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The article discusses a novel technique for cranial reconstruction in patients with invasive bone meningiomas using 68 Ga-DOTATATE PET/CT imaging and IPS CaseDesigner software to create customized 3D-printed artificial cranioplasties. Three patients with invasive bone meningiomas underwent this preoperative planning and reconstruction process successfully, resulting in appropriate cranial continuity and integrity postoperatively. The combination of imaging modalities and software demonstrated high sensitivity and specificity for detecting and planning the treatment of meningiomas involving bone, leading to successful outcomes for the patients involved. [Extracted from the article]

The article explores the use of contralateral nasofrontal trephination (CNT) and posterior palatectomy (PP) to enhance the inferior access provided by the endoscopic endonasal approach (EEA) to the craniovertebral junction (CVJ). Surgical dissections on cadaveric specimens showed that EEA combined with CNT or PP offered greater target exposure, surgical freedom, reach, and angles of attack compared to the traditional EEA corridor. The study suggests that EEA + CNT may be a superior technique for minimally invasive access to the CVJ region. [Extracted from the article]

Copyright of HNO is the property of Springer Nature 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.)

Fibrous dysplasia is an uncommon bone disorder affecting various parts of the skeleton, often affecting facial and cranial bones. In this case, a 10-year-old patient was diagnosed with fibrous dysplasia of the ethmoid sinus at an early age. The patient has experienced nasal congestion, snores, and worsening nasal patency since 2019. A CT scan revealed an expansive proliferative lesion, likely from the frontal or ethmoid bone, protruding into the nasal cavity, ethmoid sinus, and right orbit. The tumor causes bone defects in the area of the nasal bone, leading to fluid retention in the peripheral parts of the right maxillary sinus. The patient's parents decided not to undergo surgery to remove the diseased tissue and reconstruct the area, as it would be very extensive, risky, and disfiguring. The patient is being treated conservatively with an MRI, with a contrast performed approximately every six months and infusions of bisphosphonates. Despite the lesion's size, the patient does not experience pain characteristic of dysplasia, and functions typically. Fibrous dysplasia of bone is a rare condition that presents with the most visually apparent manifestations, often mistaken for other bone conditions. Advanced diagnostic tools, like CT and MRI, are used to identify conditions affecting the ethmoid sinus more frequently. However, diagnostic errors often occur in imaging studies, leading to confusion. The most common period for clinical manifestations and diagnosis is around 10 years of age. The preferred approach in managing fibrous dysplasia involves symptomatic treatment, which can alleviate airway obstruction, restore normal globe position and visual function, and address physical deformities. Surgical intervention is recommended only for patients with severe functional impairment, progressive deformities, or malignant transformation. [ABSTRACT FROM AUTHOR]

Congenital arhinia and hyporhinia are rare facial anomalies whose knowledge usually comes from case reports. The severity of each case described in literature is variable; it also depends on associated malformations too. Since the newborns are obligate nasal breathers, babies with arhinia or hyporhinia usually have respiratory distress and need airway stabilization. In addition, most of these children present difficulties in feeding and this impairment must be managed early. We describe an unusual case of partial congenital arhinia, the baby did not have other anomalies or any specific complication such as respiratory and feeding issues, so the major problem was the aesthetic and psychological issues for the family. Even if the neonatal course was uncomplicated, a coordinated approach of the pediatrician with the pediatric otolaryngologist, the geneticists and the neurosurgeons was necessary because the management of these malformations is always very complex; due to the lack of reports described in literature, an univocal management and also the best timing and technique for reconstructive surgery are still not defined. [ABSTRACT FROM AUTHOR]

Summary This report describes the application of a resorbable implant (Resorb‐Vet) made of poly‐(DL) lactide (PDLLA) for the repair of a maxillary fracture in one horse and a nasal bone fracture in another. The horses were positioned in lateral recumbency and the fracture was reduced. An absorbable plate was moulded to the bone and fixed with PDLLA pins, which were attached to an ultrasonic device and inserted into predrilled holes by ultrasonic vibrations. Once the pins contacted the bone, the ultrasonic vibrations caused liquefication of the PDLLA, which infiltrated the bone and solidified after the ultrasonic vibrations ceased. Immediate primary stability was achieved with this technique. Both horses recovered well, were discharged without complications and returned to their previous level of activity. [ABSTRACT FROM AUTHOR]

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]

