Current Issue : January - March Volume : 2013 Issue Number : 1 Articles : 6 Articles
Objective. To compare the asymmetry displayed by Philippine, Colombian, and Ethiopian unaffected parents of patients with\r\nnonsyndromic cleft palate (NSCLP) and a control population. Methods. Facial measurements were compared between unaffected\r\nparents of NSCLP patients and those in the control group for three populations from South America, Asia, and Africa by\r\nanthropometric and photographic measurements. Fluctuating and directional asymmetries, height and width proportions, were\r\nanalyzed and compared. Results. Fluctuating asymmetries (ear length, middle line to Zigion perpendicular for left and right sides)\r\nand variations in the facial thirds demonstrated statistical significance in the study group of unaffected parents from Colombia and\r\nPhilippines, while increased interorbital distance was evident in the unaffected Ethiopian parents of NSCLP patients. Conclusions.\r\nThe facial differences in unaffected parents could indicate an underlying genetic liability. Identification of these differences has\r\nrelevance in the understanding of the etiology of NSCLP....
Background: The incision used for thyroid surgery has become shorter over time, from the classical 10 cm long\r\nKocher incision to the shortest 15 mm access achieved with Minimally Invasive Video-Assisted Thyroidectomy.\r\nThis rather large interval encompasses many different possible technical choices, even if we just consider open\r\nsurgery.\r\nThe aim of the study was to assess the correlation between incision length and operation duration with a set of\r\nbiometric and clinical factors and establish a rationale for the decision on the length of incision in open surgery.\r\nMethods: Ninety-seven consecutive patients scheduled for total thyroidectomy were prospectively evaluated. All\r\noperations were performed by the same team and the surgeon decided the length of the incision according to\r\nhis personal judgement. Patients who had previously undergone neck surgery were excluded.\r\nResults: The length of the incision was strongly correlated with gender, thyroid volume, neck circumference and\r\nclinical diagnosis and weakly correlated with the body mass index. Operation duration was only weakly correlated\r\nwith gender and neck circumference. Multiple linear regression revealed that the set of factors assessed explained\r\nalmost 60 % of the variance in incision length but only 20 % of the variance in operation duration. When\r\npatients were classified according to the distribution of their thyroid volume, cases within one standard deviation\r\nof the mean did not show a significant difference in terms of operation duration with incisions of various\r\nlengths.\r\nConclusions: Although thyroid volume was a major factor in driving the decision with respect to the length of\r\nthe incision, our study shows that it had only minor effect on the duration of the operation. Many more open\r\nthyroidectomies could therefore be safely performed with shorter incisions, especially in women. Duration of the\r\noperation is probably more closely linked to the inherent technical difficulty of each case....
Background. With greater experience in microsurgical reconstruction, free tissue transfer has become common and reliable. However, total flap necrosis after microsurgical reconstruction is sometimes seen in patients who have undergone radical ablation of head and neck malignancies. We investigated factors predicting free flap loss in head and neck reconstruction. Methods. We reviewed the records of 111 free flap reconstructions carried out among 107 patients with head and neck cancer who required radical resection and microsurgical reconstruction in our unit from 2004 through 2010. Among these patients, 6 showed total flap necrosis postoperatively. We investigated the associations between primary or recurrent tumor, type of flaps, chemotherapy, and radiotherapy and flap loss. Results. Five of 20 (25.0%) patients who underwent radiotherapy developed flap necrosis: among the 91 patient who did not undergo radiotherapy, only one (1.1%) developed. Preoperative radiotherapy was statistically identified as the most important risk factor for postoperative flap failure. Conclusions. Patients receiving radiation treatment are more likely to develop total flap failure when they undergo reconstructive surgery with free flaps after tumor ablation, because the combination of endarteritis and chronic ischemia caused by radiation damaged endothelial membrane in the recipient vessels, consequently, thrombosis tends to develop....
A laser is a device that emits light (electromagnetic radiation) through a process called stimulated emission. The term laser is an acronym for light amplification by stimulated emission of radiation. Laser light is usually spatially coherent, which means that the light either is emitted in a narrow, low-divergence beam, or can be converted into one with the help of optical components such as lenses. Typically, lasers are thought of as emitting light with a narrow wavelength spectrum (\"monochromatic\" light). This is not true of all lasers; however some emit light with a broad spectrum, while others emit light at multiple distinct wavelengths simultaneously. The coherence of typical laser emission is distinctive. Most other light sources emit incoherent light, which has a phase that varies randomly with time and position....
Ample data exists about the high precision of three-dimensional (3D) scanning devices and their data acquisition of the facial\r\nsurface. However, a question remains regarding which facial landmarks are reliable if identified in 3D images taken under clinical\r\ncircumstances. Sources of error to be addressed could be technical, user dependent, or patient respectively anatomy related. Based\r\non clinical 3D photos taken with the 3dMDface system, the intra observer repeatability of 27 facial landmarks in six cleft lip\r\n(CL) infants and one non-CL infant was evaluated based on a total of over 1,100 measurements. Data acquisition was sometimes\r\nchallenging but successful in all patients. The mean error was 0.86 mm, with a range of 0.39mm (Exocanthion) to 2.21mm (soft\r\ngonion). Typically, landmarks provided a small mean error but still showed quite a high variance in measurements, for example,\r\nexocanthion from 0.04mm to 0.93 mm. Vice versa, relatively imprecise landmarks still provide accurate data regarding specific\r\nspatial planes. Onemust be aware of the fact that the degree of precision is dependent on landmarks and spatial planes in question.\r\nIn clinical investigations, the degree of reliability for landmarks evaluated should be taken into account. Additional reliability can\r\nbe achieved via multiple measuring....
Background. Inverted nipples with subareolar abscesses can recur due to insufficient resection. It is important to provide reliable\r\ncurative treatment after determination of the extent of resection by preoperative imaging evaluation. Methods. Ten patients were\r\ntreated for inverted nipples with subareolar abscess. Sonography and high-resolution MRI were used as preoperative imaging\r\nmodalities. The endpoints of preoperative imaging evaluation were defined as the identification of the abscess site, isolated fistula\r\nsite, and extent of inflammation. Results. In all patients, sonography confirmed the presence of abscesses but their locations could\r\nnot be identified. Sonography could not confirmthe presence of isolated fistula or inflammation. In contrast, high-resolution MRI\r\nnot only confirmed the presence of abscesses but also revealed their positional relationships with the nipples. In addition, highresolution\r\nMRI confirmed the presence of isolated fistulas and inflammation as well as revealed their positional relationships with\r\nthe nipples. In all patients, no recurrence was observed, and satisfactory surgical results were obtained. Conclusion.High-resolution\r\nMRI is useful in determination of the extent of resection of subareolar abscess associated with inverted nipple....
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