Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with t...Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with trisomy 21(T 21)between 16 and 25 weeks of gestation as a diagnostic tool for T 21.Methods:Facial profile images in the two dimensional(2D)gray scale were assessed to measure fetal NBL and PNT between 16 and 25 weeks of gestation.The PNT:NBL ratio of the fetuses was calculated.Nomograms were constructed from the data of morphologically normal fetuses at live birth.The PNT,NBL,and PNT:NBL ratio of fetuses with confirmed T 21(n=31)and morphologically normal fetuses at live birth(controls,n=3485)were compared.Results:Nomograms for PNT,NBL,and the PNT:NBL ratio were constructed.In T 21 fetuses,PNT(>95th percentile),NBL(<5th percentile),and the PNT:NBL ratio(>95th percentile)showed a sensitivity of 25%,29%,and 45%for PNT,NBL,and PNT:NBL,respectively,and specificity of 95%,96%,and 94%,for PNT,NBL,and PNT:NBL,respectively.All of these markers showed a negative predictive value of 99%.Conclusion:PNT,NBL,and the PNT:NBL ratio have high diagnostic value for fetuses with Down syndrome and can be incorporated easily in the current second trimester screening protocol for T 21.PNT,NBL,and the PNT:NBL ratio are more specific markers for Down syndrome than those used in previous studies.展开更多
BACKGROUND The nasal bone,being the most protruding bone in the center of the facial bones,is particularly susceptible to damage.Nasal bone fractures can often result in secondary deformation and dysfunction of the no...BACKGROUND The nasal bone,being the most protruding bone in the center of the facial bones,is particularly susceptible to damage.Nasal bone fractures can often result in secondary deformation and dysfunction of the nose,including septal fractures.Studies on functional or intra-nasal complications have been rarely reported after nasal bone fracture reduction.AIM To evaluate the severity of nasal obstruction and its improvement following nasal bone fracture reduction using inferior turbinoplasty.METHODS We conducted a retrospective review of data from 50 patients with symptomatic nasal obstruction between January to December 2010.All patients underwent preoperative Computed tomography evaluation,and symptom changes and nasal cavity volume were analyzed using a visual analog scale and acoustic rhinometry before and after surgery.Closed reduction and out-fracture of both inferior turbinates performed by the same surgeon.Treatment outcomes were assessed by comparing changes in the nasal airway volume measured using acoustic rhinometry before and after surgery.The minimal cross-sectional area(MCA)was also analyzed based on the Stranc classification.RESULTS Before reduction,the mean MCA for all cases was 0.59±0.06 cm^(2),which represented an 11%decrease compared to the average size of a Korean adult(0.65±0.03 cm^(2)).The MCA for frontal impact was 0.60±0.02 cm^(2) and for lateral impact,it was 0.58±0.03 cm^(2).After reduction via inferior turbinoplasty,the MCA improved to 0.64±0.04 cm^(2).CONCLUSION This study suggests that turbinoplasty is helpful in addressing nasal obstruction.Out-fracture of the inferior turbinate is an effective and durable technique that can be easily performed to enlarge the nasal airway with minimal morbidity.展开更多
Objective: to analyze the main points of forensic identification of nasal bone fracture injury mechanism, fracture type, fresh or old fracture and imaging examination, so as to avoid the main points and countermeasure...Objective: to analyze the main points of forensic identification of nasal bone fracture injury mechanism, fracture type, fresh or old fracture and imaging examination, so as to avoid the main points and countermeasures of false identification, and provide reference for forensic identification. Methods: a total of 98 cases of nasal bone fracture injury identification completed after identification in the center from 2015 to 2020 were selected to analyze the missed diagnosis of nasal bone fracture, fracture type, composite injury, old and new fractures, injury mechanism and degree, and key points to avoid false identification. Results: most types of nasal bone fractures were accompanied by compound injuries: X-ray missed diagnosis and CT film reading were difficult;The key points of imaging diagnosis, the identification of old and new injuries, the grasp of the injury mechanism and degree of fracture, and how to avoid false identification are the key points of forensic identification.展开更多
Objective： The treatment of fronto- basilar fractures is a demanding aspect of craniofacial frac- ture management. A sequel of inadequate or improper frac- ture management presents cosmetic and functional prob- lems ...Objective： The treatment of fronto- basilar fractures is a demanding aspect of craniofacial frac- ture management. A sequel of inadequate or improper frac- ture management presents cosmetic and functional prob- lems which are very difficult to correct. The aim of this manu- script was to examine a group of growing patients treated for frontobasilar fractures and provide clinicians a possible therapeutic option for the treatment of these challenging fractures. Methods： In this investigation, 12 patients under the age of 16 years treated for severe injuries to the frontobasilar region were included. Their records were reviewed to evalu- ate the clinical diagnosis, preoperative findings, hospital course, postoperative results, and long-term follow-up. Preoperative and postoperative CT scans were performed in all children treated. Postoperative complications were re- viewed in detail. Surgical procedures were evaluated for type and location of fixation. All complications and treat- ments were recorded. Results： Three of the patients presented with a cere-brospinal fluid （CSF） leak and required pericrartial flaps. Only 3 patients underwent removal of plates and screws due to palpability in 1 patient, loose hardware in 1 patient, and limited disturbance on growth in the rest patient. Seven patients underwent open reduction and internal fixation with resorbable plates, 4 patients with titanium plates, and 1 pa- tient with a combination. Follow-up ranged from 6 months to 5 years. No patients with a preoperative CSF leak deve- loped any recurrence of the leak. Conelusion： According to basic craniofacial principles, reducing and stabilizing the fractures should reconstruct the anterior cranial base. However, the treatment ofpaediatric maxillofacial trauma requires the evaluation of several factors. The facial skeleton of a child is constantly evolving and its growth depends on the balance of basal bone and soft tissues.展开更多
文摘Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with trisomy 21(T 21)between 16 and 25 weeks of gestation as a diagnostic tool for T 21.Methods:Facial profile images in the two dimensional(2D)gray scale were assessed to measure fetal NBL and PNT between 16 and 25 weeks of gestation.The PNT:NBL ratio of the fetuses was calculated.Nomograms were constructed from the data of morphologically normal fetuses at live birth.The PNT,NBL,and PNT:NBL ratio of fetuses with confirmed T 21(n=31)and morphologically normal fetuses at live birth(controls,n=3485)were compared.Results:Nomograms for PNT,NBL,and the PNT:NBL ratio were constructed.In T 21 fetuses,PNT(>95th percentile),NBL(<5th percentile),and the PNT:NBL ratio(>95th percentile)showed a sensitivity of 25%,29%,and 45%for PNT,NBL,and PNT:NBL,respectively,and specificity of 95%,96%,and 94%,for PNT,NBL,and PNT:NBL,respectively.All of these markers showed a negative predictive value of 99%.Conclusion:PNT,NBL,and the PNT:NBL ratio have high diagnostic value for fetuses with Down syndrome and can be incorporated easily in the current second trimester screening protocol for T 21.PNT,NBL,and the PNT:NBL ratio are more specific markers for Down syndrome than those used in previous studies.