Although embryological studies of squamates have a long history, most groups in this large clade remain poorly studied. One such group is the family Scincidae, which consists of morphologically and ecologically diverse lizards. In this study, we describe several stages of embryonic development based on cleared and stained specimens of Heremites auratus and Heremites vittatus. Our analysis indicates that the pterygoid and frontal are the first bones to be ossified at stage 34 in the skull of H. auratus. At stage 37, which was examined in both studied species, the ossified bones include the nasal, maxilla, parietal, prefrontal, premaxilla, postorbital, postfrontal, jugal, squamosal, quadrate, vomer, palatine and all mandible bones. In both species, the skull roof is relatively poorly ossified at stage 37. However, in H. auratus, the frontal and parietal bones ossify at their lateral edges at stage 37, while in H. vittatus, the frontal bones begin to ossify towards the midline. This suggests that ossification occurs later in H. auratus compared to H. vittatus, indicating a heterochronic pattern in ossification between these species. Additionally, pigmentation on the dorsal side of the body and scaling, which covered the entire body by stage 37 in H. vittatus, occur earlier compared to H. auratus. Compared to other scincid species, ossification in these lizards begins at a later stage but is completed earlier. [ABSTRACT FROM AUTHOR]

Yucatan miniature pigs, often used as large animal models in clinical research, are distinguished by a breed‐specific midfacial hypoplasia with anterior crossbite. Although this deformity can be corrected by distraction osteogenesis, a less invasive method is desirable. We chose a mechanical cyclic stimulation protocol that has been successful in enhancing sutural growth in small animals and in a pilot study on standard pigs. Yucatan minipigs (n = 14) were obtained in pairs, with one of each pair randomly assigned to sham or loaded groups. All animals had loading implants installed on the right nasal and frontal bones and received labels for cell proliferation and mineral apposition. After a week of healing and under anesthesia, experimental animals received cyclic tensile loads (2.5 Hz, 30 min) delivered to the right nasofrontal suture daily for 5 days. Sutural strains were recorded at the final session for experimental animals. Sham animals received the same treatment except without loading or strain gauge placement. In contrast to pilot results on standard pigs, the treatment did not produce the expected sutural widening and increased growth. Although sutures were not fused and strains were in the normal range, the targeted right nasofrontal suture was narrowed rather than widened, with no statistically significant changes in sutural cell proliferation, mineral apposition, or vascularity. In general, Yucatan minipig sutures were more vascular than those of standard pigs and also tended to have more proliferating cells. In conclusion, either because the sutures themselves are abnormal or because of growth restrictions elsewhere in the skull, this cyclic loading protocol was unable to produce the desired response of sutural widening and growth. This treatment, effective in normal animals, did not improve naturally occurring midfacial hypoplasia in Yucatan minipigs. [ABSTRACT FROM AUTHOR]

This study aimed to investigate nasal septum deviation (NSD), nasal bone length (NBL), and the morphology of the middle nasal conchae (MNC) and inferior nasal conchae (INC), as well as their correlations. The sample included 56 cone-beam computed tomography scans divided into two groups: a study group (SG; individuals with NF1; n = 28) and a control group (CG; individuals without NF1; n = 28). NSD, NBL, MNC, and INC classifications were assessed. MNC images were classified as normal, bullous, paradoxical, secondary, and accessory. INC images were classified as normal, lamellar, compact, combined, and bullous. Intra- and interobserver reliability were evaluated. SG had a mean NSD of 11.6° (±4.5°) compared with 9.6° (±3.2°) for the CG, showing moderate deviations with no significant difference between groups. SG had a mean NBL of 22.4 mm (±3.4 mm) compared with 22.1 mm (±3.2 mm) for the CG, with a statistically significant difference. Both groups exhibited normal, bullosa, and accessory MNC classifications. SG INC were normal, lamellar, and combined, whereas CG INC were normal and lamellar. There was a weak correlation between NSD and NBL across groups. Individuals with NF1 showed longer NBL. The weak correlation between NSD and NBL suggested multifactorial influences on these variations. These findings advance our understanding of craniofacial development in NF1 and highlight the need for further research into nasal cavity involvement in this complex genetic disorder. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective study. Objective: The Markowitz-Manson classification system categorizes nasoorbitoethmoid (NOE) fractures by severity of injury and remaining integrity of the medial canthal tendon. However, this system does not account for direction of bony displacement (in-fracture vs out-fracture), which can greatly affect symptomatology and management. We hypothesize that NOE fractures will present differently based upon their severity: Type I injuries are likely to present with medial nasal bone displacement (in-fracture), whereas Type III fractures will be more prone to lateral displacement (out-fracture). Methods: A retrospective review was performed for all patients with NOE fractures who were evaluated by the plastic surgery department at a level 1 trauma center over a 6-year period. Computed tomography data were evaluated to assess for directionality of fracture segment displacement. Frequencies of medial, lateral, and non-displacement across NOE types were compared by Chi-Squared Goodness of Fit and Fisher's Exact Tests. Results: 111 patients met inclusion criteria. The patient population was 73.9% male and averaged 51.2 years old. When bilateral fractures were counted independently, there were 141 cases in total: 115 Type I, 20 Type II, and 6 Type III. Type I fractures were most commonly in-fractured (48.7%), while Type III injuries were consistently out-fractured (100%) (p <.001). Conclusions: While Type II and III NOE fractures have dominated clinical focus, this study highlights the prevalence of impaction within Type I fractures. These findings advocate for a more comprehensive approach to the evaluation of Type I NOE fractures and their potential risks, including traumatic hypotelorism and nasal airway obstruction. [ABSTRACT FROM AUTHOR]

