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Sample records for facial bone lengthening

  1. Residual bone growth after lengthening procedures.

    PubMed

    Journeau, Pierre; Lascombes, Pierre; Barbier, Dominique; Popkov, Dmitry

    2016-12-01

    The prognosis of limb length discrepancy is a major subject in paediatric orthopaedic surgery. The strategy depends on the prognosis and must be adapted to each patient. The residual growth of the lengthened segment often remains unknown, but is dependent on age, the percentage of lengthening and other factors. Using a large cohort of 150 children who had undergone bone lengthening procedures, we describe five patterns of post-intervention growth and identify factors that are favourable for normal residual growth. The criteria for bone lengthening which should maintain good residual growth are-bone age at lengthening should be before the pubertal growth spurt; the interval between two lengthening procedures should be over three years; the percentage of lengthening should be <30% of the initial segment; and no more than two lengthening procedures should be carried out during infancy.

  2. The biology of bone lengthening.

    PubMed

    Hvid, Ivan; Horn, Joachim; Huhnstock, Stefan; Steen, Harald

    2016-12-01

    Distraction osteogenesis biologically resembles fracture healing with distinctive characteristics notably in the distraction phase of osteogenesis. In the latency phase of bone lengthening, like in the inflammatory phase of fracture repair, interleukines are released and act with growth factors released from platelets in the local haematoma, leading to attraction, proliferation and differentiation of mesenchymal stem cells into osteoblasts and other differentiated mesenchymal cells. These in turn produce matrix, collagen fibers and growth factors. A callus containing cells, collagen fibers, osteoid and cartilage matrix is formed. Provided stable fixation, distraction will trigger intramembranous bone formation. As distraction proceeds, the distraction gap develops five distinctive zones with unmineralized bone in the middle, remodelling bone peripherally, and mineralizing bone in between. During consolidation, the high concentration of anabolic growth factors in the regenerate diminishes with time as remodelling takes over to form mature cortical and cancellous bone. Systemic disease, congenital bone deficiencies, medications and substance abuse can influence the quality and quantity of regenerate bone, usually in a negative way. The regenerate bone can be manipulated when needed by using injection of mesenchymal stem cells and platelets, growth factors (BMP-2 and -7), and systemic medications (bisphosphonates and parathyroid hormone). Growth factors and systemic anabolic and antiresorptive drugs are prescribed on special indications, while distraction osteogenesis is not an authorized indication. To some extent, however, these compounds can be used off-label. Use in children presents special problems since growth factors and specific anabolic medications may involve a risk of inducing cancer.

  3. Bone regenerate formation in cortical bone during distraction lengthening. An experimental study.

    PubMed

    Delloye, C; Delefortrie, G; Coutelier, L; Vincent, A

    1990-01-01

    The aim of this study was to delineate the pattern of bone regeneration from cortical bone segments during distraction lengthening. The lengthening procedure was applied for various periods through the Ilizarov system on the forearms of mature dogs. Bone was sectioned either by corticotomy, preserving the nutrient artery integrity, or by osteotomy. When an osteotomy was performed, the marrow cavity was in some cases plugged with either resorbable bone wax or nonresorbable material. Under distraction, both periosteal and medullary callus on either side of the gap gave rise to new bone trabeculae. The trabeculae on either side were oriented along the direction of distraction and progressively approached one another. This striated callus emerging from both sides was the most characteristic pattern of bone regeneration subsequent to distraction lengthening. Fusion was achieved approximately four weeks after the end of the lengthening period. Most of the new bone was formed by membranous ossification; some cartilaginous nodules developed. Corticalization of the bone trabeculae that had begun at three months was not fully achieved at five months after the lengthening period. There were no differences found in the pattern of bone healing and the amount of newly formed bone after corticotomy or osteotomy with or without resorbable bone wax plugging.

  4. A comprehensive approach to long-standing facial paralysis based on lengthening temporalis myoplasty.

    PubMed

    Labbè, D; Bussu, F; Iodice, A

    2012-06-01

    Long-standing peripheral monolateral facial paralysis in the adult has challenged otolaryngologists, neurologists and plastic surgeons for centuries. Notwithstanding, the ultimate goal of normality of the paralyzed hemi-face with symmetry at rest, and the achievement of a spontaneous symmetrical smile with corneal protection, has not been fully reached. At the beginning of the 20(th) century, the main options were neural reconstructions including accessory to facial nerve transfer and hypoglossal to facial nerve crossover. In the first half of the 20(th) century, various techniques for static correction with autologous temporalis muscle and fascia grafts were proposed as the techniques of Gillies (1934) and McLaughlin (1949). Cross-facial nerve grafts have been performed since the beginning of the 1970s often with the attempt to transplant free-muscle to restore active movements. However, these transplants were non-vascularized, and further evaluations revealed central fibrosis and minimal return of function. A major step was taken in the second half of the 1970s, with the introduction of microneurovascular muscle transfer in facial reanimation, which, often combined in two steps with a cross-facial nerve graft, has become the most popular option for the comprehensive treatment of long-standing facial paralysis. In the second half of the 1990s in France, a regional muscle transfer technique with the definite advantages of being one-step, technically easier and relatively fast, namely lengthening temporalis myoplasty, acquired popularity and consensus among surgeons treating facial paralysis. A total of 111 patients with facial paralysis were treated in Caen between 1997 and 2005 by a single surgeon who developed 2 variants of the technique (V1, V2), each with its advantages and disadvantages, but both based on the same anatomo-functional background and aim, which is transfer of the temporalis muscle tendon on the coronoid process to the lips. For a comprehensive

  5. Periosteum and bone marrow in bone lengthening: a DEXA quantitative evaluation in rabbits.

    PubMed

    Guichet, J M; Braillon, P; Bodenreider, O; Lascombes, P

    1998-10-01

    We quantitatively studied the role of periosteum and bone marrow-endosteum during lengthening in 18 growing rabbits, comparing four surgical procedures: 1) periosteum and bone marrow preservation, 2) periosteum preservation, bone marrow destruction, 3) periosteum destruction, bone marrow preservation, 4) periosteum and bone marrow destruction. An external fixator was set on one femur, the other serving as a control. Distraction began on day 5 and stopped on day 25 (0.25 mm/12 hours). On day 30, femora were harvested with a layer of muscle. Area, bone mineral content and density were measured by dual-energy x-ray absorptiometry. Procedure 2 showed the highest increase in bone mineral content around the elongated callus (127%) compared to procedures: 1 (81%), 3 (25%) and 4 (-8%, i.e., resorption of bone ends). A statistically significant effect on bone formation was observed when preserving (vs. destroying): 1) periosteum, 2) bone marrow (effect observed only around the distraction gap), 3) periosteum and bone marrow in combination. Periosteum alone forms a larger callus, with more mineral content than bone marrow alone, and destruction of both results in the absence of bone formation around the distraction area. Careful preservation of periosteum is essential to bone healing. Formation of bone with a large mineral content does not require bone marrow preservation, but there is an interaction effect on healing between bone marrow and periosteum.

  6. [Lengthening temporalis myoplasty: A new approach to facial rehabilitation with the "mirror-effect" method].

    PubMed

    Blanchin, T; Martin, F; Labbe, D

    2013-12-01

    Peripheral facial paralysis often reveals two conditions that are hard to control: labial occlusion and palpebral closure. Today, there are efforts to go beyond the sole use of muscle stimulation techniques, and attention is being given to cerebral plasticity stimulation? This implies using the facial nerves' efferent pathway as the afferent pathway in rehabilitation. This technique could further help limit the two recalcitrant problems, above. We matched two groups of patients who underwent surgery for peripheral facial paralysis by lengthening the temporalis myoplasty (LTM). LTM is one of the best ways to examine cerebral plasticity. The trigeminal nerve is a mixed nerve and is both motor and sensory. After a LTM, patients have to use the trigeminal nerve differently, as it now has a direct role in generating the smile. The LTM approach, using the efferent pathway, therefore, creates a challenge for the brain. The two groups followed separate therapies called "classical" and "mirror-effect". The "mirror-effect" method gave a more precise orientation of the patient's cerebral plasticity than did the classical rehabilitation. The method develops two axes: voluntary movements patients need to control their temporal smile; and spontaneous movements needed for facial expressions. Work on voluntary movements is done before a "digital mirror", using an identical doubled hemiface, providing the patient with a fake copy of his face and, thus, a 7 "mirror-effect". The spontaneous movements work is based on what we call the "Therapy of Motor Emotions". The method presented here is used to treat facial paralysis (Bell's Palsies type), whether requiring surgery or not. Importantly, the facial nerve, like the trigeminal nerve above, is also a mixed nerve and is stimulated through the efferent pathway in the same manner.

  7. [The value of selected imaging techniques in evaluation of bone regeneration during limb lengthening].

    PubMed

    Synder, M; Hussein, A A; Niedzielski, K; Grzegorzewski, A

    2000-01-01

    The paper presents the value of different imaging techniques, including X-rays, ultrasonography, computed tomography and densitometry in the evaluation of bone regenerates during limb lengthening. Material consisted of 60 children, age ranging from 4 to 18 years who underwent surgery using the Ilizarov technique because of limb inequality. During of limb lengthening different imaging techniques were employed for monitoring regenerate growth and remodeling. The study showed that all the employed imaging techniques play an important role in monitoring bone regenerate remodeling at different stages of limb lengthening.

  8. [Bone lengthening and soft tissue correction using the Ilizarov technique].

    PubMed

    Schiessel, A; Windhager, R; Fellinger, E; Kotz, R

    1998-05-22

    From March 1989 to September 1995 at the Department of Orthopedic Surgery at the Vienna General Hospital 31 limb-lengthenings or corrections of the soft-tissue (contractions of joints, clubfeet) using the Ilizarov method were performed. 15 patients have already finished growth. All complications were analysed according to Paley's classification. The tibia-group (n=13) reached an average lengthening of 3.5 cm (2-5.7 cm) [16% (6-35%) of the initial length] with a healing index of 1.7 mo/cm and a complication rate of 42%. In the femur-group (n=8) a mean lengthening of 5.4 cm (2.5-9.4 cm) [21% (7-34%) of the initial length] could be achieved with a healing rate of 1.3 mo/cm and a complication rate of 40%. The ulna-group (n=3) reached an average lengthening of 2.6 cm (2.2-3.4 cm) [21% (17-24%) or the initial length] with a healing index of 1.4 mo/cm and a complication rate of 17%. The knee contracture group (n=2) was free of complications. The Ilizarov technique has been performed successfully in a high percentage although extensive elongations reported by Ilizarov could not be achieved neither by us nor by other authors. The above-mentioned method has been proved to be efficient and successful to correct deformities of the soft-tissue.

  9. The importance of densitometric testing in the evaluation of regenerated bone during long bone lengthening by the Ilizarov method.

    PubMed

    Hussein, Abdulwahab; Faflik, Jakub; Bik, Krzysztof

    2002-06-30

    Background. Lengthening a long bone by cutting it surgically and then stretching it a process laden with numerous complications. Among the greatest threats is surely the insufficient support strength of the lengthening limb due to inadequate calcification of the newly generated bone tissue. This leads to fractures, distortion of the axis, or lack of osseous consolidation around the newly formed bone. In order to reduce the number of such complications constant diligent monitoring of the entire process is necessary, from the moment treatment is commenced until the distraction apparatus is removed. The purpose of the present study was to evaluate the usefulness of densitometric testing at various stages in the process of lengthening long bones.
    Material and method. The testing involved 17 children, in 20 limbs were lengthened by the Ilizarov method. The average shortening was 4,70 cm (range 3,5-13 cm). the article compares the results of density assessments of regenerated bone using ultrasonographic testing and densitometry.
    Conclusions. Densinometric testing constitutes an important supplement to the evaluation of regenerated bone. This is an easy test to perform and repeat, enabling the physician to evaluate the degree of mineralization of the regenerated bone, reach conclusions regarding its consolidation and mechanical strength, and make a decision regarding the removal of the external stabilizer.

  10. Ilizarov Method for Bone Lengthening and Defect Management Review of Contemporary Literature.

    PubMed

    Gubin, Alexander; Borzunov, Dmitry; Malkova, Tatiana

    2016-06-01

    Since its origination in the middle of the past century, the Ilizarov method has advanced greatly and has become a viable method for bone lengthening, severe deformity correc- tion, and defect management. As the reported studies show, it remains one of the most used tools for bone reconstruction. The original method and its modifications continue to be the topic of interest for orthopaedic scientists as evidenced by the number of clinical studies on the Ilizarov method that have been published in orthopaedic journals in the period from 2000 through 2014, most of which present the out- comes of treating large series of patients using distraction osteogenesis for bone lengthening, defect management, and deformity correction. We made a review of contemporary clinical studies on the Ilizarov method used for bone length- ening and defect management.

  11. [The value of methods of bone regeneration evaluation in limb lengthening by the Wagner, Ilizarov methods and by physeal distraction].

    PubMed

    Tesiorowski, Maciej; Kacki, Wojciech; Jasiewicz, Barbara; Rymarczyk, Adrian; Sebastianowicz, Piotr

    2005-01-01

    Limb lengthening is a long-lasting process, and during new bone formation different complications may occur. Due to this, early diagnosis of disturbances of new bone formation leading to such complications is of importance. The goal of this study is to analyze already used methods of regenerate evaluation. Material consists of retrospective data of 237 patients, who underwent limb lengthening between 1983 and 2002 by one of three methods: Wagner method, Ilizarow method and physeal distraction. During femoral lengthening by Wagner method appropriate shape of regenerate according to Hamanishi was observed in 9 cases (29.0%), and during tibia lengthening--only in 1 case (6.7%). During femoral lengthening by physeal distraction appropriate shape of regenerate (A or B according to Hamanishi) was observed in 24 cases (77.4%), and during tibia lengthening--in 11 cases (78.6%). During femoral lengthening by Ilizarow method appropriate shape of regenerate was observed in 51 cases (72.9%), and during tibia lengthening--in 46 cases (66.7%). Only in Wagner method a correlation between abnormal regenerate shape and bone consolidation complications was noted. Methods of evaluation of bone regeneration during distraction osteogenesis give only descriptive assessment. So far parameters applied for evaluation of distraction osteogenesis in Ilizarow method and physeal distraction do not allow for detailed assessment of bone regeneration process.

  12. [A new surgical method: lengthening of jaw bone by means of distraction technique].

    PubMed

    Nord, P G

    2001-05-30

    Callus distraction, or distraction osteogenesis as the method also is called, is a new surgical technique which makes it possible to create new bone by bone elongation. The method was originally used in orthopedic surgery to extend long bones but has subsequently proved useful for extending the mandible as well as other bones in the facial skeleton. By callus distraction, it is now possible to treat severe jaw anomalies and also to treat bone defects in the jaws without bone transplantation. This article describes the biological background to the method and the basic principles that must be observed for successful results. The treatment of four patients illustrates the method.

  13. [Bone distraction using an external fixator: a new mandibular lengthening technic. A preliminary study apropos of 2 cases of children with mandibular hypoplasia].