基金Supported by the National Research Foundation of Korea Grant funded by the Korea Government(MSIT),No.2020R1A2C1100891Soonchunhyang Research und,No.2023-0048.
文摘BACKGROUND The nasal bone,being the most protruding bone in the center of the facial bones,is particularly susceptible to damage.Nasal bone fractures can often result in secondary deformation and dysfunction of the nose,including septal fractures.Studies on functional or intra-nasal complications have been rarely reported after nasal bone fracture reduction.AIM To evaluate the severity of nasal obstruction and its improvement following nasal bone fracture reduction using inferior turbinoplasty.METHODS We conducted a retrospective review of data from 50 patients with symptomatic nasal obstruction between January to December 2010.All patients underwent preoperative Computed tomography evaluation,and symptom changes and nasal cavity volume were analyzed using a visual analog scale and acoustic rhinometry before and after surgery.Closed reduction and out-fracture of both inferior turbinates performed by the same surgeon.Treatment outcomes were assessed by comparing changes in the nasal airway volume measured using acoustic rhinometry before and after surgery.The minimal cross-sectional area(MCA)was also analyzed based on the Stranc classification.RESULTS Before reduction,the mean MCA for all cases was 0.59±0.06 cm^(2),which represented an 11%decrease compared to the average size of a Korean adult(0.65±0.03 cm^(2)).The MCA for frontal impact was 0.60±0.02 cm^(2) and for lateral impact,it was 0.58±0.03 cm^(2).After reduction via inferior turbinoplasty,the MCA improved to 0.64±0.04 cm^(2).CONCLUSION This study suggests that turbinoplasty is helpful in addressing nasal obstruction.Out-fracture of the inferior turbinate is an effective and durable technique that can be easily performed to enlarge the nasal airway with minimal morbidity.
文摘Objective: to analyze the main points of forensic identification of nasal bone fracture injury mechanism, fracture type, fresh or old fracture and imaging examination, so as to avoid the main points and countermeasures of false identification, and provide reference for forensic identification. Methods: a total of 98 cases of nasal bone fracture injury identification completed after identification in the center from 2015 to 2020 were selected to analyze the missed diagnosis of nasal bone fracture, fracture type, composite injury, old and new fractures, injury mechanism and degree, and key points to avoid false identification. Results: most types of nasal bone fractures were accompanied by compound injuries: X-ray missed diagnosis and CT film reading were difficult;The key points of imaging diagnosis, the identification of old and new injuries, the grasp of the injury mechanism and degree of fracture, and how to avoid false identification are the key points of forensic identification.
文摘Objective： The treatment of fronto- basilar fractures is a demanding aspect of craniofacial frac- ture management. A sequel of inadequate or improper frac- ture management presents cosmetic and functional prob- lems which are very difficult to correct. The aim of this manu- script was to examine a group of growing patients treated for frontobasilar fractures and provide clinicians a possible therapeutic option for the treatment of these challenging fractures. Methods： In this investigation, 12 patients under the age of 16 years treated for severe injuries to the frontobasilar region were included. Their records were reviewed to evalu- ate the clinical diagnosis, preoperative findings, hospital course, postoperative results, and long-term follow-up. Preoperative and postoperative CT scans were performed in all children treated. Postoperative complications were re- viewed in detail. Surgical procedures were evaluated for type and location of fixation. All complications and treat- ments were recorded. Results： Three of the patients presented with a cere-brospinal fluid （CSF） leak and required pericrartial flaps. Only 3 patients underwent removal of plates and screws due to palpability in 1 patient, loose hardware in 1 patient, and limited disturbance on growth in the rest patient. Seven patients underwent open reduction and internal fixation with resorbable plates, 4 patients with titanium plates, and 1 pa- tient with a combination. Follow-up ranged from 6 months to 5 years. No patients with a preoperative CSF leak deve- loped any recurrence of the leak. Conelusion： According to basic craniofacial principles, reducing and stabilizing the fractures should reconstruct the anterior cranial base. However, the treatment ofpaediatric maxillofacial trauma requires the evaluation of several factors. The facial skeleton of a child is constantly evolving and its growth depends on the balance of basal bone and soft tissues.