After nasal bone fractures, fractures of the mandible are the most frequently encountered injuries of the facial skeleton. Accurate identification of fracture locations is critical for effectively managing these injuries. To address this need, JawFracNet, an innovative artificial intelligence method, has been developed to enable automated detection of mandibular fractures in cone-beam computed tomography (CBCT) scans. JawFracNet employs a 3-stage neural network model that processes 3-dimensional patches from a CBCT scan. Stage 1 predicts a segmentation mask of the mandible in a patch, which is subsequently used in stage 2 to predict a segmentation of the fractures and in stage 3 to classify whether the patch contains any fracture. The final output of JawFracNet is the fracture segmentation of the entire scan, obtained by aggregating and unifying voxel-level and patch-level predictions. A total of 164 CBCT scans without mandibular fractures and 171 CBCT scans with mandibular fractures were included in this study. Evaluation of JawFracNet demonstrated a precision of 0.978 and a sensitivity of 0.956 in detecting mandibular fractures. The current study proposes the first benchmark for mandibular fracture detection in CBCT scans. Straightforward replication is promoted by publicly sharing the code and providing access to JawFracNet on grand-challenge.org. [ABSTRACT FROM AUTHOR]

Background and Objectives: Postoperative recovery from general anesthesia is a multidimensional process, and patient-centered outcome assessment should be considered an important indicator of recovery quality. This study compared the effectiveness of intraoperative lidocaine and magnesium on postoperative recovery in nasal bone fracture surgery, using the quality of recovery-40 questionnaire (QoR-40) to assess recovery quality and pain intensity. Materials and Methods: A total of 74 patients scheduled for elective closed reduction surgery for isolated nasal bone fracture were assigned to the intraoperative infusions of lidocaine or magnesium. Immediately after anesthetic induction, 1.5 mg/kg lidocaine or 20 mg/kg magnesium was administered over 10 min, followed by a continuous infusion of 2 mg/kg/h lidocaine or 20 mg/kg/h magnesium until the end of the surgery. The primary outcome variable was the QoR-40 survey on postoperative day 1. The secondary outcome variables included postoperative pain intensity, sedation score, the incidence of postoperative nausea and vomiting, and other side effects. Results: The global QoR-40 score at postoperatively 24 h was comparable between the intraoperative lidocaine and magnesium groups. Postoperative pain 30 min after surgery was significantly lower in the lidocaine group than in the magnesium group (p = 0.01), along with lower rescue analgesic consumption (p = 0.003), but pain intensity was not different at other time points (2, 6, and 24 h). The incidence of nausea and vomiting and the sedation score in the post-anesthetic care unit were not significantly different between the two groups. Conclusions: Intraoperative lidocaine and magnesium had no difference in the scores of postoperative QoR-40, but lidocaine was associated with lower postoperative pain scores and analgesic requirement in comparison to magnesium in the closed reduction of nasal bone fractures. [ABSTRACT FROM AUTHOR]