    PubMed

    Kollar, E M; Diner, P A; Vazquez, M P; Accart, G; Pirollo, M

    1994-01-01

    The authors expose a technical innovation concerning mandibular lengthening without any bone graft, by applying to the mandibular Ilizarov's principles about limb lengthening by osseous distraction. This surgical technique concerns children with mandibular hypoplasia, like the Hanhart's syndrome (aglossia-adactylia, first observation), or Hemifacial Microsomia (second observation). The purpose of this new technique is mandibular lengthening with functional and aesthetic correction of the mandibular growth deficiency, and minimal morbidity. A specialist staff is essential to realize a distraction device with his minimal and appropriate shape for children, as well as a protection device conception. This external distraction device is placed with transmandibular pins. After mandibular corticotomy by endobuccal incision, the distraction is accomplished, at home by the parents, at the rythm of 1 mm p. two days. The distraction goes on about 2 months, depending on the lack of mandibular growth, and a retention device, much more light, is necessary during 8 weeks more to stabilize the osteogenesis. At the term of an eight weeks gradual distraction, the mandibular lengthening is 17.5 mm for the horizontal ramus (first observation), and 13 mm for the vertical ramus (second observation). The functional and aesthetic results, the swift and secure surgical procedure, lead to put forward this mandibular distraction technique in any mandibular or facial defects.

  14. Current approaches to flexible intramedullary nailing for bone lengthening in children.

    PubMed

    Popkov, Dmitry; Lascombes, Pierre; Journeau, Pierre; Popkov, Arnold

    2016-12-01

    Limb-length discrepancies and extremity deformities are among the most common non-traumatic orthopaedic conditions for which children are hospitalised. There is a need to develop new treatment options for lower-limb length discrepancy in order to ameliorate treatment outcomes, avoid or reduce rates of complication and provide early rehabilitation. The authors report on the basic principles, experimental and clinical data, advantages, problems and complications of a combined technique associating the Ilizarov method and flexible intramedullary nailing (FIN) in limb lengthening and deformity correction in children. They describe features of the use of hydroxyapatite-coated intramedullary nails in patients with certain metabolic bone disorders and in cases where bone consolidation has been compromised. The advantages of bone lengthening using a combined technique (circular fixator plus FIN) are a lower healing index, quicker distraction-consolidation, a reduced rate of septic and bone complications, the ability to correct deformities gradually and the increased stability of bone fragments during the external fixation period and after frame removal.

  15. The incorporation of allogeneic and autogenous bone graft in healing of lateral column lengthening of the calcaneus.

    PubMed

    Templin, David; Jones, Kerwyn; Weiner, Dennis S

    2008-01-01

    Lateral column calcaneal lengthening as described by Mosca is a widely accepted technique for the correction of hindfoot valgus and pes planus. It is performed with both allogeneic and autogenous bone graft. The purpose of this study was to evaluate the incorporation of these 2 types of bone graft in this procedure. A retrospective review of all lateral calcaneal lengthenings performed by 4 pediatric orthopaedic surgeons over a 10-year period was conducted. Radiographs at the last follow-up visit were independently examined by 3 reviewers. Incorporation of the bone graft was determined by 2 criteria: (1) presence of continuity of trabecular lines between graft and native bone, and (2) inability to distinguish the boundary between bone graft and native bone. A consensus or majority opinion (2 out of 3 reviewers) was considered positive for graft incorporation. Thirty-five lateral column lengthenings in 26 patients were reviewed, 30 of which used allograft bone and 5 autograft. Ninety-seven percent of the allograft cases and 80% of the autograft cases were incorporated at final follow-up. There was 1 case of graft failure in each of the 2 groups. Follow-up in the allograft failure was 6 weeks; the autogenous failure 7.2 years. Interrater reliability was good (kappa=0.61, P < .0001). No adverse events or complications were noted with the use of allograft bone in this series. Allogeneic bone graft is rapidly integrated into native bone and is a desirable substitute to autogenous bone for use in lateral column lengthenings, avoiding any patient morbidity from graft harvesting.

  16. Tissue-Engineered Autologous Grafts for Facial Bone Reconstruction

    PubMed Central

    Bhumiratana, Sarindr; Bernhard, Jonathan C.; Alfi, David M.; Yeager, Keith; Eton, Ryan E.; Bova, Jonathan; Shah, Forum; Gimble, Jeffrey M.; Lopez, Mandi J.; Eisig, Sidney B.; Vunjak-Novakovic, Gordana

    2016-01-01

    Facial deformities require precise reconstruction of the appearance and function of the original tissue. The current standard of care—the use of bone harvested from another region in the body—has major limitations, including pain and comorbidities associated with surgery. We have engineered one of the most geometrically complex facial bones by using autologous stromal/stem cells, without bone morphogenic proteins, using native bovine bone matrix and a perfusion bioreactor for the growth and transport of living grafts. The ramus-condyle unit (RCU), the most eminent load-bearing bone in the skull, was reconstructed using an image-guided personalized approach in skeletally mature Yucatan minipigs (human-scale preclinical model). We used clinically approved decellularized bovine trabecular bone as a scaffolding material, and crafted it into an anatomically correct shape using image-guided micromilling, to fit the defect. Autologous adipose-derived stromal/stem cells were seeded into the scaffold and cultured in perfusion for 3 weeks in a specialized bioreactor to form immature bone tissue. Six months after implantation, the engineered grafts maintained their anatomical structure, integrated with native tissues, and generated greater volume of new bone and greater vascular infiltration than either non-seeded anatomical scaffolds or untreated defects. This translational study demonstrates feasibility of facial bone reconstruction using autologous, anatomically shaped, living grafts formed in vitro, and presents a platform for personalized bone tissue engineering. PMID:27306665

  17. Non-invasive evaluation of facial crestal bone with ultrasonography

    PubMed Central

    Sinjab, Khaled; Chung, Ming-Pang; Chiang, Yi-Chen; Wang, Hom-Lay; Giannobile, William V.; Kripfgans, Oliver D.

    2017-01-01

    Purpose Facial crestal bone level and dimension determine function and esthetics of dentition and dental implants. We have previously demonstrated that ultrasound can identify bony and soft tissue structures in the oral cavity. The aim of this study is to evaluate the accuracy of using ultrasound to measure facial crestal bone level and thickness. Materials and methods A commercially available medical ultrasound scanner, paired with a 14 MHz imaging probe was used to scan dental and periodontal tissues at the mid-facial site of each tooth on 6 fresh cadavers. The alveolar crest level in relation to the cemento-enamel junction and its thickness on ultrasound images were measured and compared to those on cone-beam computed tomography (CBCT) scans and/or direct measurements on a total of 144 teeth. Results The mean crestal bone level measured by means of ultrasound, CBCT and direct measures was 2.66 ± 0.86 mm, 2.51 ± 0.82 mm, and 2.71 ± 1.04 mm, respectively. The mean crestal bone thickness was 0.71 ± 0.44 mm and 0.74 ± 0.34 mm, measured by means of ultrasound and CBCT, respectively. The correlations of the ultrasound readings to the other two methods were between 0.78 and 0.88. The mean absolute differences in crestal bone height and thickness between ultrasound and CBCT were 0.09 mm (-1.20 to 1.00 mm, p = 0.06) and 0.03 mm (-0.48 to 0.54 mm, p = 0.03), respectively. Conclusion Ultrasound was as accurate in determining alveolar bone level and its thickness as CBCT and direct measurements. Clinical trials will be required to further validate this non-ionizing and non-invasive method for determining facial crestal bone position and dimension. PMID:28178323

  18. Limb lengthening in achondroplasia

    PubMed Central

    Chilbule, Sanjay K; Dutt, Vivek; Madhuri, Vrisha

    2016-01-01

    Background: Stature lengthening in skeletal dysplasia is a contentious issue. Specific guidelines regarding the age and sequence of surgery, methods and extent of lengthening at each stage are not uniform around the world. Despite the need for multiple surgeries, with their attendant complications, parents demanding stature lengthening are not rare, due to the social bias and psychological effects experienced by these patients. This study describes the outcome and complications of extensive stature lengthening performed at our center. Materials and Methods: Eight achondroplasic and one hypochondroplasic patient underwent bilateral transverse lengthening for tibiae, humeri and femora. Tibia lengthening was carried out using a ring fixator and bifocal corticotomy, while a monolateral pediatric limb reconstruction system with unifocal corticotomy was used for the femur and humerus. Lengthening of each bone segment, height gain, healing index and complications were assessed. Subgroup analysis was carried out to assess the effect of age and bone segment on the healing index. Results: Nine patients aged five to 25 years (mean age 10.2 years) underwent limb lengthening procedures for 18 tibiae, 10 femora and 8 humeri. Four patients underwent bilateral lengthening of all three segments. The mean length gain for the tibia, femur and humerus was 15.4 cm (100.7%), 9.9 cm (52.8%) and 9.6 cm (77.9%), respectively. Healing index was 25.7, 25.6 and 20.6 days/cm, respectively, for the tibia, femur and humerus. An average of 33.3% height gain was attained. Lengthening of both tibia and femur added to projected height achieved as the 3rd percentile of standard height in three out of four patients. In all, 33 complications were encountered (0.9 complications per segment). Healing index was not affected by age or bone segment. Conclusion: Extensive limb lengthening (more than 50% over initial length) carries significant risk and should be undertaken only after due consideration. PMID

  19. Aneurysmal Bone Cyst of the Temporal Bone Presenting with Headache and Partial Facial Palsy

    PubMed Central

    Kletke, Stephanie N.; Popovic, Snezana; Algird, Almunder; Alobaid, Abdullah; Reddy, Kesava K. V.

    2015-01-01

    Background Aneurysmal bone cysts (ABCs) are benign bony lesions that rarely affect the skull base. Very few cases of temporal bone ABCs have been reported. We describe the first case of a temporal bone ABC that was thought to be consistent with a meningioma based on preoperative magnetic resonance imaging (MRI) findings. Clinical Presentation An otherwise healthy 23-year-old woman presented with a pulsatile noise in her left ear and a 4-week history of throbbing headache with nausea. There was no associated emesis, visual or auditory changes, or other neurologic features. Neurologic examination revealed a left lower motor neuron facial paresis. Computed tomography and MRI studies demonstrated a large lesion in the left middle cranial fossa skull base with erosion of the petrous temporal bone. Based on the presence of a “dural tail” on preoperative contrast-enhanced T1-weighted imaging, the lesion was interpreted to likely be consistent with a meningioma. An orbitozygomatic approach was utilized for surgical excision. Histopathologic evaluation was consistent with an ABC. Conclusion Postoperatively the patient had improvement in the lower motor neuron facial paresis. It is important to consider ABC in the differential diagnosis of intracranial lesions accompanied by the dural tail sign on MRI. PMID:26251800

  20. The effect of loading in mechanical response predictions of bone lengthening.

    PubMed

    Okyar, A Fethi; Bayoglu, Riza

    2012-11-01

    Intramedullary (IM) distractor nails have become a viable alternative in bone-distraction operations. Upon stabilization of the fractured/dissected limb via the nail, the resulting construct accommodates the load bearing function of the otherwise healthy limb. In establishing design performance targets for these devices, in vitro test conditions are widely accepted leaving the in vivo conditions aside. However, in vivo device failures due to distraction forces necessitate novel modeling considerations. It is especially important to simulate the loads in limb distraction, as this brings the bone-implant construct to a totally different regime than the hip-joint contact force (Point-Force Model, PFM). In this work we used a simplified approach to incorporate ligament stretching due to limb distraction via self-equilibrating spring elements in a finite-element setting (spring-force model, SFM). We compared the effect of loading type on load transmission paths through the locking pins, for these two distinct loading modes, namely, SFM and PFM. The two modes illustrate entirely different load transfer regimes around the bone/nail interface region. In order to avoid high contact stresses between the nail and the bone segments, it is advisable to keep the osteotomy away from the mid-range between the pin connections. It was also seen for both loading modes that including an additional pin at a load transfer location does not significantly alter the load carried by a single pin (the additional pin rather acts as a geometric stabilizer).

  1. A case of recovery of oral function with dental implants following facial bone trauma.

    PubMed

    Kamoi, Hisahiro

    2012-01-01

    A 44-year-old woman had sustained facial lacerations, loss of several teeth, alveolar bone fracture, and severe vertical bone resorption in conjunction with a shattered alveolar bone and marked loss of intraoral function and facial disfigurement in a car accident. She underwent 9 surgical procedures by plastic surgeons to treat the facial lesions, including hold facial scar formation reduction surgery, reduction of fractures of the nasal and cheek bones, and bone transplants. To restore intraoral function and improve facial appearance, plastic surgeons transplanted a rib into the maxillary sinus while dental surgeons simultaneously inserted 5 dental implants. Eleven months after the dental implant surgery, a complete upper denture and a mandibular gingival ceramometal-casting crown were fitted. After insertion of the final prosthodontics, regular follow-up examinations were performed to check dental occlusion, oral hygiene, and the condition of the gingival tissue. In the years since the upper dental implants were fitted, there have been no bone resorption and no functional problems. Transplantation of rib bones is an effective method for maxillary reconstruction and remains effective even after the insertion of dental implants. The patient is extremely satisfied with the results. A means of maintaining oral health over the long term, and of motivating the patient to maintain oral health, should be established.

  2. The facial-bone fractures among fatally injured car occupants in frontal collisions.

    PubMed

    Nikolic, S D; Atanasijevic, T C; Popovic, V M; Soc, M V

    2009-04-01

    The retrospective study was performed of all deceased car-occupants in frontal car collisions in order to identify persons with facial-bone fractures. The sample consisted of 482 cases: 378 males and 104 females, average age of 39.59+/-16.01 years. There were 239 car-drivers, 194 front-seat passengers, and 49 rear-seat passengers. In 46 of 482 cases, single fracture of upper facial bones was established: nasal fractures were the most common, followed by zygomatic. In 118 of 482 cases, fracture of upper facial bones was established, as well as 70 cases of jawbone. The fractured facial bones either of the upper or lower face could not be a factor that predicts the position of the deceased in the motor vehicle at the moment of injury (lambda=0.989, p>0.05). The multi-fractured facial-bones were very often associated with the multi-fractured cranial bones - 85 cases (chi(2) =138.75, df=8, p<0.001), as well as jawbone fracture - 35 cases (chi(2) =20.52, df=4, p<0.001). Brain injuries were more present and more severe (coup and contrecoup-contusion and brain laceration) if more facial-bone fractures were involved (chi(2) =147.99, df=8, p<0.001). Cases with only contrecoup brain contusions, associated with multi-fractured facial-bones, were rare - 6 of 118. These fractures are very often associated with cranial fractures, as well as with brain injuries and were caused by intensive contact of the deceased's head with the car's pillar.

