastic lesions also observed were Rhinoscleroma, Mucormycosis, tuberculosis, chronic rhinitis and chronic sinusitis in population.Most common benign neoplastic lesions were haemangioma with 4 cases which constituted 30.77% of all benign neoplastic lesions and showed a high incidence in the sixth decade of life with female predominance. . Most common malignant nasal mass is squamous cell carcinoma constituting 53.33% of all lesions. Out of 8 cases males were more commonly effected by malignant lesions in the fifth and sixth decade of life.Second most comman malignant lesion observed was basal cell carcinoma it was 40% of all malignant lesions commonly nodular type followed by nasopharyngeal carcinoma (6.67%) more common in fifth and sixth decade of life.DISCUSSION;- Most of the nasal cavity lesions present with non specific and overlapping symptoms. From the clinical and macroscopic examination it is difficult to comment on the nature of the lesion. A careful histopathological examination is needed for a definitive diagnosis. Sinonsal masses have various differential diagnosis. Malignant lesions should be distinguished from non malignant lesions. The objectives of this study was to study the histopathological patterns, proportion of various lesions in the nasal cavity and paranasal sinuses and to correlate histomorphological features with their clinical features CONCLUSION :-From this study it is quite evident that masses in the nasal cavity and paranasal sinuses form a complex and wide spectrum of lesions ranging from non-neoplastic lesions to benign and malignant neoplastic lesions. Non neoplastic lesions were more comman than neoplastic lesions Sinonasal polyps were the most common lesions in the present study,the age incidence ranges from 1st decade to 7th decade. There was slight female preponderance. Maximum number of non-neoplastic lesions were found in the third decade of life, benign and malignant neoplastic lesions were found in the fifth decade of life. Histopathological examination is very important in diagnosing the lesions. All the cases were classified according to WHO classification 2017. The age of incidence of nasal masses ranged from seven to eighty with an almost equal sex predilection and overlapping presentation. This may cause a diagnostic dilemma for the accurate and timely diagnosis and intervention which signifies the need of a more accurate diagnostic method.Features like nasal bone involvement, necrosis and epistaxis suggestive of malignancy were also seen in fungal infections like Mucormycosis and Aspergillosis. There were specimens with dual lesions which was almost impossible to diagnosed clinically. [ABSTRACT FROM AUTHOR]