Background: In 2020, the coronavirus SARS-CoV-2 led to a pandemic that had a major impact on the global health care systems. The aim of this study was to analyze the impact of the Covid-19 pandemic on nasal bone (NB) fracture patterns/distributions and circumstances in a German cranio-maxillofacial trauma center. Materials and methods: This retrospective study compared the nasal fracture patterns of patients in the PreCovid (PC) era (February 2019 - January 2020) with patients in the IntraCovid (IC) era (February 2020 - January 2021). In addition to baseline characteristics, the type of NB fractures, the circumstances leading to NB fracture and hospital admissions/treatments were analyzed. Results: The present study showed a significant decrease in the total number of NB fractures during the Covid-19 pandemic. In the IC period, a significant increase in falls and virus-/flu associated syncopes leading to NB fractures was detected. At the same time, a significant decrease in sports accidents, road traffic accidents and interpersonal violence leading to NB fractures was observed in the IC period. Under the influence of the Covid-19 pandemic, a significant increase in accidents at home, accidents during the weekdays and closed reductions under local anesthesia was detected when being compared to the PC period. The daytime of trauma leading to NB fractures also changed significantly from night-time (PC) to morning-time (IC). Conclusion: The Covid-19 pandemic had a significant impact on the NB fracture circumstances and treatment modalities. Therefore, the results of this study can serve as a baseline for further studies of the impact of the Covid-19 pandemic on NB fracture patterns among different countries. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to evaluate the etiology, incidence, demographics, and characteristics of maxillofacial fractures treated at a university hospital over a seven-year period. Methods: We performed a retrospective analysis of 1,757 patients with maxillofacial fractures who were referred to our department between May 2012 and March 2019. The patients' demographic and clinical characteristics were noted, as well as the fracture type, location, and etiology. The treatment modalities were also analyzed. Results: A total of 2,173 maxillofacial fractures were seen in 1,757 patients. The male to female ratio was 3.9:1, and the mean patient age was 31.89 ± 17.70 years (range: 0–95 years). Maxillofacial injuries were most prevalent in the 19–28 years age group (23.9% of cases), with a general increase in injuries observed between 2013 and 2018 across all age groups. The most common etiological factor was assault (29.1%), followed by falls (26%). In male patients, assault was reported as the main cause, while in female patients, falls were identified as the main cause. The nasal bone was the most common site of fracture, followed by the maxilla. The average time from admission to surgery was 2.8 days, with local anesthesia being the most frequent surgical intervention. The average time from admission to surgery was 2.8 ± 2.5 days (range: 0–20 days), with surgeries performed under local anesthesia being more frequent than those carried out under general anesthesia. Among the surgical interventions, the most common general anesthesia technique for fracture reduction was open reduction and internal fixation with plates and screws. Plate exposure, wound-site infection, and temporomandibular joint ankylosis were the major complications encountered in the study population. Conclusion: The study reveals significant variability in maxillofacial fractures based on gender, age, and etiology. Assault emerged as the leading cause of these fractures, followed by falls and road traffic accidents. Men were affected by maxillofacial trauma four times more often than women, with the highest incidence occurring in the 19–28 years age group. Nasal fractures were the most frequently observed (78.7%), while condylar-subcondylar process fractures were the most common type of mandibular fracture. Given these findings, a targeted, lifelong prevention strategy focused on high-risk groups could significantly reduce the burden of maxillofacial trauma. [ABSTRACT FROM AUTHOR]

BACKGROUND: 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. OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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]

Copyright of Gaceta Médica de México is the property of Publicidad Permanyer SLU 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.)

The document explores the life and work of Sir Percivall Pott (1714-1788) and his lacrimal treatise from 1758, focusing on lacrimal drainage disorders. Pott, a renowned English surgeon, made significant contributions to the field of ophthalmology. The treatise discusses various aspects of lacrimal disorders, including etiologies, clinical presentations, and management strategies, providing valuable insights into the historical understanding of these conditions. The text also includes criticisms and assessments of Pott's work, highlighting the importance of his observations in advancing the science of lacrimal drainage disorders. [Extracted from the article]

Objective The purpose of this study was to investigate the application value of Chromosomal microarray analysis (CMA) in prenatal diagnosis of nuchal translucency (NT) thickening and nasal bone dyscalcification. Methods The fetuses diagnosed with NT thickening and nasal bone dyscalcification at the Prenatal Diagnosis Center of Meizhou People's Hospital from September 2022 to April 2024, who underwent CMA and karyotype analysis were collected to analyze the relationship between NT thickening and nasal bone dyscalcification and chromosome abnormalities. The detection of chromosomal abnormalities in fetuses with NT thickening, nasal bone dyscalcification and the value of ultrasound combined with CMA in prenatal diagnosis were analyzed. Results In 75 fetuses with NT thickening and/or nasal bone dyscalcification, 11 cases of chromosome aneuploidy were detected by karyotype analysis, and 5 cases of pathogenic copy number variations (CNV) were detected by CMA, with an additional detection rate of 6.7%. The additional diagnosis rates of CMA were 6.0% and 5.0% in fetuses with simple NT thickening and nasal bone dyscalcification, respectively. Conclusion CMA technique is of high value in prenatal diagnosis of fetuses with NT thickening and nasal bone dyscalcification, it can improve the detection rate of fetal chromosomal abnormalities, and the combined application of multiple techniques can provide a more comprehensive evaluation of the fetuses. [ABSTRACT FROM AUTHOR]

Background: Hump reduction with traditional ostectomy is an invasive procedure performed in aesthetic rhinoplasty. Natural and flawless nasal dorsum can be obtained with wedge ostectomy (WO) technique. Objective: The objective of this study is to describe the nasal dorsum WO technique and examine its effectiveness in correcting nasal dorsum with absent and minor humps in patients undergoing aesthetic rhinoplasty. Materials and Methods: Senior author performed 488 rhinoplasty and septorhinoplasty operations from April 2009 to April 2021. After exclusion of major hump patients, the remaining 312 patients had a secondary evaluation for suitability for wedge ostectomy. After secondary examination, 87 patients, including 19 with absent humps (0 mm) and 68 with small humps (1–3 mm) were operated. Results: Nasal bone hump reduction with WO has proven satisfactory results in majority of patients, minimal revision in done in five patients but no complications were occurred related to this method. Conclusions: Nasal dorsum WO provides lesser invasive approach to bony hump reduction in selected patients, ensuring bone cortex continuity in nasal dorsum. It decreases possible dorsal nasal irregularities associated with conventional coronal plane ostectomies. At the same time, it provides a natural and anatomically accurate nasal dorsum. [ABSTRACT FROM AUTHOR]