  3. Bilateral Facial Paralysis Caused by Temporal Bone Fracture: A Case Report

    PubMed Central

    Ghiasi, Samad; Banaei, Mehdi

    2016-01-01

    Introduction Although bilateral facial nerve palsy is a rare condition, its etiology is more detectable than the unilateral type. A temporal bone fracture is one cause of bilateral facial nerve palsy, contributing in 3% of the cases. Case Presentation Here, we report the case of a 35-year-old man complaining of bilateral incomplete eye closure, two weeks after a closed head injury caused by a motor vehicle accident. Conclusions The high resolution computed tomography findings revealed a bilateral temporal bone fracture line, which extended to the fallopian canal. With regard to treatment, near complete recovery was obvious after two weeks of treatment with oral corticosteroids. Overall, bilateral facial palsy is hard to diagnose; therefore, clinical suspicion and the early detection of facial nerve injuries is necessary for good nerve recovery in temporal bone fractures. PMID:27679786

  4. The study of barium concentration in deciduous teeth, impacted teeth, and facial bones of Polish residents.

    PubMed

    Fischer, Agnieszka; Malara, Piotr; Wiechuła, Danuta

    2014-10-01

    The study determines the concentration of Ba in mineralized tissues of deciduous teeth, permanent impacted teeth, and facial bones. The study covers the population of children and adults (aged 6-78) living in an industrial area of Poland. Teeth were analyzed in whole, with no division into dentine and enamel. Facial bones and teeth were subjected to the following preparation: washing, drying, grinding in a porcelain mortar, sample weighing (about 0.2 g), and microwave mineralization with spectrally pure nitric acid. The aim of the study was to determinate the concentration of Ba in deciduous teeth, impacted permanent teeth, and facial bones. The concentration of barium in samples was determined over the ICP OES method. The Ba concentration in the tested bone tissues amounted to 2.2-15.5 μg/g (6.6 μg/g ± 3.9). The highest concentration of Ba was present in deciduous teeth (10.5 μg/g), followed by facial bones (5.2 μg/g), and impacted teeth (4.3 μg/g) (ANOVA Kruskal-Wallis rank test, p = 0.0002). In bone tissue and impacted teeth, Ba concentration increased with age. In deciduous teeth, the level of Ba decreased with children's age.

  5. Microstructural properties of the mid-facial bones in relation to the distribution of occlusal loading.

    PubMed

    Janovic, Aleksa; Milovanovic, Petar; Saveljic, Igor; Nikolic, Dalibor; Hahn, Michael; Rakocevic, Zoran; Filipovic, Nenad; Amling, Michael; Busse, Bjoern; Djuric, Marija

    2014-11-01

    Although the concept of the occlusal load transfer through the facial skeleton along the buttresses has been extensively studied, there has been no study to link microarchitecture of the mid-facial bones to the occlusal load distribution. The aim of this study was to analyze micro-structural properties of the mid-facial bones in relation to occlusal stress. The study was performed by combining the three-dimensional finite element analysis (3D FEA) and micro-computed tomography analysis (micro-CT). Clenching was simulated on the computer model of the adult male human skull which was also used as a source of bone specimens. After the FEA was run, stress was measured at the specific sites in cortical shell and trabecular bone of the model along and between the buttresses. From the corresponding sites on the skull, twenty-five cortical and thirteen cancellous bone specimens were harvested. The specimens were classified into high stress or low stress group based on the stress levels measured via the FEA. Micro-architecture of each specimen was assessed by micro-CT. In the high stress group, cortical bone showed a tendency toward greater thickness and density, lower porosity, and greater pore separation. Stress-related differences in microstructure between the groups were more pronounced in trabecular bone, which showed significantly greater bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) in the high stress group. Our results suggest that the mid-facial bones in the adult dentate male skull exhibit regional variations in cortical and trabecular bone micro-architecture that could be a consequence of different occlusal stress.

  6. Tibial Lengthening Using a Fixator-Assisted Lengthening Plate: A New Technique

    PubMed Central

    Tosun, Haci Bayram; Agir, Ismail; Gumustas, Seyitali; Serbest, Sancar; Uludag, Abuzer; Celik, Suat

    2016-01-01

    Background There are many techniques that are used for limb lengthening. Lengthening a limb over a plate is an alternative choice used in children or when using an intramedullary nail is difficult. Objectives In this study, we presented a new technique for tibial lengthening using a monolateral external fixator over a lengthening plate. Materials and Methods For tibial lengthening, a monolateral external fixator was attached to the composite bone model medially. After a corticotomy was performed, the lengthening plate was placed laterally. Three locking screws were inserted proximally, and two cortical screws were inserted into a lengthening hole that was 1 cm below the osteotomy site. We avoided contact between the screws of the lengthening plate and the pins of the external fixator. During bone lengthening with the monolateral external fixator, the screws at the lengthening hole were able to slide distally with the distal segment of the tibia to allow for tibial elongation. Two locking screws were fixed at the distal locking holes of the plate when the bone elongation was complete. The external fixator was then removed. Results The fixator-assisted lengthening plate allowed bone lengthening without malalignment. There were no mechanical problems associated with the external fixator during the lengthening process. Plate osteosynthesis was stable after the fixator was removed. There was no contact between the screws of plate and the Schanz pins of the external fixator under C-arm fluoroscopy. Conclusions The fixator-assisted lengthening plate technique helps to maintain the stability and alignment at both sides of an osteotomy during tibial elongation. It allows the early removal of the external fixator immediately after lengthening is completed. This technique can be applied in children with open physes and in patients with a narrow medullary canal who are unsuitable for limb lengthening over an intramedullary nail. PMID:28184364

  7. Experimental model for bone regeneration in oral and cranio-maxillo-facial surgery.

    PubMed

    Mardas, Nikos; Dereka, Xanthippi; Donos, Nikolaos; Dard, Michel

    2014-02-01

    Bone and tooth loss, as a result of trauma, anatomical or congenital reasons, cancer, and periodontal disease, is a common therapeutic problem in the fields of cranio-maxillo-facial surgery and periodontics. The proposed techniques for the treatment of various bone defects encountered include bone grafts, bone substitutes, guided tissue regeneration, and distraction osteogenesis as well as their combinations. In addition, dental implants have been successfully utilized for the restoration of full or partial edentulism. The introduction and development of new therapeutic approaches and devices demand the use of appropriate animal models that present bone anatomy and healing comparable to human. Among other animal models, the pig is extensively documented in several biomedical areas and has been largely used in maxillo-facial surgery and implants dentistry-related research. Anatomical and physiological similarities with human in size, physiology, and bone biology contribute to a successful involvement of this animal to understand and treat various osseous lesions. However, improvements and standardization are requested with respect to consistency and discrimination abilities. The aim of this review is to provide a critical appraisal of the literature related to swine models for the evaluation of cranio-maxillo-facial osseous defect healing, regeneration, and bone-implant interface. This review should assist researchers in the field to select the most appropriate model for each dedicated purpose and also contribute to stimulate an innovative thinking on the use of porcine models.

  8. Limb lengthening in Turner syndrome.

    PubMed

    Noonan, K J; Leyes, M; Forriol, F

    1997-01-01

    We report the results and complications of eight consecutive patients who underwent bilateral tibial lengthenings for dwarfism associated with Turner syndrome. Lengthening was performed via distraction osteogenesis with monolateral external fixation. Tibias were lengthened an average distance of 9.2 centimeters or 33 percent of the original tibial length. The average total treatment time was 268 days. The overall complication rate was 169 percent for each tibia lengthened and each segment required an average of 1.7 additional procedures. Seven cases (44 percent) required Achilles tendon lengthening and nine cases (56 percent) developed angulation before or after fixator removal; six of these segments required corrective osteotomy for axial malalignment. Two cases (12.5 percent) developed distraction site nonunion and required plating and bone grafting. From this series we conclude that tibial lengthening via distraction osteogenesis can be used to treat disproportionate short stature in patients with Turner syndrome. However, the benefit of a cosmetic increase in height may not compensate for the high complication rate. Efforts to determine the psychosocial and functional benefits of limb lengthening in patients with short stature is necessary to determine the true cost-benefit ratio of this procedure.

  9. Limb lengthening in Turner syndrome.

    PubMed Central

    Noonan, K. J.; Leyes, M.; Forriol, F.

    1997-01-01

    We report the results and complications of eight consecutive patients who underwent bilateral tibial lengthenings for dwarfism associated with Turner syndrome. Lengthening was performed via distraction osteogenesis with monolateral external fixation. Tibias were lengthened an average distance of 9.2 centimeters or 33 percent of the original tibial length. The average total treatment time was 268 days. The overall complication rate was 169 percent for each tibia lengthened and each segment required an average of 1.7 additional procedures. Seven cases (44 percent) required Achilles tendon lengthening and nine cases (56 percent) developed angulation before or after fixator removal; six of these segments required corrective osteotomy for axial malalignment. Two cases (12.5 percent) developed distraction site nonunion and required plating and bone grafting. From this series we conclude that tibial lengthening via distraction osteogenesis can be used to treat disproportionate short stature in patients with Turner syndrome. However, the benefit of a cosmetic increase in height may not compensate for the high complication rate. Efforts to determine the psychosocial and functional benefits of limb lengthening in patients with short stature is necessary to determine the true cost-benefit ratio of this procedure. Images Figure 1a Figure 1b Figure 1c PMID:9234980

  10. Dose and diagnostic image quality in digital tomosynthesis imaging of facial bones in pediatrics

    NASA Astrophysics Data System (ADS)

    King, J. M.; Hickling, S.; Elbakri, I. A.; Reed, M.; Wrogemann, J.

    2011-03-01

    The purpose of this study was to evaluate the use of digital tomosynthesis (DT) for pediatric facial bone imaging. We compared the eye lens dose and diagnostic image quality of DT facial bone exams relative to digital radiography (DR) and computed tomography (CT), and investigated whether we could modify our current DT imaging protocol to reduce patient dose while maintaining sufficient diagnostic image quality. We measured the dose to the eye lens for all three modalities using high-sensitivity thermoluminescent dosimeters (TLDs) and an anthropomorphic skull phantom. To assess the diagnostic image quality of DT compared to the corresponding DR and CT images, we performed an observer study where the visibility of anatomical structures in the DT phantom images were rated on a four-point scale. We then acquired DT images at lower doses and had radiologists indicate whether the visibility of each structure was adequate for diagnostic purposes. For typical facial bone exams, we measured eye lens doses of 0.1-0.4 mGy for DR, 0.3-3.7 mGy for DT, and 26 mGy for CT. In general, facial bone structures were visualized better with DT then DR, and the majority of structures were visualized well enough to avoid the need for CT. DT imaging provides high quality diagnostic images of the facial bones while delivering significantly lower doses to the lens of the eye compared to CT. In addition, we found that by adjusting the imaging parameters, the DT effective dose can be reduced by up to 50% while maintaining sufficient image quality.

  11. Metatarsal lengthening by distraction osteogenesis: a report of two cases.

    PubMed

    Saxby, T; Nunley, J A

    1992-01-01

    Two cases of lengthening of metatarsals by distraction osteogenesis are reported. One of these cases is an acquired deformity of the first metatarsal; the other is a congenital short fourth metatarsal. By following the principles set forth by Ilizarov, it was possible to lengthen the metatarsal bones and surrounding soft tissues without open lengthening of tendons or secondary bone grafting of the distraction gap. We believe this method is an improvement over previously described methods of metatarsal lengthening.

  12. Bad to the bone: facial structure predicts unethical behaviour

    PubMed Central

    Haselhuhn, Michael P.; Wong, Elaine M.

    2012-01-01

    Researchers spanning many scientific domains, including primatology, evolutionary biology and psychology, have sought to establish an evolutionary basis for morality. While researchers have identified social and cognitive adaptations that support ethical behaviour, a consensus has emerged that genetically determined physical traits are not reliable signals of unethical intentions or actions. Challenging this view, we show that genetically determined physical traits can serve as reliable predictors of unethical behaviour if they are also associated with positive signals in intersex and intrasex selection. Specifically, we identify a key physical attribute, the facial width-to-height ratio, which predicts unethical behaviour in men. Across two studies, we demonstrate that men with wider faces (relative to facial height) are more likely to explicitly deceive their counterparts in a negotiation, and are more willing to cheat in order to increase their financial gain. Importantly, we provide evidence that the link between facial metrics and unethical behaviour is mediated by a psychological sense of power. Our results demonstrate that static physical attributes can indeed serve as reliable cues of immoral action, and provide additional support for the view that evolutionary forces shape ethical judgement and behaviour. PMID:21733897

  13. Bad to the bone: facial structure predicts unethical behaviour.

    PubMed

    Haselhuhn, Michael P; Wong, Elaine M

    2012-02-07

    Researchers spanning many scientific domains, including primatology, evolutionary biology and psychology, have sought to establish an evolutionary basis for morality. While researchers have identified social and cognitive adaptations that support ethical behaviour, a consensus has emerged that genetically determined physical traits are not reliable signals of unethical intentions or actions. Challenging this view, we show that genetically determined physical traits can serve as reliable predictors of unethical behaviour if they are also associated with positive signals in intersex and intrasex selection. Specifically, we identify a key physical attribute, the facial width-to-height ratio, which predicts unethical behaviour in men. Across two studies, we demonstrate that men with wider faces (relative to facial height) are more likely to explicitly deceive their counterparts in a negotiation, and are more willing to cheat in order to increase their financial gain. Importantly, we provide evidence that the link between facial metrics and unethical behaviour is mediated by a psychological sense of power. Our results demonstrate that static physical attributes can indeed serve as reliable cues of immoral action, and provide additional support for the view that evolutionary forces shape ethical judgement and behaviour.

  14. Post-Traumatic Bilateral Facial Paralysis Associated with Temporal Bone Fracture.

    PubMed

    Habib, Syed Shahid; Al Rouq, Fawzia; Meo, Imran

    2015-10-01

    Bilateral traumatic facial paralysis is a very rare clinical condition. Loss of taste sensation, associated with bilateral traumatic paralysis, is even rarer and has not been well described in the literature. In this report, a 23-year old male, who developed bilateral facial paralysis with loss of taste sensation and hearing impairment, following a motor vehicle accident, is presented. He had initially presented with unconsciousness for about 2 hours after he sustained closed head injury after a motor vehicle accident. Initial Computed Tomography (CT) scans revealed a small epidural hematoma, right temporal bone fracture and air densities around the basal cistern. On the 4th day after trauma, he was noted to have incomplete closure of both eyes and was feeling difficulty with chewing and drooling of saliva. Electrodiagnostic testing confirmed the diagnosis of bilateral facial paralysis-House-Brackmann (HB) grade V. Electroneuronography (ENoG) showed degeneration of 90% nerve fibres bilaterally. The high-resolution CT scans showed bilateral temporal bone fractures. At 3 months of follow-up, the patient had partial recovery of facial nerve function bilaterally and improvement in HB classification to grade III and ENoG of 60% was observed.

  15. Giant-cell lesions of the facial bones

    SciTech Connect

    Som, P.M.; Lawson, W.; Cohen, B.A.

    1983-04-01

    Giant-cell lesions of the paranasal sinuses, including the giant-cell reparative granuloma, the brown tumor of hyperparathyroidism, the true giant-cell tumor, cherubism, and the aneurysmal bone cyst, are uncommon entities. Plain radiographic and computed-tomographic studies of these lesions are described and the differential diagnosis is discussed.