Background: We aimed to develop a mould for the over-flexion and over-extension positions to solve the technical problem of patients who find it difficult to form the over-flexion and over-extension positions of the cervical spine by lowering their heads forwards and raising their heads backwards. Materials and Methods: We calculated the average physiological bending radian of normal people and measured the depth of the cervical physiological curve using Borden's method. Finally, we designed a mould that conformed to the characteristics of the human cervical spine to conduct nasal bone examinations in the over-flexion and over-extension positions in combination with the patient's examination position. Results: When the neck is equipped with an over-flexion and over-extension mould when performing coronal nasal bone examinations, the nasal bone structure is more fully displayed than in routine examinations; furthermore, the clinical diagnosis efficiency greatly improves, and the rate of misdiagnosis significantly reduces. Conclusion: This model increases the comfort of patients and solves the technical problem of patients who cannot maintain the over-flexion and over-extension positions for an extended period. [ABSTRACT FROM AUTHOR]

The optimal timing of rhinoplasty for patients with nasal bone fractures remains controversial. We investigated whether the timing of rhinoplasty after nasal trauma affects the aesthetic outcome of the procedure. A total of 41 adult patients with nasal bone fractures who underwent rhinoplasty between 2006 and 2021 were enrolled in this study. A visual analog scale (VAS) was used to indicate the assessor's satisfaction with the surgical outcome after a comparison of the pre- and postoperative facial photographs of each patient. Of the 41 patients, 28 underwent rhinoplasty within 14 days after nasal trauma (early rhinoplasty group), whereas 13 underwent rhinoplasty more than 14 days after nasal trauma (late rhinoplasty group). The rate of receiving spreader and shield graft was higher in the late rhinoplasty group (p = 0.043 and 0.018, respectively). Patients with type IV or V nasal bone fracture and patients with preoperative saddle noses had higher VAS scores than those with types I to III fractures and those without preoperative saddle nose (p = 0.003 and 0.020, respectively). There was no significant difference in overall aesthetic outcome between the early and late rhinoplasty groups. Both groups achieved significantly better radix height, dorsal height, and tip projection after rhinoplasty. The aesthetic outcome of rhinoplasty performed in the early posttrauma period is comparable with that of rhinoplasty performed more than 2 weeks after nasal bone fracture. Rhinoplasty can be considered a safe surgical treatment option for nasal bone fracture, even in the early posttrauma period. Level of Evidence : 4. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study is to review whether legislative change enforcing safer riding conditions for Electric Scooters (E‐Scooter), regardless of other factors, had an impact on reducing significant head, facial and neck trauma. Additionally, to identify the radiological injury patterns for head, face and neck injuries identified on CT imaging for a patient's initial presentation to the emergency department (ED) resulting from an E‐Scooter accident. Methods: A retrospective single‐centre observational study at a metropolitan tertiary ED of patients presenting after an E‐Scooter accident comparing 6 months before and after legislative change. Results: Four hundred and forty‐three patients presented following an E‐Scooter accident: 191 patients 6 months before and 252 patients 6 months after legislative change. One hundred and sixty‐two patients pre‐ and 217 patients post‐legislative change had negative CT studies. Twenty‐nine patients pre‐ and 35 patients post‐legislative change had CT studies demonstrating significant head, face or neck trauma. The most common type of intracranial bleeding was subarachnoid haemorrhage followed by subdural haemorrhage with a significant proportion (41%) presenting with multi‐factorial intracranial bleeding. There was no specific injury pattern involving the cranial vault or cervical spine. Of the patients presenting with a significant injury, facial bones were the most common injury site (84% (n = 54)). The most common site of facial fractures was the nasal bones followed by dental trauma and maxillary fractures. Conclusion: This single‐centre, retrospective observational study has shown no reduction in serious head, neck and facial injuries. Large‐scale, multicentre studies will need to be undertaken to understand the true impact of legislative change. [ABSTRACT FROM AUTHOR]