  16. Massive osteoradionecrosis of facial bones and soft tissues.

    PubMed

    Benlier, E; Alicioglu, B; Kocak, Z; Yurdakul-Sikar, E; Top, H

    2009-01-01

    Osteoradionecrosis (ORN) is one of the most serious and uncommon complications in head and neck irradiation for cancer. It is defined as a combination of necrotic soft tissue and bone not being able to heal spontaneously, it demonstrates a general resistance to antibiotics and requires conservative surgical management. Even with modern radiation therapy, its incidence is highly unpredictable and varies between 4-30%. We report on a patient with a huge open cavitation in the cheek, communicating with the mouth and extending to contralateral periodontal gingival and temporal fossa. He had been treated with radiation therapy for nasopharyngeal cancer 5 years ago and presented with restriction of the opening of the mouth. Osteonecrosis complicated with osteomyelitis was evident in bilateral mandible and maxillary bones and the temporal bone. The ramus of the mandible and zygomatic arc were resected, subtotal maxillectomy was performed and the defect was repaired by a free double island flap from the scapular and parascapular osteocutaneous latissimus dorsi muscle flap supplied by subscapular artery. To our knowledge, this is the most extensive bone and soft tissue destruction due to radiation reported in the literature.

  17. The effect of bone displacement operations on facial soft tissues.

    PubMed

    Habib, Ali; Hisham, Ahmed

    2013-01-01

    A novel biomechanical model for face soft tissue (skin, mucosa, and muscles) is introduced to investigate the effect of mandible and chin bone displacement on the overall appearance of the patient's face. Nonlinear FE analysis is applied to the model and the results obtained are used to help surgeons to decide the amount of displacement required.

  18. Asymmetric Facial Bone Fragmentation Mirrors Asymmetric Distribution of Cranial Neuromasts in Blind Mexican Cavefish.

    PubMed

    Gross, Joshua B; Gangidine, Andrew; Powers, Amanda K

    2016-11-01

    Craniofacial asymmetry is a convergent trait widely distributed across animals that colonize the extreme cave environment. Although craniofacial asymmetry can be discerned easily, other complex phenotypes (such as sensory organ position and numerical variation) are challenging to score and compare. Certain bones of the craniofacial complex demonstrate substantial asymmetry, and co-localize to regions harboring dramatically expanded numbers of mechanosensory neuromasts. To determine if a relationship exists between this expansion and bone fragmentation in cavefish, we developed a quantitative measure of positional symmetry across the left-right axis. We found that three different cave-dwelling populations were significantly more asymmetric compared to surface-dwelling fish. Moreover, cave populations did not differ in the degree of neuromast asymmetry. This work establishes a method for quantifying symmetry of a complex phenotype, and demonstrates that facial bone fragmentation mirrors the asymmetric distribution of neuromasts in different cavefish populations. Further developmental studies will provide a clearer picture of the developmental and cellular changes that accompany this extreme phenotype, and help illuminate the genetic basis for facial asymmetry in vertebrates.

  19. Asymmetric Facial Bone Fragmentation Mirrors Asymmetric Distribution of Cranial Neuromasts in Blind Mexican Cavefish

    PubMed Central

    Gross, Joshua B.; Gangidine, Andrew; Powers, Amanda K.

    2017-01-01

    Craniofacial asymmetry is a convergent trait widely distributed across animals that colonize the extreme cave environment. Although craniofacial asymmetry can be discerned easily, other complex phenotypes (such as sensory organ position and numerical variation) are challenging to score and compare. Certain bones of the craniofacial complex demonstrate substantial asymmetry, and co-localize to regions harboring dramatically expanded numbers of mechanosensory neuromasts. To determine if a relationship exists between this expansion and bone fragmentation in cavefish, we developed a quantitative measure of positional symmetry across the left-right axis. We found that three different cave-dwelling populations were significantly more asymmetric compared to surface-dwelling fish. Moreover, cave populations did not differ in the degree of neuromast asymmetry. This work establishes a method for quantifying symmetry of a complex phenotype, and demonstrates that facial bone fragmentation mirrors the asymmetric distribution of neuromasts in different cavefish populations. Further developmental studies will provide a clearer picture of the developmental and cellular changes that accompany this extreme phenotype, and help illuminate the genetic basis for facial asymmetry in vertebrates. PMID:28078105

  20. An intermaxillary fixation screw traction wire: an aid for facial bone fracture repair.

    PubMed

    Kim, Myung-Good; Yoo, Roh-Eul; Chang, Hak; Kwon, Sung-Tack; Baek, Rong-Min; Minn, Kyung-Won

    2009-07-01

    We have devised a new technique to improve stabilization of fractured facial bone fractures (frontal sinus fractures, zygomatic fractures, mandibular condyle fractures) by intermaxillary fixation screw traction wires (stainless steel wires through intermaxillary fixation screws). A retrospective study evaluating intermaxillary fixation screw traction wires was performed. We have used this technique for 3 cases of frontal sinus fractures, 9 cases of zygomatic fractures, and 7 cases of mandibular condyle fractures. After dissection of a fractured site, a hole is drilled on the fractured bone where it does not interfere with positioning the plate across the fracture line. After an intermaxillary fixation screw is inserted, a stainless steel wire is tied through a hole in the screw head. By the aid of wire for traction, the displaced fractured bone is easily aligned to the proper position. Plates and screws are applied readily on the predetermined area. A retrospective study on 19 patients using intermaxillary fixation screw traction wires was performed. The diagnoses and associated complications of the cases were recorded. No associated complication as a result of using this technique was identified. The use of intermaxillary fixation screw traction wire enhances stabilization and visualization without possible risk for surrounding soft tissue injury using, a sharp traction device like a bone hook. An intermaxillary fixation screw traction wire is an useful aid for visualization and stabilization during facial bone fracture reduction, particularly where exposure is difficult such as in the condylar region of the mandible. And unlike a classic traction wire, the intermaxillary fixation screw traction wire has almost no risk of having it loosened from the screw.

  1. Facial features and hyoid bone position in preschool children with obstructive sleep apnea syndrome.

    PubMed

    Vieira, Bruno B; Itikawa, Carla E; de Almeida, Leila A; Sander, Heidi H; Aragon, Davi C; Anselmo-Lima, Wilma T; Matsumoto, Mirian; Valera, Fabiana C P

    2014-05-01

    The aim of the study was to evaluate facial features and hyoid bone position in children with obstructive sleep apnea syndrome (OSAS) by cephalometric radiography. A prospective cross-sectional study was conducted in a tertiary referral hospital. Twenty-nine children in the 3-6 year age bracket were evaluated: 14 children with OSAS and 15 nasal-breathing children. All children underwent otorhinolaryngologic examination, and those with OSAS also underwent in-laboratory polysomnography for diagnostic confirmation. The children were then submitted to orthodontic evaluation and cephalometry. Lateral cephalometric radiographs from children with OSAS were compared to those of nasal-breathing children. We found no differences between the two groups regarding the linear and angular measurements of the face. However, the children with OSAS presented, already at the preschool age, with an inferiorly positioned hyoid bone, thus increasing the pharyngeal area. In children with OSAS, the hyoid bone appears to be in a significantly inferior position at an early age. Our findings provide evidence that there is a relationship between the position of the hyoid bone and OSAS in children, which could contribute to the persistence of OSAS into adulthood.

  2. Cranial imaging in autosomal recessive osteopetrosis. Part I. Facial bones and calvarium.

    PubMed

    Elster, A D; Theros, E G; Key, L L; Chen, M Y

    1992-04-01

    Cranial imaging studies (radiographs, computed tomographic [CT] scans, magnetic resonance [MR] images, and bone marrow scintigrams) in 13 infants and children with autosomally recessive osteopetrosis were reviewed to characterize patterns of facial and calvarial involvement at presentation and with progression of disease. In the mandible, a characteristic triangular opacity representing calcification within the secondary condylar cartilage ossification center was seen in 10 of the 13 patients. Defective dentition with incomplete enamel formation and/or caries was encountered in all patients. The paranasal sinuses were poorly pneumatized in all patients, but the ethmoid sinuses tended to be the least severely affected. Hypertelorism was present in five of the 13 patients, with a characteristic "space-alien" appearance on frontal radiographs. In younger patients, the calvarium demonstrated a high-attenuation inner table, a broad, low-attenuation diploic space, and a less high-attenuation outer table at CT. In three older children, a "hair-on-end" appearance was seen, which, at bone marrow scintigraphy, corresponded to areas of marked hematopoietic activity. Regions of sclerotic bone demonstrated low signal intensity on both T1- and T2-weighted MR images; areas containing marrow had intermediate signal intensity. These many new radiologic features of osteopetrosis are related to its pathophysiologic characteristics.

  3. Lengthenings and Shortenings in Germanic

    ERIC Educational Resources Information Center

    Kaden, Christiane

    2016-01-01

    Many languages have processes which lengthen or shorten a vowel or consonant. In this dissertation, I concentrate on Open Syllable Lengthening, Closed Syllable Shortening, Monosyllabic Lengthening and Trochaic Lengthening, and present a formal model which captures these lengthenings and shortening as the insertion, deletion or reassignment of a…

  4. Femoral lengthening in children and adolescents.

    PubMed

    Pejin, Z

    2017-02-01

    Current lengthening techniques are still based on the Ilizarov method and the concept of callotasis. Research and progress in medical devices have led to constant improvement in results. Hexapod fixators allow more precise correction of complex deformities, with shorter learning curve. Associating lengthening by external fixation (EF) to internal fixation (K-wire, intramedullary nail or locking plate) has reduced EF times and complications rates, while improving anatomic and functional results. Lengthening nails provides faster recovery of range of motion and return to activity during lengthening and consolidation, with better psychological tolerance. Lengthening with deformity correction by retrograde nailing has no impact on consolidation. Monolateral EF is a reliable and easy-to-implement technique that is well tolerated by patients. Association to internal fixation gives promising results. Bone healing solidity assessment on plain X-ray is highly subjective, with wide inter- and intra-observer variation; bone mineralization is better assessed in terms of pixel-value ratio (PVR: ratio of pixel value of regenerate to adjacent bone) on picture archiving and communication system (PACS) digitized radiographs, providing objective assessment of callus solidity.

  5. Lower limb lengthening in turner dwarfism.

    PubMed

    Hahn, Soo Bong; Park, Hui Wan; Park, Hong Jun; Seo, Young Jin; Kim, Hyun Woo

    2003-06-30

    The aim of this study was to review our cases of lower limb lengthening to treat Turner dwarfism, and to speculate whether or not effective limb lengthening can be achieved in this rare condition. Twelve tibiae and 2 femora were lengthened in 6 patients using the Ilizarov method for the tibia and a gradual elongation nail for the femur. The mean age at the time of surgery was 19 years, and the patients were followed up for a minimum of 2 years. The average gain in the tibial and femoral length was 6.2 cm and 6.0 cm, respectively. The average healing index of tibia and femur was 1.9 and 1.7 months. The average tibia-to-femur ratio improved from 0.68 preoperatively to 0.81 postoperatively, and leg-trunk ratios improved from 0.88 to 0.99. Seven segments (50.0 percent) had completed the lengthening protocol without complications. Two segments (14.3 percent) had an intractable pin site infection requiring a pin exchange, and four segments (35.7 percent) had twelve complications (a nonunion at the distraction site, premature consolidation, Achilles tendon contractures and planovalgus). The overall rate of complications was 100 percent for each bone lengthened. All the patients showing a nonunion at the distraction site had a reduced bone mass, which was less than 65 percent of those of the age-matched normal population. Despite the complications, all patients were satisfied with the results, and lower limb lengthening in Turner Dwarfism believed to be a valid option. However, it may require careful management in a specialist unit in order to prevent complications during the lengthening procedure. In addition, the osteopenia associated with an estrogen deficiency leading to problems in consolidation is a difficult issue to address.

  6. Severe growth retardation following limb lengthening: a case report.

    PubMed Central

    Price, C. T.; Carantzas, A. C.

    1996-01-01

    The first limb lengthening was reported by Codivilla in 1905. Common complications reported with this procedure include pain tract infections, angulation deformities, joint contractures, and residual limb length discrepancies. Growth arrest or severe growth retardation in the lengthened bones has rarely been reported. We report a case of a skeletally immature patient with right sided hemihypertrophy who underwent lengthening of the left lower extremity by the method of DeBastiani using Orthofix external fixators. Postoperatively he developed severe growth retardation in the lengthened limb, as evidenced by the Mosely straight line graph, and recurrence of his limb length discrepancy. The reason for this growth retardation remains unknown; however, we hypothesize that premature closure at one or more of the physes occurred because of increased tension across the growth plates. The practice of over-lengthening a congenitally short limb prior to physeal closure should be questioned because resumption of growth after lengthening may be unpredictable. PMID:9129286

  7. [Limb lengthening in children with osteogenesis imperfecta].

    PubMed

    Sułko, Jerzy; Radło, Wojciech

    2005-01-01

    The authors operated on 7 children (5 girls, 2 boys) suffering from osteogenesis imperfecta (oi) type I according to Sillence classification, with lower limbs discrepancy. We elongated 10 segments (7 femurs and 3 tibias). Mean age at operation time was 14.7 years (13-17 years). The mean leg length discrepancy was 9.3 cm (4-18 cm), and shortening of one bone was 6.5 cm (4-9 cm). We used Ilizarov technique twice in tibial lengthening. We used Wagner technique in one tibial elongation and in 7 femur elongation. Except for one tibia, in the remaining cases there was Rush rod inserted intramedullary in the bone being elongated. During tibial elongation we fixed lateral malleous by screw. The osteotomy was performed in proximal metaphysis of the 5 femurs and 3 tibias, and in distal femurs in two cases. The elongation was 1 mm for day, with frequency 4 x 1/4 mm. The mean bone lengthening achieved was 5.5 cm (2-9 cm); the mean lengthening of the limb was 7.9 cm (2-18 cm). The mean time of elongation was 2.8 months (2-5 months). Elongation index was 26 days for 1 cm of lengthening. The mean time of fixator removal was 9.2 months (4-13 months). Healing index was 58 day/1 cm (overall number of days for 1 cm lengthening). The complications occurred in all the patients. Although the risk of numerous complication is high, lower limbs lengthening in children with type I osteogeneis imperfecta is possible to perform and allows equalizing discrepant limbs or, at least reducing the difference.

  8. Strict X-ray beam collimation for facial bones examination can increase lens exposure

    PubMed Central

    Powys, R; Robinson, J; Kench, P L; Ryan, J; Brennan, P C

    2012-01-01

    Objectives It is well accepted that collimation is a cost-effective dose-reducing tool for X-ray examinations. This phantom-based study investigated the impact of X-ray beam collimation on radiation dose to the lenses of the eyes and thyroid along with the effect on image quality in facial bone radiography. Methods A three-view series (occipitomental, occipitomental 30 and lateral) was investigated, and radiation doses to the lenses and thyroid were measured using an Unfors dosemeter. Images were assessed by six experienced observers using a visual grading analysis and a total of 5400 observations were made. Results Strict collimation significantly (p<0.0001) reduced the radiation dose to the lenses of the eyes and thyroid when using a fixed projection-specific exposure. With a variable exposure technique (fixed exit dose, to simulate the behaviour of an automatic exposure control), while strict collimation was again shown to reduce thyroid dose, higher lens doses were demonstrated when compared with larger fields of exposure. Image quality was found to significantly improve using strict collimation, with observer preference being demonstrated using visual grading characteristic curves. Conclusion The complexities of optimising radiographic techniques have been shown and the data presented emphasise the importance of examining dose-reducing strategies in a comprehensive way. PMID:22374279

  9. Current concepts of leg lengthening.

    PubMed

    Hasler, Carol C; Krieg, Andreas H

    2012-06-01

    Any lower limb discrepancy may be equalised by conservative means (insoles, prosthesis and orthosis). However, their long-term acceptance is low in regard to function, costs, expenditure and appearance. Timely epiphysiodesis is the best option in uniplanar deformities with adequate remaining growth and for patients whose predicted final body height is above the 50th percentile. However, many patients present late or with multi-planar deformities, which warrant more sophisticated operative approaches. The history of surgical bone lengthening comprises 100 exciting years of struggling, development and ongoing learning. The initial strategy of acute or rapid incremental distraction had lasted almost half a century until Ilizarov recognised the benefits of biological periosteum-preserving osteotomies and incremental lengthening at slow rates (1 mm/day) at a 4 × 0.25-mm daily rhythm, well appreciated as callotasis. In parallel, ring and wire constructs made complex three-dimensional axial, translational and rotational bone moulding possible. Taylor Spatial Frames-built on hexapod strut-linked platform technology as known from flight simulators-took limb correction to a more reliable, more precise and aesthetical level, all the more that the whole process became web-based. It represents state-of-the-art methodology and technology for complex, multi-plane deformities. Due to the significant risk of secondary malalignment, indications for lengthening by unilateral fixation have shrunken to moderate amounts of length disparity and uni- to bi-planar deformities in patients with still open physes. Mechanical or motorised, minimally invasively placed nails prevent muscle fixation and, therefore, ease rehabilitation, increase patient comfort and potentially shorten the overall time of sick leave and refrain from sports activities. Hence, they offer a valuable alternative for low-grade complexity situations. It remains to be proved if the significantly higher implant costs

  10. Leg lengthening - slideshow

    MedlinePlus

    ... Indications URL of this page: //medlineplus.gov/ency/presentations/100127.htm Leg lengthening - series—Indications To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 3 Go to slide 2 ...

  11. Crown lengthening procedure in the management of amelogenesis imperfecta

    PubMed Central

    Kalaivani, S.; Manohar, Jenish; Shakunthala, P.; Sujatha, S.; Rajasekaran, S. A.; Karthikeyan, B.; Kalaiselvan, S.

    2015-01-01

    Full mouth rehabilitation includes a promising treatment planning and execution thus fulfilling esthetic, occlusal, and functional parameters maintaining the harmony of the stomatognathic system. Crown lengthening procedures have become an integral component of the esthetic armamentarium and are utilized with increasing frequency to enhance the appearance of restorations placed in the esthetic zone. Crown lengthening plays a role to create healthy relationship of the gingiva and bone levels so as to gain access to more of the tooth which can be restored, if it is badly worn, decayed or fractured, below the gum line. This paper highlights the full mouth crown lengthening procedure performed on a patient with amelogenesis imperfecta. PMID:26538965

  12. Crown lengthening procedure in the management of amelogenesis imperfecta.

    PubMed

    Kalaivani, S; Manohar, Jenish; Shakunthala, P; Sujatha, S; Rajasekaran, S A; Karthikeyan, B; Kalaiselvan, S

    2015-08-01

    Full mouth rehabilitation includes a promising treatment planning and execution thus fulfilling esthetic, occlusal, and functional parameters maintaining the harmony of the stomatognathic system. Crown lengthening procedures have become an integral component of the esthetic armamentarium and are utilized with increasing frequency to enhance the appearance of restorations placed in the esthetic zone. Crown lengthening plays a role to create healthy relationship of the gingiva and bone levels so as to gain access to more of the tooth which can be restored, if it is badly worn, decayed or fractured, below the gum line. This paper highlights the full mouth crown lengthening procedure performed on a patient with amelogenesis imperfecta.

  13. Neural control of lengthening contractions.

    PubMed

    Duchateau, Jacques; Enoka, Roger M

    2016-01-01

    A number of studies over the last few decades have established that the control strategy employed by the nervous system during lengthening (eccentric) differs from those used during shortening (concentric) and isometric contractions. The purpose of this review is to summarize current knowledge on the neural control of lengthening contractions. After a brief discussion of methodological issues that can confound the comparison between lengthening and shortening actions, the review provides evidence that untrained individuals are usually unable to fully activate their muscles during a maximal lengthening contraction and that motor unit activity during submaximal lengthening actions differs from that during shortening actions. Contrary to common knowledge, however, more recent studies have found that the recruitment order of motor units is similar during submaximal shortening and lengthening contractions, but that discharge rate is systematically lower during lengthening actions. Subsequently, the review examines the mechanisms responsible for the specific control of maximal and submaximal lengthening contractions as reported by recent studies on the modulation of cortical and spinal excitability. As similar modulation has been observed regardless of contraction intensity, it appears that spinal and corticospinal excitability are reduced during lengthening compared with shortening and isometric contractions. Nonetheless, the modulation observed during lengthening contractions is mainly attributable to inhibition at the spinal level.

  14. Unusual multifocal intraosseous papillary intralymphatic angioendothelioma (Dabska tumor) of facial bones: a case report and review of literature

    PubMed Central

    2013-01-01

    Abstract Papillary intralymphatic angioendothelioma (PILA) or Dabska tumor is extremely rare, and often affects the skin and subcutaneous tissues of children. Since its first description by Dabska, only a few intraosseous cases have been described in the literature and none of them presents with multifocal osteolytic lesion of bones. We present a case of unusual multifocal intraosseous PILA in facial bones occurring in a 1 year 3 month old male child. Computed tomography (CT) scan revealed multifocal osteolytic lesions were located at the left zygoma, left orbital bone and right maxillary. Histologically, the lesions were ill-defined and composed of multiple delicate interconnecting vascular channels with papillae formation which projected into the lumen lined by atypical plumped endothelial cells. The vascular channels were also lined by plump cuboidal endothelial cells with focal hobnailed or “match-head” appearance. In some areas, endothelial cells formed solid-appearing aggregates with vessel lumens. By immunohistochemistry, the tumor cells were positive for CD31, CD34 and D2-40 at varying intensity. A final diagnosis of intraosseous PILA was made. To the best of our knowledge, this case is the first case of primary multifocal osseous PILA. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1919488629100787 PMID:24063649

  15. Occlusal load distribution through the cortical and trabecular bone of the human mid-facial skeleton in natural dentition: a three-dimensional finite element study.

    PubMed

    Janovic, Aleksa; Saveljic, Igor; Vukicevic, Arso; Nikolic, Dalibor; Rakocevic, Zoran; Jovicic, Gordana; Filipovic, Nenad; Djuric, Marija

    2015-01-01

    Understanding of the occlusal load distribution through the mid-facial skeleton in natural dentition is essential because alterations in magnitude and/or direction of occlusal forces may cause remarkable changes in cortical and trabecular bone structure. Previous analyses by strain gauge technique, photoelastic and, more recently, finite element (FE) methods provided no direct evidence for occlusal load distribution through the cortical and trabecular bone compartments individually. Therefore, we developed an improved three-dimensional FE model of the human skull in order to clarify the distribution of occlusal forces through the cortical and trabecular bone during habitual masticatory activities. Particular focus was placed on the load transfer through the anterior and posterior maxilla. The results were presented in von Mises stress (VMS) and the maximum principal stress, and compared to the reported FE and strain gauge data. Our qualitative stress analysis indicates that occlusal forces distribute through the mid-facial skeleton along five vertical and two horizontal buttresses. We demonstrated that cortical bone has a priority in the transfer of occlusal load in the anterior maxilla, whereas both cortical and trabecular bone in the posterior maxilla are equally involved in performing this task. Observed site dependence of the occlusal load distribution may help clinicians in creating strategies for implantology and orthodontic treatments. Additionally, the magnitude of VMS in our model was significantly lower in comparison to previous FE models composed only of cortical bone. This finding suggests that both cortical and trabecular bone should be modeled whenever stress will be quantitatively analyzed.

  16. Humeral lengthening by distraction osteogenesis: a safe procedure?

    PubMed

    Ruette, Peter; Lammens, Johan

    2013-12-01

    This study was conducted to assess the safety of humeral lengthening using an Ilizarov frame. We retrospectively reviewed 26 humeral segments in 17 patients that were lengthened at our department between 1993 and 2011. There were varying aetiologies including achondroplasia, epiphyseal dysplasia, Oilier disease, trauma or infection of the proximal humeral growth-plate, unicameral bone cyst and brachial plexus injury. Mean age at start of surgery was 17.05 years (range : 5-40). The mean lengthening achieved was 8.85 (3-13) cm. Mean lengthening percentage was 353% (range : 10-48). Average healing index was 30.56 days/cm (range : 17.46-4232). There was a significant difference in healing index between achondroplasia patients (28.79 days/cm) compared to others (33.41 days/cm). Minor problems included pin tract infection (14 segments). More important obstacles were temporary elbow flexion contracture (7 segments), premature consolidation (6 segments), radial nerve dysaesthesia (6 segments) and loosening of a Schanz screw (1 segment). Complications included one fracture and one progressive bowing after frame removal. One planned lengthening was not completely achieved. Despite a lot of obstacles, humeral lengthening using an Ilizarov frame provided a reliable method to treat the functional or cosmetic problems of upper limb shortening.

  17. Simultaneous ipsilateral femoral and tibial lengthening with the Ilizarov method.

    PubMed

    Curran, A R; Kuo, K N; Lubicky, J P

    1999-01-01

    Eight pediatric patients who underwent nine simultaneous ipsilateral femoral and tibial lengthenings with the Ilizarov external fixator were reviewed. The patient's demographics, diagnoses, corticotomy levels, mechanical axes, healing indices, amounts of lengthening, and complications were recorded. The patients' average age was 8 years 10 months (5 years 4 months-15 years 10 months) with an average follow-up of 49 months (30-88 months). The percentage of femoral lengthening averaged 16.7% (8-23%) with an average healing index of 28 days/cm (20-38 days/cm). The percentage of tibial lengthening averaged 18% (9.6-23.6%) with an average healing index of 29 days/cm (1940 days/cm). Four complications in three patients occurred as a direct result of the lengthening process. Three of the complications involved soft-tissue contractures, which were each successfully treated with one additional surgical procedure, whereas the fourth complication involved poor bone regeneration and required bone grafting and additional immobilization.

  18. Leg lengthening and shortening

    MedlinePlus

    ... lead to very unequal leg lengths. They include: Poliomyelitis Cerebral palsy Small, weak muscles or short, tight ( ... Cerebral palsy Legg-Calve-Perthes disease Long bones Polio Review Date 11/20/2014 Updated by: Neil ...

  19. Limb lengthening and correction of deformity in the lower limbs of children with osteogenesis imperfecta.

    PubMed

    Saldanha, K A N; Saleh, M; Bell, M J; Fernandes, J A

    2004-03-01

    We performed limb lengthening and correction of deformity of nine long bones of the lower limb in six children (mean age, 14.7 years) with osteogenesis imperfecta (OI). All had femoral lengthening and three also had ipsilateral tibial lengthening. Angular deformities were corrected simultaneously. Five limb segments were treated using a monolateral external fixator and four with the Ilizarov frame. In three children, lengthening was done over previously inserted femoral intramedullary rods. The mean lengthening achieved was 6.26 cm (mean healing index, 33.25 days/cm). Significant complications included one deep infection, one fracture of the femur and one anterior angulation deformity of the tibia. The abnormal bone of OI tolerated the external fixators throughout the period of lengthening without any episodes of migration of wires or pins through the soft bone. The regenerate bone formed within the time which is normally expected in limb-lengthening procedures performed for other conditions. We conclude that despite the abnormal bone characteristics, distraction osteogenesis to correct limb-length discrepancy and angular deformity can be performed safely in children with OI.

  20. Free bone graft reconstruction of irradiated facial tissue: Experimental effects of basic fibroblast growth factor stimulation

    SciTech Connect

    Eppley, B.L.; Connolly, D.T.; Winkelmann, T.; Sadove, A.M.; Heuvelman, D.; Feder, J. )

    1991-07-01

    A study was undertaken to evaluate the potential utility of basic fibroblast growth factor in the induction of angiogenesis and osseous healing in bone previously exposed to high doses of irradiation. Thirty New Zealand rabbits were evaluated by introducing basic fibroblast growth factor into irradiated mandibular resection sites either prior to or simultaneous with reconstruction by corticocancellous autografts harvested from the ilium. The fate of the free bone grafts was then evaluated at 90 days postoperatively by microangiographic, histologic, and fluorochrome bone-labeling techniques. Sequestration, necrosis, and failure to heal to recipient osseous margins was observed both clinically and histologically in all nontreated irradiated graft sites as well as those receiving simultaneous angiogenic stimulation at the time of graft placement. No fluorescent activity was seen in these graft groups. In the recipient sites pretreated with basic fibroblast growth factor prior to placement of the graft, healing and reestablishment of mandibular contour occurred in nearly 50 percent of the animals. Active bone formation was evident at cortical margins adjacent to the recipient sites but was absent in the more central cancellous regions of the grafts.

  1. Aesthetic Surgical Crown Lengthening Procedure

    PubMed Central

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A.; Shibli, Jamil A.; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment. PMID:26609452

  2. [Motor nerves of the face. Surgical and radiologic anatomy of facial paralysis and their surgical repair].

    PubMed

    Vacher, C; Cyna-Gorse, F

    2015-10-01

    Motor innervation of the face depends on the facial nerve for the mobility of the face, on the mandibular nerve, third branch of the trigeminal nerve, which gives the motor innervation of the masticator muscles, and the hypoglossal nerve for the tongue. In case of facial paralysis, the most common palliative surgical techniques are the lengthening temporalis myoplasty (the temporal is innervated by the mandibular nerve) and the hypoglossal-facial anastomosis. The aim of this work is to describe the surgical anatomy of these three nerves and the radiologic anatomy of the facial nerve inside the temporal bone. Then the facial nerve penetrates inside the parotid gland giving a plexus. Four branches of the facial nerve leave the parotid gland: they are called temporal, zygomatic, buccal and marginal which give innervation to the cutaneous muscles of the face. Mandibular nerve gives three branches to the temporal muscles: the anterior, intermediate and posterior deep temporal nerves which penetrate inside the deep aspect of the temporal muscle in front of the infratemporal line. The hypoglossal nerve is only the motor nerve to the tongue. The ansa cervicalis, which is coming from the superficial cervical plexus and joins the hypoglossal nerve in the submandibular area is giving the motor innervation to subhyoid muscles and to the geniohyoid muscle.

  3. Limb lengthening combined with deformity correction in children with the Taylor Spatial Frame.

    PubMed

    Iobst, Christopher

    2010-11-01

    It is difficult to replicate the regular rate and rhythm described by Ilizarov while lengthening with the Taylor Spatial Frame. The purpose of the study was to examine whether this breach of Ilizarov's principles has any deleterious effect on the ability of children to make healthy regenerate bone. A retrospective case-control study was performed comparing pediatric patients undergoing primarily lengthening with Taylor Spatial Frame rings and struts, and patients undergoing lengthening with Taylor Spatial Frame rings and Ilizarov clickers. Fifteen patients had primarily lengthening with Taylor Spatial Frame rings and struts, and six patients had lengthening with Taylor Spatial Frame rings and Ilizarov clickers. Statistically, there was no significant difference between the two groups in terms of age, latency, pre-operative bone length percentage, and average length gained. The lengthening index for the strut group (1.79 months/cm) was significantly different from the clicker group (1.33 months/cm) with P=0.012. For a pediatric patient with lower extremity long bone deformities in multiple planes, the Taylor Spatial Frame is an excellent option. However, the surgeon should anticipate a slightly longer duration of treatment with the Taylor Spatial Frame compared to Ilizarov frames and plan his/her fixation accordingly. For the straightforward lengthening of pediatric long bones without significant concomitant deformity, our results indicate that the Ilizarov method appears to be superior to the Taylor Spatial Frame struts and should still be considered the gold standard.