This preliminary study aimed to assess the efficacy of zygomatic buttress bone grafting for nasal floor augmentation in patients with a unilateral alveolar cleft who were referred after the optimal timetable for this surgery had elapsed. Five patients, aged 12–18 years, with unilateral alveolar clefts were treated at Qaem Hospital, Mashhad, Iran. Initially, a mucous layer was established on the side of the cleft nose, followed by forming a bony bridge between the defect's sides through a bone graft derived from the zygomatic buttress and xenograft bone powder. Subsequently, the grafted region was covered with an absorbable collagen membrane, and the oral-side flap was sealed. Post-operative follow-ups occurred at 1 week, 1 month, and 3 months, and cone beam computed tomography (CBCT) was performed 6 months post-treatment. Discrepancy between the anterior edge height of the pyriform aperture on the healthy and cleft sides post-grafting was assessed. The average disparity between the height of the anterior edge of the pyriform aperture on the healthy side and the peak height achieved post-grafting on the cleft side was 1.90 ± 2.82 mm. Within the limitations of the study, it seems that zygomatic buttress is applicable for late unilateral alveolar bone grafting as an intraoral source, and is helpful in symmetric bony nasal floor reconstruction, with a good success rate. [ABSTRACT FROM AUTHOR]

Objective: To investigate the changes in condyle‐glenoid fossa relationship after maxillary skeletal expansion (MSE) and to verify the correlation between the condyle positional changes and expansion effect. Methods: In this study, 20 patients (mean age 21.1 ± 5.7 years, 8 male, 12 female) with maxillary transverse deficiency (MTD) were treated with the MSE appliance, which contained molar bands and a expander with four micro‐implants. The CBCT images were taken before expansion (T0), after expansion (T1) and after 6 months of maintenance (T2). The posterior TMJ space (PS), superior TMJ space (SS), anterior TMJ space, coronal lateral TMJ space (CLS), coronal medial TMJ space (CMS), condyle axis angle, maxillary basal bone width (BWM), inter‐molars width, nasal bone width, molar inclination and molar palatal cusp height (U6H) were measured using Dolphin Imaging. Results: At T1, compared with T0, the PS and SS significantly increased by 0.41 mm (P =.008) and 0.3 mm (P =.007). But only the SS significantly increased by 0.21 mm (P =.025) at T2. There was a significant difference of 0.37 mm (left–right, P =.014) between the left and right SS at T0, but no significant difference at T1 and T2. The increased BMW showed weak positive correlations with the change of PS (P =.015) and CMS (P =.031), and the decreased U6H showed weak negative correlations with the change of PS (P =.015) and CLS (P =.031) at T1. Conclusions: The use of MSE led to an increase in the SS and PS, which were weakly correlated with BWM and U6H. But this effect in the TMJ space gradually diminished after 6 months of maintenance, and the symmetry of the condyle‐fossa relationship was preserved. [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.

Maxillonasal dysplasia, known as Binder's syndrome, is a rare congenital deformity characterised by distinctive facial features, including a malformed midface and nose, as well as abnormal positions of the nasal bones. In addition, maxillary hypoplasia, or a shorter upper jaw, and nasal abnormalities may manifest as a flattened nose. Many cases of this condition are associated with other malocclusions, and those affected can be easily identified. Individuals with Binder's syndrome typically present with an undeveloped upper jaw, a projecting lower jaw, a smaller nose, a flat nasal bridge, and midfacial hypoplasia. This is the first case report describing a physiotherapy method for maxillonasal dysplasia. Hereby, the authors present a case report of a six-month-old male child with Binder's syndrome who exhibited delayed developmental milestones and physical anomalies. The child's mother had a complicated pregnancy, culminating in an emergency caesarean section due to preterm premature rupture of membranes. The infant, born with Binder's syndrome and a cleft palate, displayed poor head control, an inability to roll, and reluctance to engage in sensory interactions. Examination revealed bilateral cortical thumbs, hip joint abnormalities, and heightened sensitivity to touch. Magnetic Resonance Imaging (MRI) findings indicated semilobar Holoprosencephaly (HPE) and dysgenesis of the corpus callosum. Physiotherapeutic interventions focused on parent education and home exercise programs targeting developmental milestones. Over the course of two months, the infant showed significant progress in head control and rolling. Furthermore, after four months of training, the child gained sitting control. The present case underscores the importance of early intervention and parental involvement in optimising outcomes for children with Binder's syndrome. [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]

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]

Background: Aim-The aim of study was to evaluate the prevalence of maxillofacial fracture following road traffic accidents, to access the pattern of maxillofacial fracture and to estimate the most common type of facial fracture following road traffic accidents in patient attending a tertiary health care center. Materials and methods: Patient coming to ENT OPD and casualty of Shri Vasantrao Naik government medical college Yavatmal with facial bone fractures following RTA, were evaluated in this study. Results: Total 140 patients were evaluated with facial bone fracture after RTA. The prevalence of facial fracture in RTA patient is 11.2%. Majority of them were in age group of 21 to 40 years. Male preponderance was seen. Most common facial fracture was mandible 48.5%, followed by nasal bone 18.5%, ZMC 17.1%, multiple bone fracture 10.7%. Among all mandible fractures 47.19% had parasymphysis fracture. Two wheeler accidents were majorly seen 47.1%, 33.6% four wheeler, 16.4% pedestrians and 2.9% three wheeler. Among the 2 wheeler drivers, majority 78.8% were not wearing helmets. Majority 60.7% cases needed surgery and 39.3% were treated conservatively. Among surgical cases 12.9% of cases had complication following surgery. Conclusion: On the basis of data which was reproduced after examination of 140 patients, having RTA with facial bone fractures attending tertiary care hospital, it is concluded that most common fracture following RTA is mandible. In mandible, the most common site is parasymphysis. Two wheeler accidents were majorly seen. Majority of patients were under influence of alcohol. Majority of them were not wearing helmets. To avoid RTA, it is important to implement stringent traffic rules, improving the quality of roads, safety regulation rules should be followed. ORIF being the main stay of treatment in present study followed by IMF. [ABSTRACT FROM AUTHOR]