  4. Distraction osteogenesis for ulnar lengthening in Kienbock’s disease

    PubMed Central

    Kawoosa, A. A.; Mir, M. R.; Butt, M. F.

    2006-01-01

    Ulnar lengthening is an accepted modality of treatment to achieve joint levelling in Kienbock’s disease. The conventional method of ulnar lengthening with a plate and bone graft is fraught with complications including graft site morbidity, non-union, hardware removal and difficulty in the achievement of a proper length. We used a Umex distractor to achieve distraction osteogenesis in a group of 12 patients and assessed them over an average follow-up period of 29.5 months. We had one excellent, ten good and one fair result. We conclude that distraction osteogenesis addresses all the complications of coventional lengthening in addition to providing an increase in the local blood supply, which might be beneficial in a disease that is primarily an avascular necrosis. This procedure addresses both the biomechanical and the biological aspects of this disease. PMID:16821009

  5. Pelvic Support Osteotomy; Salvage Procedure in Chronically Dislocated Hips Case Report: Technical Note on the On-lay Bone Positioning of a Lengthening Nail and Review of the Literature

    PubMed Central

    Reynders-Frederix, Pieter; Reynders-Frederix, Cristina; Wajid, Muhammad

    2016-01-01

    Background: Young patients with a acquired dislocation of the hip with concomitant shortening of the lower limb is a difficult diagnostic problem with few definite treatment options. Methods: We used the technique, originally described by Ilizarov, with a double femur osteotomy and lengthening the femur. Lengthening was done with a sub muscular placed on-lay femur distraction rod. Distraction of the rod was done by fluid mechanics. After lengthening, the distraction was secured by a parked plate by locking the distal part of the plate. Results: This patient needed a lengthening of 60 mm, distraction time was 36 days with a distraction index of 1.61 mm per day and a healing index of 31.4 days per cm lengthening.We encountered one complication in which an exchange of the plastic feeding tube was needed at 20 days post-surgery. Conclusions: In the reported case we could improve gait with reduced limping and equalizing her leg length discrepancy. PMID:27583056

  6. Clinical Results and Complications of Lower Limb Lengthening for Fibular Hemimelia

    PubMed Central

    Mishima, Kenichi; Kitoh, Hiroshi; Iwata, Koji; Matsushita, Masaki; Nishida, Yoshihiro; Hattori, Tadashi; Ishiguro, Naoki

    2016-01-01

    Abstract Fibular hemimelia is a rare but the most common congenital long bone deficiency, encompassing a broad range of anomalies from isolated fibular hypoplasia up to substantial femoral and tibial shortening with ankle deformity and foot deficiency. Most cases of fibular hemimelia manifest clinically significant leg length discrepancy (LLD) with time that requires adequate correction by bone lengthening for stable walking. Bone lengthening procedures, especially those for pathological bones, are sometimes associated with severe complications, such as delayed consolidation, fractures, and deformities of the lengthened bones, leading to prolonged healing time and residual LLD at skeletal maturity. The purpose of this study was to review our clinical results of lower limb lengthening for fibular hemimelia. This study included 8 Japanese patients who diagnosed with fibular hemimelia from physical and radiological findings characteristic of fibular hemimelia and underwent single or staged femoral and/or tibial lengthening during growth or after skeletal maturity. LLD, state of the lengthened callus, and bone alignment were evaluated with full-length radiographs of the lower limb. Previous interventions, associated congenital anomalies, regenerate fractures were recorded with reference to medical charts and confirmed on appropriate radiographs. Successful lengthening was defined as the healing index <50 days/cm without regenerate fractures. A significant difference was observed in age at surgery between successful and unsuccessful lengthening. The incidence of regenerate fractures was significantly correlated with callus maturity before frame removal. LLD was corrected within 11 mm, whereas mechanical axis deviated laterally. Particular attention should be paid to the status of callus maturation and the mechanical axis deviation during the treatment period in fibular hemimelia. PMID:27227952

  7. Bilateral double level tibial lengthening in dwarfism☆

    PubMed Central

    Burghardt, Rolf D.; Yoshino, Koichi; Kashiwagi, Naoya; Yoshino, Shigeo; Bhave, Anil; Paley, Dror; Herzenberg, John E.

    2015-01-01

    Purpose Outcome assessment after double level tibial lengthening in patients with dwarfism. Methods Fourteen patients with dwarfism were analyzed after bilateral simultaneous double level tibial lengthening. Results Average age was 15.1 years. Average lengthening was 13.5 cm. The two levels were lengthened by an average of 7.5 cm proximally and 6.0 cm distally. Concomitant deformities were also addressed during lengthening. External fixation treatment time averaged 8.8 months. Healing index averaged 0.7 months/cm. Conclusion Bilateral tibial lengthening for dwarfism is difficult, but the results are usually quite gratifying. PMID:26566326

  8. Lengthening Temporalis Myoplasty: Virtual Animation-Assisted Technical Video.

    PubMed

    Aljudaibi, Nawaf; Bennis, Yasmine; Duquennoy-Martinot, Veronique; Labbé, Daniel; Guerreschi, Pierre

    2016-09-01

    Lengthening temporalis myoplasty is a well-established procedure for dynamic palliative reanimation of the lip in facial palsy sequelae. The particularity of this technique is that the entire temporal muscle is transferred from the coronoid process to the upper half of the lip without interposition of aponeurotic tissue. To date, no video describing the technique was available. This is the first video describing the entire procedure, from preoperative markings through postoperative rehabilitation. In the video presented herein, the authors craft virtual three-dimensional animations in addition to a live operation on a patient performed by Daniel Labbé, who first described this technique 20 years ago.

  9. Forces involved in lower limb lengthening: an in vivo biomechanical study.

    PubMed

    Lauterburg, Martin Th; Exner, G Ulrich; Jacob, Hilaire A C

    2006-09-01

    Despite improvements in surgical techniques for limb-lengthening procedures, the complication rate remains high. Bone fixators must cope with the forces involved during treatment, providing sufficient strength to maintain integrity of the limb in the course of lengthening, while permitting some "micromotion" across the bone gap that could enhance healing during the final phase of bone consolidation. This study reports on the forces generated during limb lengthening in the distraction and consolidation phases. Forces were measured on 19 patients between 6 and 22 years of age with 10 femoral and 11 tibial lengthenings of 1 mm/day by means of a monotube external fixator, fitted diaphysially, and modified to measure tension and weight-bearing forces. Peak force measured during the lengthening period amounted to about 14 N/kg of body mass. Generally, distraction forces leveled off at between 8 and 10 N/kg of body mass. During the consolidation period, the average force carried by the fixator dropped from 55% initially to about 10% of the force transmitted to the ground, consistent with increased load carrying capacity of the bone as healing progressed. Studying the forces involved in limb lengthening is important to gain knowledge of the forces required to overcome the resistance offered by the tissues that bridge the osteotomy site, to understand the biology of distraction osteogenesis and histiogenesis across the regenerate over time, and to provide scientific guidelines for frame removal.

  10. [Rehabilitation of facial paralysis].

    PubMed

    Martin, F

    2015-10-01

    Rehabilitation takes an important part in the treatment of facial paralysis, especially when these are severe. It aims to lead the recovery of motor activity and prevent or reduce sequelae like synkinesis or spasms. It is preferable that it be proposed early in order to set up a treatment plan based on the results of the assessment, sometimes coupled with an electromyography. In case of surgery, preoperative work is recommended, especially in case of hypoglossofacial anastomosis or lengthening temporalis myoplasty (LTM). Our proposal is to present an original technique to enhance the sensorimotor loop and the cortical control of movement, especially when using botulinum toxin and after surgery.

  11. Limb Lengthening in Patients with Achondroplasia

    PubMed Central

    Park, Kwang-Won; Garcia, Rey-an Niño; Rejuso, Chastity Amor; Choi, Jung-Woo

    2015-01-01

    Purpose Although bilateral lower-limb lengthening has been performed on patients with achondroplasia, the outcomes for the tibia and femur in terms of radiographic parameters, clinical results, and complications have not been compared with each other. We proposed 1) to compare the radiological outcomes of femoral and tibial lengthening and 2) to investigate the differences of complications related to lengthening. Materials and Methods We retrospectively reviewed 28 patients (average age, 14 years 4 months) with achondroplasia who underwent bilateral limb lengthening between 2004 and 2012. All patients first underwent bilateral tibial lengthening, and at 9-48 months (average, 17.8 months) after this procedure, bilateral femoral lengthening was performed. We analyzed the pixel value ratio (PVR) and characteristics of the callus of the lengthened area on serial radiographs. The external fixation index (EFI) and healing index (HI) were computed to compare tibial and femoral lengthening. The complications related to lengthening were assessed. Results The average gain in length was 8.4 cm for the femur and 9.8 cm for the tibia. The PVR, EFI, and HI of the tibia were significantly better than those of the femur. Fewer complications were found during the lengthening of the tibia than during the lengthening of the femur. Conclusion Tibial lengthening had a significantly lower complication rate and a higher callus formation rate than femoral lengthening. Our findings suggest that bilateral limb lengthening (tibia, followed by femur) remains a reasonable option; however, we should be more cautious when performing femoral lengthening in selected patients. PMID:26446651

  12. The Facial Growth Pattern and the Amount of Palatal Bone Deficiency Relative to Cleft Size Should Be Considered in Treatment Planning

    PubMed Central

    2016-01-01

    Background: The aim of this study is to determine the best surgical/orthodontic treatment plan for the complete bilateral and unilateral cleft lip and palate patient to achieve all treatment goals of facial aesthetics, speech, dental function, and psychosocial development. Methods: Review of 40 years of serial complete bilateral cleft lip and palate and complete unilateral cleft lip and palate dental casts and photographs from birth to adolescence, with serial cephs starting at 4 years. This was part of a multicenter international 3-dimensional palatal growth study of serial dental casts of patients who developed good speech, occlusion, and facial growth. Results: Nasoalveolar molding and gingivoperiosteoplasty were introduced without proven longitudinal benefits. The procedure bodily retruded the premaxilla, which “telescoped” backward causing synostosis at the premaxillary vomerine suture. The resulting midfacial recessiveness with an anterior dental crossbite can only be corrected by midfacial protraction or a Le Fort I surgery. Conclusions: Staged orthodontic/surgical treatment limiting premaxillary retraction forces to lip adhesion or forces that cause only premaxillary ventroflexion produce the best results. The palatal cleft should be closed between 18 and 24 months when the ratio of the cleft to the palatal size medial to the alveolar ridge is at least 10%. The protruding premaxilla should only be ventroflexed but never bodily retruded. The facial growth pattern and degree of palatal bone deficiency are the main items to be considered in treatment planning. PMID:27579230

  13. Slide crown lengthening procedure using wide surface incisions and cyanoacrylate.

    PubMed

    Szymaitis, Dennis W

    2011-01-01

    This article introduces the slide crown lengthening procedure (SCLP), which incorporates surgical design features to overcome present crown lengthening procedure (CLP) shortcomings. The result is a 75% decrease in required surgery on adjacent teeth and a corresponding 75% reduction in surgical time. Other advantages include a reduction in surgical morbidity, improvement in terminal esthetics, and fewer teeth subject to papillae removal and apically repositioned gingiva. The 20 to 30 degree incision forming the slide is the pivotal feature; it allows effortless flap positioning. This incision angle enables wide surface incisions to adhere flaps together by producing stronger fibrin clots, decreasing tissue retraction angles, and reforming disrupted fibrin clots as incision sides slide while maintaining contact. This enhanced fibrin clot eliminates the need for sutures. The slide produced by the 20 to 30 degree incision functions for crown lengthening on all sites (facial, lingual, or palatal). This versatile surgical design introduces a new healing dimension that adapts to and provides benefits for other dental surgeries, such as gingival grafts, endodontic surgery, implants, and extractions.

  14. Response of ramus following vertical lengthening with distraction osteogenesis.

    PubMed

    Tuzuner-Oncul, Aysegul Mine; Kisnisci, Reha S

    2011-09-01

    Vertical lengthening of the mandibular ramus is considered to be one of the least stable surgical procedures in the management of musculoskeletal maxillofacial deformities. The aim of this study was to evaluate the response of the mandibular ramus following vertical lengthening by means of distraction osteogenesis. This study included eight non-syndromic adult patients with temporomandibular joint ankylosis. The vertical height deficiency of the mandibular ramus and the ramus/condyle unit on the affected side were simultaneously reconstructed by transportation of a bone segment using distraction osteogenesis following gap arthroplasty. Lateral and posteroanterior (PA) cephalograms taken postoperatively before active distraction, at the completion of distraction and 6, 12, 24 months after distraction, were compared to evaluate the changes of the ramus height. In all cases the vertical ramus and ramus/condyle unit height loss were successfully reconstructed by distraction osteogenesis. There was no relapse in the amount of height gained by distraction osteogenesis at the 24 months follow-up review (p>0.05). Acute one stage vertical lengthening of the mandibular ramus is considered to be one of the least stable musculoskeletal procedures with relapse being a significant adverse outcome. In this clinical study gradual vertical lengthening of the ramus through ramus/condyle unit distraction osteogenesis has maintained the initial vertical ramus height gained for 24 months.

  15. Femoral lengthening with a motorized intramedullary nail

    PubMed Central

    Horn, Joachim; Grimsrud, Øyvind; Dagsgard, Anita Hoddevik; Huhnstock, Stefan; Steen, Harald

    2015-01-01

    Purpose We assessed whether an intramedullary lengthening device would reduce the problems normally associated with the external fixation technique. We also wanted to determine whether it is a reliable construct for limb lengthening and deformity correction in the femur. Patients and methods We conducted a matched-pair comparison of 30 femoral lengthenings, 15 with a motorized intramedullary nail (the nail group) and 15 lengthenings with an external ring fixator (the fixator group). The patients were matched based on age, sex, amount of lengthening, and the etiology of leg length discrepancy. Mean lengthening was 35 (25–55) mm in the nail group and 38 (15–75) mm in the fixator group. Outcome measures were: lengthening and alignment achieved, consolidation index, knee range of motion (ROM), and complications. Results The pairs in this matched-pair study were similar in terms of age, sex, diagnosis, and amount of lengthening. The planned amount of lengthening was achieved in all patients in both groups and axis correction was considered sufficient. The mean radiographic consolidation index in the nail group, at 1.5 (0.9–3.0) months/cm, was better than the mean value for the fixator group (1.9 (0.9–3.4) months/cm) (p = 0.01). Knee ROM was better in the nail group during the lengthening, 6 weeks after lengthening was completed, and 6 months after lengthening was completed (p < 0.001). A larger number of complications were observed in the fixator group than in the nail group. Interpretation A lengthening nail may be superior to external fixation in femoral lengthening, when the anatomical conditions and the complexity of the deformity allow the use of an intramedullary nail. PMID:25191936

  16. Facial paralysis

    MedlinePlus

    ... otherwise healthy, facial paralysis is often due to Bell palsy . This is a condition in which the facial ... speech, or occupational therapist. If facial paralysis from Bell palsy lasts for more than 6 to 12 months, ...