With the increasing use of sustainable energy sources, the electric scooter has become a widely used vehicle. The aim of the study is to analyse the types of facial fracture related to road traffic accidents to outline the need for dedicated road rules. An observational, retrospective, multicentre study was carried out at the Maxillofacial Surgery Units of six Italian hospitals. Fifty patients (mean age was 34.76 years) from January 2020 to January 2024 were enrolled. The severity of trauma was evaluated by the Facial Injury Severity Scale (FISS) by Bagheri et al. Most of the accidents occurred during the day and the weekend in spring or summer; 24 drivers collided with infrastructures or pedestrians, while 26 involved other vehicles. A total of 33 vehicles were rented, and 17 were privately owned. A total of 43 subjects were not wearing helmets, five patients were drunk, and three patients took drugs. In order of frequency, the facial fractures involved: zygomatico-maxillary-orbital complex (ZMOC) (n = 16), mandibular condyle (n = 13), nasal bone (n = 11), orbit floor (n = 8), and mandibular body (n = 7). Fractures such as Le Fort I (n = 4), naso-orbito-ethmoidal NOE (n = 4) and mandibular ramus (n = 4) were less common. Other types of facial fracture were rare. Thirty patients reported multiple facial fractures. The vast majority of the cases showed a low severity grade FISS score. Fifteen patients suffered polytrauma. The mean hospitalisation time was 8.3 days. As accidents with electric scooters are increasing, it is important to characterise the most frequent facial fractures to improve patient management and encourage the introduction of new road rules. [ABSTRACT FROM AUTHOR]

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Mummification of corpses with partial skeletonization is not an uncommon occurrence in daily forensic work. Cooperation between different forensic fields is important in these cases in terms of obtaining the most accurate and forensically relevant results, especially when child abuse and neglect is suspected. In Central Europe, up to 21% of children are exposed to physical and psychological harm, which is mostly perpetrated by family members. This report describes a case of subadult female mummified remains in which interdisciplinary forensic pathology, forensic anthropology, and entomology input was needed to obtain legally relevant results. Entomological analysis of the fly and beetle species present served primarily to estimate the postmortem interval. External examination confirmed advanced postmortem decomposition of the body. The anthropological findings based on radiographs and analysis of selected bones confirmed various antemortem fractures and post-traumatic changes involving the ribs, the distal portion of the humerus, the nasal bones, and the anterior portions of the maxilla and mandible. Furthermore, non-specific findings of growth arrest (Harris) lines in the distal metaphysis of the right tibia indicated growth retardation and, overall, child neglect. The autopsy findings confirmed subdural blood coagulum, part of which formed a clearly moulded plaster mass that had originally been attached to the cranial vault up to the internal lamina. The findings indicated a post-traumatic condition as the underlying cause of death in this child. Interdisciplinary forensic analyses confirmed that the child had been repeatedly exposed to violent assaults throughout her lifetime. Key points If mummified remains with partial skeletonization of a subadult are found, collaboration among forensic experts is required In this case, dried subdural blood coagulum indicated post-traumatic, non-spontaneous subdural haemorrhage Periosteal reaction present on the facial bones and distal portion of the humerus was a suspicious finding Analyses of female subadult remains based on an interdisciplinary approach revealed a syndrome of child abuse and neglect [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]

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]

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]