  17. Limb Lengthening and Then Insertion of an Intramedullary Nail: A Case-matched Comparison

    PubMed Central

    Kleinman, Dawn; Fragomen, Austin T.; Ilizarov, Svetlana

    2008-01-01

    Distraction osteogenesis is an effective method for lengthening, deformity correction, and treatment of nonunions and bone defects. The classic method uses an external fixator for both distraction and consolidation leading to lengthy times in frames and there is a risk of refracture after frame removal. We suggest a new technique: lengthening and then nailing (LATN) technique in which the frame is used for gradual distraction and then a reamed intramedullary nail inserted to support the bone during the consolidation phase, allowing early removal of the external fixator. We performed a retrospective case-matched comparison of patients lengthened with LATN (39 limbs in 27 patients) technique versus the classic (34 limbs in 27 patients). The LATN group wore the external fixator for less time than the classic group (12 versus 29 weeks). The LATN group had a lower external fixation index (0.5 versus 1.9) and a lower bone healing index (0.8 versus 1.9) than the classic group. LATN confers advantages over the classic method including shorter times needed in external fixation, quicker bone healing, and protection against refracture. There are also advantages over the lengthening over a nail and internal lengthening nail techniques. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18800209

  18. Limb Lengthening Using the PRECICETM Nail System: Complications and Results

    PubMed Central

    Wiebking, Ulrich; Liodakis, Emmanouil; Kenawey, Mohamed; Krettek, Christian

    2016-01-01

    Background Three types of telescopic nails are mainly used for intramedullary limb lengthening nowadays. Despite some important advantages of this new technology (e.g. controlled distraction rate, not restricted availability, possibility to perform accordion maneuvers), few articles exist on clinical results and complications after lengthening with the PRECICETM nail (Ellipse, USA). Objectives The aim of the current study was to describe and analyze the complications associated with lengthening with the PRECICETM nail. Are the problems preventable when using the PRECICE, related to the distraction rate control, the lengthening goals and technique and handling? Methods We retrospectively reviewed the charts of 9 patients operated between 2012 and 2013 with a PRECICETM nail for a leg length discrepancy (LLD). The mean age of the patients was 32 years (range, 17 - 48 years). There were 5 femoral and 4 tibial procedures. The causes of LLD were posttraumatic (n = 5) and congenital (n = 4). The mean LLD was 36.4 ± 11.4 mm. The minimum follow-ups were 2 months (average, 5 months; range, 2 - 9 months). Results The mean distraction rate was 0.5 ± 0.1 mm/day. We observed in 7 patients differences in achieving the lengthening goals (average, 1.6 mm; range, -20.0 - 5.0 mm). Average lengthening was 34.7 ± 10.7 mm. All patients reached normal alignment and normal joint orientation. An unintentional loss of the achieved length during the consolidation phase was noticed in patients with delayed bone healing in two cases. In the first case (loss of 20mm distraction) the nail could be redistracted and the goal length was achieved. In the second case (loss of 10mm distraction) the nail broke shortly after the diagnosis and the nail was exchanged. Conclusions We report of loss of achieved length after lengthening with a telescopic nail. Weight bearing before complete consolidation of the regenerate might be a risk factor for that. Thorough examination of the limb length and careful

  19. Diagnostic imaging in the planning and monitoring of limb lengthening by the Ilizarov method.

    PubMed

    Swiatkowski, Jan; Zarek, Sławomir; Macias, Jarosław

    2002-06-30

    Limb lengthening is a long and complicated process, and therefore requires monitoring by use of imaging methods. In planning the application of the Ilizarov method, it is essential to consider the pathology as a whole, and not merely the individual symptoms. This is particularly important in generalized defect on bone formation. The baseline clinical and radiological evaluation should elucidate the etiology of deformations and the extent of changes. Routine X ray examinations during limb lengthening (apart from baseline and immediate post-surgery) should be performed after two and four weeks of distraction, and then every month until the Ilizarov apparatus is removed. Bone cross-sections obtained in CT scans enable the evaluation of the rate of bone regeneration and the reconstruction of tubular bone shape. In doubtful situations CT scans of the regenerated bone three months after removal of the apparatus are also recommended.

  20. [Dual energy X-ray absorptiometry in Ilizarov lower extremity lengthening: preliminary study].

    PubMed

    Wroński, S; Wojciechowski, P; Wójcik, K; Kusz, D

    1999-01-01

    Ilizarov method for lower extremity lengthening has been employed in 107 patients. Some 25% of numerous complications are bony union disturbances. Dual energy X-ray absorptiometry (DEXA) for assessment of new bone formation was introduced to reduce these problems. Detailed densitometry methodology developed on the ground of 93 measurements in 11 patients is presented. Pre-operative measurement was followed by subsequent evaluations done every 3 weeks after the onset of distraction. DEXA was capable of showing the callus 3-4 weeks earlier than conventional radiography. DEXA allows for adjusting the pace of lengthening to the extent of new bone mineralization, evaluation of lengthening achieved, determining the timing for safe removal of the apparatus. The need for temporary rearranging of the apparatus and troublesome image analysis are among the drawbacks of the method.

  1. Facial Scar Revision: Understanding Facial Scar Treatment

    MedlinePlus

    ... Contact Us Trust your face to a facial plastic surgeon Facial Scar Revision Understanding Facial Scar Treatment When ... face like the eyes or lips. A facial plastic surgeon has many options for treating and improving facial ...

  2. Comparison between lengthening over nail and conventional Ilizarov lengthening: a prospective randomized clinical study.

    PubMed

    El-Husseini, Timour F; Ghaly, Nabil A M; Mahran, Mahmoud A; Al Kersh, Mohamed Ahmed; Emara, Khaled M

    2013-08-01

    The aim of this study is to compare lengthening over an intramedullary nail to the conventional Ilizarov method with regard to percentage length increase, external fixation index, consolidation index and incidence of complications. This is a prospective randomized controlled study. Thirty-one limbs in 28 patients were included in the study; 15 were lengthened over an intramedullary nail, and 16 limbs were lengthened conventionally. The mean duration of external fixation in the lengthening over nail group was 52.2 days compared to 180.4 days in the conventional group. There was higher incidence of complications in the conventional method group. In comparison with conventional Ilizarov lengthening, lengthening over an intramedullary nail offers a shorter period of external fixation and fewer complications overall, but there is a high incidence of deep intramedullary infection which is serious.

  3. Cosmetic Lateral Canthoplasty: Lateral Canthoplasty to Lengthen the Lateral Canthal Angle and Correct the Outer Tail of the Eye

    PubMed Central

    Yun, Byung Min

    2016-01-01

    There are many women who want larger and brighter eyes that will give a favorable impression. Surgical methods that make the eye larger and brighter include double eyelidplasty, epicanthoplasty, as well as lateral canthoplasty. Double eyelidplasty produces changes in the vertical dimension of the eyes, whereas epicanthoplasty and lateral canthoplasty create changes in the horizontal dimension of the eyes. Epicanthoplasty, a surgical procedure which enlarges the eye horizontally, is performed at the inner corner of the eye, whereas lateral canthoplasty enlarges the outer edge of the eye. In particular, if the slant of the palpebral fissure is raised and the horizontal dimension of the palpebral fissure is short, adjusting the slant of the palpebral fissure through lateral canthoplasty can achieve an enlargement of eye width and smoother features. Depending on the patient's condition, even better results can be achieved if this procedure is performed in conjunction with other procedures, such as double eyelidplasty, epicanthoplasty, eye roll formation surgery, fat graft, and facial bone contouring surgery. In this paper, the authors will introduce in detail their surgical method for a cosmetic lateral canthoplasty that lengthens the lateral canthal angle and corrects the outer tail of the eyes, in order to ease the unfavorable impression. PMID:27462564

  4. Structural changes in the lengthened rabbit muscle

    PubMed Central

    Berki, Sándor; Shisha, Tamás; Kiss, Sándor; Szőke, György

    2008-01-01

    This study evaluated the histological changes in muscle tissue after limb lengthening in skeletally mature and immature rabbits and assessed the most vulnerable level of striated muscle. Twenty-three male domestic white rabbits, divided into six groups, were operated on and different lengthening protocols were used in the mature and immature rabbits. The histopathological changes were analysed by a semi-quantitative method according to the scoring system of Lee et al. (Acta Orthop Scand 64(6):688–692, 1993). After the evaluation of the five main degenerative parameters (muscle atrophy, muscle nuclei internalisation, degeneration of the muscle fibre, perimysial and endomysial fibrosis, haematomas), it is evident that the adults lengthened at a rate of 1.6 mm/day showed more degenerative changes than those lengthened at 0.8 mm/day. The adult 1.6 mm/day lengthened group presented significantly higher damage in the muscle and lower regenerative signs compared with the young 1.6 mm/day lengthened group, according to the summarised degenerative scores. PMID:18259704

  5. Lengthened temporal integration in schizophrenia.

    PubMed

    Parsons, Brent D; Gandhi, Shilpa; Aurbach, Elyse L; Williams, Nina; Williams, Micah; Wassef, Adel; Eagleman, David M

    2013-01-01

    Research in schizophrenia has tended to emphasize deficits in higher cognitive abilities, such as attention, memory, and executive function. Here we provide evidence for dysfunction at a more fundamental level of perceptual processing, temporal integration. On a measure of flicker fusion, patients with schizophrenia exhibited significantly lower thresholds than age and education matched healthy controls. We reasoned that this finding could result from a longer window of temporal integration or could reflect diminished repetition suppression: if every frame of the repeating stimulus were represented as novel, its perceived duration would be accordingly longer. To tease apart these non-exclusive hypotheses, we asked patients to report the number of stimuli perceived on the screen at once (numerosity) as they watched rapidly flashing stimuli that were either repeated or novel. Patients reported significantly higher numerosity than controls in all conditions, again indicating a longer window of temporal integration in schizophrenia. Further, patients showed the largest difference from controls in the repeated condition, suggesting a possible effect of weaker repetition suppression. Finally, we establish that our findings generalize to several different classes of stimuli (letters, pictures, faces, words, and pseudo-words), demonstrating a non-specific effect of a lengthened window of integration. We conclude that the visual system in schizophrenics integrates input over longer periods of time, and that repetition suppression may also be deficient. We suggest that these abnormalities in the processing of temporal information may underlie higher-level deficits in schizophrenia and account for the disturbed sense of continuity and fragmentation of events in time reported by patients.

  6. [Facial palsy].

    PubMed

    Cavoy, R

    2013-09-01

    Facial palsy is a daily challenge for the clinicians. Determining whether facial nerve palsy is peripheral or central is a key step in the diagnosis. Central nervous lesions can give facial palsy which may be easily differentiated from peripheral palsy. The next question is the peripheral facial paralysis idiopathic or symptomatic. A good knowledge of anatomy of facial nerve is helpful. A structure approach is given to identify additional features that distinguish symptomatic facial palsy from idiopathic one. The main cause of peripheral facial palsies is idiopathic one, or Bell's palsy, which remains a diagnosis of exclusion. The most common cause of symptomatic peripheral facial palsy is Ramsay-Hunt syndrome. Early identification of symptomatic facial palsy is important because of often worst outcome and different management. The prognosis of Bell's palsy is on the whole favorable and is improved with a prompt tapering course of prednisone. In Ramsay-Hunt syndrome, an antiviral therapy is added along with prednisone. We also discussed of current treatment recommendations. We will review short and long term complications of peripheral facial palsy.

  7. Facial Fractures

    PubMed Central

    White, Lawrence M.; Marotta, Thomas R.; McLennan, Michael K.; Kassel, Edward E.

    1992-01-01

    Appropriate clinical radiographic investigation, together with an understanding of the normal radiographic anatomy of the facial skeleton, allows for precise delineation of facial fracutres and associated soft tissue injuries encountered in clinical practice. A combination of multiple plain radiographic views and coronal and axial computed tomographic images allow for optimal delineation of fracture patterns. This information is beneficial in the clinical and surgical management patients with facial injuries

  8. Digital Lengthening to Treat Finger Deficiency: An Experience of 201 Digits in 104 Patients

    PubMed Central

    2017-01-01

    Objectives. We evaluated the results of digital lengthening by distraction and second-stage bone graft. Methods. We treated finger deficiency of 201 digits in 104 patients (68 males, 36 females) by digital distraction and second-stage bone graft. The distraction was performed with a rate of 1 mm/day (for the first ten days) and 0.5 mm/day followed by using a self-designed bilateral tubal-helical external fixator. The mean follow-up period was 42 months (range 6 to 60 months). Results. The mean lengthening was 29.2 mm (range 25 to 40 mm) and 18.7 mm (range 12 to 32 mm) for metacarpal bones and phalanges, respectively. The mean elongation rate was 174.4% (range 145% to 202%) and 184.8% (range 115% to 283%) for metacarpal bones and phalanges, respectively. The static two-point discriminations and SpO2 showed no significant differences before and after distraction. Four complications were observed (two skin ruptures and two phalangeal splitting). No pin tract infection or tendon rupture showed. Digital lengthening improved functions of the hand. Conclusion. Digital distraction and second-stage bone graft is an effective method to compensate disabilities caused by lack of finger length. It could be an alternative plan for patients with thumb deficiency instead of toe-to-thumb transplant and patients with finger deficiency instead of ray resection. PMID:28286765

  9. Facial Scar Revision: Understanding Facial Scar Treatment

    MedlinePlus

    ... Contact Us Trust your face to a facial plastic surgeon Facial Scar Revision Understanding Facial Scar Treatment ... face like the eyes or lips. A facial plastic surgeon has many options for treating and improving ...

  10. Growth factors in human serum during operative tibial lengthening with the Ilizarov method.

    PubMed

    Stogov, Maksim V; Luneva, Svetlana N; Novikov, Konstantin I

    2013-12-01

    Despite the widespread clinical use of distraction osteogenesis for limb lengthening, the cellular and molecular mechanisms by which this surgical treatment promotes new bone formation in humans are not well understood. The aim of the research was to study the levels of growth factors (GFs) in the serum of patients that were undergoing tibial lengthening with the Ilizarov method of distraction osteogenesis. Those were patients with unilateral congenital discrepancy of the tibia (n = 12), unilateral posttraumatic tibial shortening (n = 7), and healthy patients that underwent cosmetic bilateral tibial lengthening (n = 10). The study established that unlike the congenital group, the posttraumatic group and healthy subjects showed a significantly evident increase in the levels of angiogenic GFs in their serum on day 10 of distraction. In the congenital group, the changes were not significant at this time point. The levels of TGF-α, TGF-β1, and TGF-β2 tended to decrease on day 10 of distraction and on day 30 of the post-distraction period in the cosmetic and posttraumatic groups while they grew in the congenital group. Most dynamic changes in the GFs levels during tibial lengthening were noted in the subjects undergoing cosmetic lengthening, and the least ones were in the congenital group.