To explore and evaluate the value of chromosomal microarray analysis (CMA) in prenatal diagnosis of fetuses with ultrasound abnormalities. Methods: A retrospective analysis was performed on 370 fetuses with ultrasound abnormalities received invasive prenatal diagnosis at Meizhou People's Hospital from October 2022 to December 2023. Fetal specimens were analyzed by CMA, and the detection rates of aneuploidy and pathogenic (P)/likely pathogenic (LP) copy number variations (CNVs) in ultrasound structural abnormalities (malformations of fetal anatomy) and non-structural abnormalities (abnormalities of fetal nonanatomical structure) were analyzed. Results: There were 114 (30.8%) cases with isolated ultrasound structural abnormalities, 226 (61.1%) cases with isolated non-structural abnormalities (182 isolated ultrasound soft markers abnormalities, 30 isolated fetal growth restriction (FGR), and 8 isolated abnormalities of amniotic fluid volume), and 30 (8.1%) cases with both structural and non-structural abnormalities. The overall detection rate of aneuploidy and P/LP CNVs in isolated ultrasonic structural abnormalities was 5.3%, among which cardiovascular system abnormalities were the highest. In addition, the largest number of fetuses with non-structural abnormalities was nuchal translucency (NT) thickening (n = 81), followed by ventriculomegaly (n = 29), and nasal bone dysplasia (n = 24). The detection rate of chromosomal abnormalities of fetuses with abnormal ultrasound soft markers was 9.9%, and the detection rate in single abnormal ultrasound soft marker, and multiple ultrasound soft markers abnormalities was 9.7% (16/165) and 11.8% (2/17), respectively. Moreover, the detection rate of chromosomal abnormalities of fetuses with FGR and structural abnormalities combined with non-structural abnormalities was 6.7% (2/30), and 13.3% (4/30), respectively. Conclusion: The incidence of chromosomal abnormalities (aneuploidy and P/LP CNVs) varies among different fetal ultrasound abnormalities. [ABSTRACT FROM AUTHOR]

Objective: Consultations requested by the forensic medicine clinic and fulfilled by the otorhinolaryngology clinic were discussed in the context of literature findings, taking into account their characteristics and the issues to be considered in reporting. Material and Methods: The cases which were examined retrospectively in terms of sociodemographic characteristics and contents were divided into groups based on trauma to the face-head-neck region, otological symptoms, and injuries that could be resolved with basic medical intervention (BMI) versus those that could not be resolved with BMI. Results: The mean age of the 134 cases evaluated was 41.13±16.02 years, with the youngest being 18 and the oldest 82 years old. Fifty-eight cases (43.2%) had injuries that could be resolved with BMI. Forty-two cases (31.3%) had fractures in the facial or nasal bones. 10 cases (7.5%) with traumatic tympanic membrane perforation, 19 cases (14.1%) without tympanic membrane perforation were consulted for hearing evaluation, and 9 cases (6.7%) were consulted for acoustic trauma. The evaluation of sequelae conditions was conducted on average 9.27±1.34 months after the date of incident, with the shortest duration being 7 months and the longest being 11 months. Conclusion: It should be noted that radiological imaging accompanying physical examination in facial and nasal bone fractures is considered evidentiary, and it should not be forgotten that the clinical findings must be supported by properly interpreted imaging methods. It is crucial that reports are prepared with an accurate approach in line with the criteria in the Forensic Medical Guide in order to prevent the cases from experiencing the loss of rights during the ongoing legal process and to protect the physician from investigations that may arise from incomplete or incorrect medical practices. [ABSTRACT FROM AUTHOR]

Introduction: Free-living amoeba is ubiquitous in fresh water, mud, and moist soil; although seldom pathogenic to humans, Naegleria fowleri , Acanthamoeba spp., and Balamuthia spp. are known to cause infections of the central nervous system. Methods: We report two interesting cases, both of which presented with a rapid-onset and fulminant course. The first case details a 36-year-old male with a history of surgically corrected nasal bone fracture 15 years back, who presented with acute onset of fever, headache and convulsions. Results: Direct smears of cerebrospinal fluid (CSF) revealed motile trophozoites resembling N. fowleri and were later confirmed by molecular diagnosis (polymerase chain reaction [PCR]). Subsequently, the source was identified as water used for religious purposes. Unfortunately, the patient succumbed to cardiac arrest. The second case is that of a 4-year-old boy from Palakkad district, Kerala, who presented with sudden onset of nasal discharge, fever, headache, vomiting, seizures and altered sensorium. His CSF smear examination showed motile trophozoites resembling Acanthamoeba spp. While undergoing treatment, he seized thrice before going into cardiac arrest. Despite extensive resuscitation measures, the child could not be revived and passed away. The postmortem CSF sample sent for molecular analysis confirmed infection by Acanthamoeba spp. Conclusion: Rapid progression and lack of definite treatment options make this a highly fatal condition. Although clinical presentations of both patients were indicative of pyogenic meningitis, parasitic infection was suspected when the CSF was found turbid with no bacteria, high protein, and low sugar. High index of suspicion helped us to get an early preliminary diagnosis from direct microscopy. [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]

The article discusses the anatomy of nasal cartilage, specifically the lateral and septal cartilages, and their roles in shaping the nose during rhinoplasty surgeries. It highlights the challenges of visualizing the septal cartilage using ultrasound and proposes a modified scanning technique to overcome these obstacles. The study was funded by various institutions in Taiwan, and the authors declare no conflicts of interest. The data supporting the findings are available from the corresponding author upon request. [Extracted from the article]

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]

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]

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]

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]