  11. Intramedullary leg lengthening with a motorized nail

    PubMed Central

    2011-01-01

    Background and purpose In the last decade, intramedullary limb lengthening has become a viable alternative to traditional external systems. We retrospectively analyzed the use of an intramedullary motorized nail (Fitbone) in a consecutive series of 32 patients. Patients and methods During the period September 2006 to December 2008, 32 consecutive patients with a median age of 17 (IQR: 15–19) years were treated with a fully implantable, motorized intramedullary lengthening device (Fitbone). The median leg length discrepancy was 35 (IQR: 30–44) mm at the femur (n = 21) and 28 (IQR: 25–30) mm at the tibia (n = 11). Results Leg lengthening was successful in 30 of 32 cases, with no residual relevant discrepancy (± 5 mm). No intraoperative complications were observed. The consolidation index was significantly different (p = 0.04) between femoral lengthening (mean 35 days/cm) and tibial lengthening (mean 48 days/cm) but did not depend on age older/younger than 16 or previous operations at the affected site. 3 problems, 3 obstacles, and 4 complications (3 minor, 1 major) were encountered in 8 patients, 5 of which were implant-associated. Interpretation This technique even allows correction in patients with multiplanar deformities. Compared to external devices, intramedullary systems provide comfort and reduce complication rates, give improved cosmetic results, and lead to fast rehabilitation since percutaneous, transmuscular fixation is prevented. This results in reasonable overall treatment costs despite the relatively high costs of implants. PMID:21561309

  12. Lengthening of intercalary allograft combined with free vascularized fibular graft after reconstruction in pediatric osteosarcoma of femur.

    PubMed

    Han, Chung-Soo; Chung, Duke-Whan; Lee, Jung-Hee; Jeong, Bi-O

    2010-01-01

    Involvement of the growth plate by a tumor or an injured growth plate during surgical procedures causes a discrepancy in the limb length. To address this problem,distraction osteogenesis is a well-established procedure for the treatment of defect and leg length discrepancy inviable bone tissues. We present the lengthening of an intercalary allograft combined with a vascularized fibular graft after reconstruction of osteosarcoma in the femoral metaphysis of a 10-year-old boy. The ability to lengthen through a composite allograft-vascularized fibular graft would add another option for reconstruction in skeletally immature children after resection for bone sarcomas.

  13. Facial fractures.

    PubMed Central

    Carr, M. M.; Freiberg, A.; Martin, R. D.

    1994-01-01

    Emergency room physicians frequently see facial fractures that can have serious consequences for patients if mismanaged. This article reviews the signs, symptoms, imaging techniques, and general modes of treatment of common facial fractures. It focuses on fractures of the mandible, zygomaticomaxillary region, orbital floor, and nose. Images p520-a p522-a PMID:8199509

  14. Cephalometric soft tissue facial analysis.

    PubMed

    Bergman, R T

    1999-10-01

    My objective is to present a cephalometric-based facial analysis to correlate with an article that was published previously in the American Journal of Orthodontic and Dentofacial Orthopedics. Eighteen facial or soft tissue traits are discussed in this article. All of them are significant in successful orthodontic outcome, and none of them depend on skeletal landmarks for measurement. Orthodontic analysis most commonly relies on skeletal and dental measurement, placing far less emphasis on facial feature measurement, particularly their relationship to each other. Yet, a thorough examination of the face is critical for understanding the changes in facial appearance that result from orthodontic treatment. A cephalometric approach to facial examination can also benefit the diagnosis and treatment plan. Individual facial traits and their balance with one another should be identified before treatment. Relying solely on skeletal analysis, assuming that the face will balance if the skeletal/dental cephalometric values are normalized, may not yield the desired outcome. Good occlusion does not necessarily mean good facial balance. Orthodontic norms for facial traits can permit their measurement. Further, with a knowledge of standard facial traits and the patient's soft tissue features, an individualized norm can be established for each patient to optimize facial attractiveness. Four questions should be asked regarding each facial trait before treatment: (1) What is the quality and quantity of the trait? (2) How will future growth affect the trait? (3) How will orthodontic tooth movement affect the existing trait (positively or negatively)? (4) How will surgical bone movement to correct the bite affect the trait (positively or negatively)?

  15. Bone

    NASA Astrophysics Data System (ADS)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  16. The Sequoia circular fixator for limb lengthening.

    PubMed

    Hardy, J M; Tadlaoui, A; Wirotius, J M; Saleh, M

    1991-10-01

    With the Sequoia fixator, lengthenings can be achieved based on the clinical facts of the case. The device is a modular apparatus that can perform corrections in several planes, and, if necessary, in a septic environment. In our opinion, a "lengthener surgeon" is one who can foresee problems and take appropriate steps to prevent them. Likewise, the surgeon must act as the coordinator of an entire team. A successful lengthening is 5% surgery and 95% postoperative nursing and physiotherapy care. In the future, a number of changes will simplify postoperative management: 1. Composite carbon rings will make the frames radiolucent and one third lighter than those made of stainless steel. Automatic tensioners will help maintain steady tension on the wires. 2. Digital analysis of the callus will provide norms of consolidation, allowing faster fixator removal and conversion to an orthosis. 3. Incorporating the foot in the frame to overcome equinus will eliminate the need for tenotomy. We believe that monolateral and ring fixators can work together in certain locations. That is why we proposed, at the 18th Societé Internationale de Chirurgie Orthopédique et Traumatologique meeting, a combined monolateral-ring construct that can be used for lengthening throughout the proximal femoral metaphysis.

  17. Safe Cosmetic Leg Lengthening for Short Stature: Long-term Outcomes.

    PubMed

    Elbatrawy, Yasser; Ragab, Ibrahim Mohammed A

    2015-07-01

    It is well known that limb lengthening is performed to treat limb-length discrepancies resulting from congenital anomalies and developmental problems. However, few studies discuss lengthening for cosmetic purposes. The current authors conducted a prospective study with long-term follow-up. From July 2002 through June 2007, 133 patients requested that their height be increased. Fifty-two were approved to undergo limb-lengthening surgery. Two were lost to final follow-up, leaving 50 in the study group. For all patients, the Ilizarov ring external fixator was applied with a maximum-stability technique that achieved frame stability and allowed patients to ambulate with a walker from the first week postoperatively. The method requires close follow-up for early detection of problems. Physiotherapy improved ankle function and prevented plantar flexion deformity, which can occur during lengthening. Excellent final outcomes were achieved in all patients except one, who required additional surgery. The Ilizarov device is a safe tool for limb lengthening in individuals of short stature when applied with the authors' maximum stability technique. To the authors' knowledge, this is the first article on this topic to report long-term results (minimum 5-year follow-up for all patients). Many factors influence the outcome of lengthening surgery performed with Ilizarov devices: the material of the rings, the use of a hybrid technique combining pins and wires, the diameter and number of pins over each bone segment, the size of the rings around the limb, the surgical technique for pin insertion, and the use of hydroxyapatite-coated pins or regular stainless pins.

  18. Facial tics

    MedlinePlus

    Tic - facial; Mimic spasm ... Tics may involve repeated, uncontrolled spasm-like muscle movements, such as: Eye blinking Grimacing Mouth twitching Nose wrinkling Squinting Repeated throat clearing or grunting may also be ...

  19. Facial anatomy.

    PubMed

    Marur, Tania; Tuna, Yakup; Demirci, Selman

    2014-01-01

    Dermatologic problems of the face affect both function and aesthetics, which are based on complex anatomical features. Treating dermatologic problems while preserving the aesthetics and functions of the face requires knowledge of normal anatomy. When performing successfully invasive procedures of the face, it is essential to understand its underlying topographic anatomy. This chapter presents the anatomy of the facial musculature and neurovascular structures in a systematic way with some clinically important aspects. We describe the attachments of the mimetic and masticatory muscles and emphasize their functions and nerve supply. We highlight clinically relevant facial topographic anatomy by explaining the course and location of the sensory and motor nerves of the face and facial vasculature with their relations. Additionally, this chapter reviews the recent nomenclature of the branching pattern of the facial artery.

  20. Long-term results of forearm lengthening and deformity correction by the Ilizarov method.

    PubMed

    Orzechowski, Wiktor; Morasiewicz, Leszek; Krawczyk, Artur; Dragan, Szymon; Czapiński, Jacek

    2002-06-30

    Background. Shortening and deformity of the forearm is most frequently caused by congenital disorders or posttraumatic injury. Given its complex anatomy and biomechanics, the forearm is clearly the most difficult segment for lengthening and deformity correction.
    Material and methods. We analyzed 16 patients with shortening and deformity of the forearm, treated surgically, using the Ilizarov method in our Department from 1989 to 2001. in 9 cases 1-stage surgery was sufficient, while the remaining 7 patients underwent 2-5 stages of treatment. At total of 31 surgical operations were performed. The extent of forearm shortening ranged from 1,5 to 14,5 cm (5-70%). We development a new fixator based on Schanz half-pins.
    Results. The length of forearm lengthening per operative stage averaged 2,35 cm. the proportion of lengthening ranged from 6% to 48% with an average of 18,3%. The mean lengthening index was 48,15 days/cm. the per-patient rate of complications was 88% compared 45% per stage of treatment, mostly limited rotational mobility and abnormal consolidation of regenerated bone.
    Conclusions. Despite the high complication rate, the Ilizarov method is the method of choice for patients with forearm shortenings and deformities. Treatment is particularly indicated in patients with shortening caused by disproportionate length of the ulnar and forearm bones. Treatment should be managed so as cause the least possible damage to arm function, even at the cost of limited lengthening. Our new stabilizer based on Schanz half-pins makes it possible to preserve forearm rotation.

  1. Recurrent unilateral facial nerve palsy in a child with dehiscent facial nerve canal

    PubMed Central

    Liu, Christopher; Ulualp, Seckin O; Koral, Korgun

    2016-01-01

    Objective: The dehiscent facial nerve canal has been well documented in histopathological studies of temporal bones as well as in clinical setting. We describe clinical and radiologic features of a child with recurrent facial nerve palsy and dehiscent facial nerve canal. Methods: Retrospective chart review. Results: A 5-year-old male was referred to the otolaryngology clinic for evaluation of recurrent acute otitis media and hearing loss. He also developed recurrent left peripheral FN palsy associated with episodes of bilateral acute otitis media. High resolution computed tomography of the temporal bones revealed incomplete bony coverage of the tympanic segment of the left facial nerve. Conclusions: Recurrent peripheral FN palsy may occur in children with recurrent acute otitis media in the presence of a dehiscent facial nerve canal. Facial nerve canal dehiscence should be considered in the differential diagnosis of children with recurrent peripheral FN palsy. PMID:28228958

  2. Recent advances in limb lengthening. Part I: Clinical advances.

    PubMed

    Sproul, J T; Price, C T

    1992-03-01

    The discipline of limb lengthening has undergone numerous advances in recent years. An increased understanding of the biology of distraction osteogenesis, as well as technical advances, has made lengthening more feasible. However, significant problems remain unsolved, and complications--although less severe and long standing--still remain. Little is known about the effect of distraction on soft tissues. Lengthening in skeletally mature patients remains difficult. The myriad of conditions that require lengthening often confounds comparison of techniques. Uniform indications for limb lengthening may never exist, but increasing experience helps guide patient selection.

  3. Facial attractiveness.

    PubMed

    Little, Anthony C

    2014-11-01

    Facial attractiveness has important social consequences. Despite a widespread belief that beauty cannot be defined, in fact, there is considerable agreement across individuals and cultures on what is found attractive. By considering that attraction and mate choice are critical components of evolutionary selection, we can better understand the importance of beauty. There are many traits that are linked to facial attractiveness in humans and each may in some way impart benefits to individuals who act on their preferences. If a trait is reliably associated with some benefit to the perceiver, then we would expect individuals in a population to find that trait attractive. Such an approach has highlighted face traits such as age, health, symmetry, and averageness, which are proposed to be associated with benefits and so associated with facial attractiveness. This view may postulate that some traits will be universally attractive; however, this does not preclude variation. Indeed, it would be surprising if there existed a template of a perfect face that was not affected by experience, environment, context, or the specific needs of an individual. Research on facial attractiveness has documented how various face traits are associated with attractiveness and various factors that impact on an individual's judgments of facial attractiveness. Overall, facial attractiveness is complex, both in the number of traits that determine attraction and in the large number of factors that can alter attraction to particular faces. A fuller understanding of facial beauty will come with an understanding of how these various factors interact with each other. WIREs Cogn Sci 2014, 5:621-634. doi: 10.1002/wcs.1316 CONFLICT OF INTEREST: The author has declared no conflicts of interest for this article. For further resources related to this article, please visit the WIREs website.

  4. Lengthening over nails using the double plate system ONAS-DPS

    PubMed Central

    Antolič, Vane

    2016-01-01

    Stable insertion of large Schanz screws behind an intramedullary (IM) nail when lengthening over nails (LON) may be difficult due to the limited bone stock. Additionally, the highly probable contact between the screws and IM nail (which is difficult to avoid) increases the likelihood of infection spreading from the skin via Schanz screws directly to the IM nail. A new device for LON has been developed. Instead of inserting Schanz screws from the external fixator beside the IM nail (as in standard LON), a system of two overlaying plates was constructed. Schanz screws can be fixed to the plates without entering the bone. The plates are fixed to the bone using four angle stability screws. The holes in the plates offer stabile fixation for a chosen angle under which the screw is positioned through the cortical bone. Using the new system there is no need to place Schanz screws behind the IM nail. Instead, Schanz screws pass to the plate and not through the bone. The new system for elongation over IM nail is called “Over Nail Angle Stability-Double Plate System” (ONAS-DPS) [Antolič V (2013) Modular side device with an intramedullary nail for guiding a bone during its lengthening. World Intellectual Property Organization. International Publication number: WO 2013/176632 A1]. PMID:27163094

  5. Guiding atypical facial growth back to normal. Part 1: Understanding facial growth.

    PubMed

    Galella, Steve; Chow, Daniel; Jones, Earl; Enlow, Donald; Masters, Ari

    2011-01-01

    Many practitioners find the complexity of facial growth overwhelming and thus merely observe and accept the clinical features of atypical growth and do not comprehend the long-term consequences. Facial growth and development is a strictly controlled biological process. Normal growth involves ongoing bone remodeling and positional displacement. Atypical growth begins when this biological balance is disturbed With the understanding of these processes, clinicians can adequately assess patients and determine the causes of these atypical facial growth patterns and design effective treatment plans. This is the first of a series of articles which addresses normal facial growth, atypical facial growth, patient assessment, causes of atypical facial growth, and guiding facial growth back to normal.

  6. Facial blindsight

    PubMed Central

    Solcà, Marco; Guggisberg, Adrian G.; Schnider, Armin; Leemann, Béatrice

    2015-01-01

    Blindsight denotes unconscious residual visual capacities in the context of an inability to consciously recollect or identify visual information. It has been described for color and shape discrimination, movement or facial emotion recognition. The present study investigates a patient suffering from cortical blindness whilst maintaining select residual abilities in face detection. Our patient presented the capacity to distinguish between jumbled/normal faces, known/unknown faces or famous people’s categories although he failed to explicitly recognize or describe them. Conversely, performance was at chance level when asked to categorize non-facial stimuli. Our results provide clinical evidence for the notion that some aspects of facial processing can occur without perceptual awareness, possibly using direct tracts from the thalamus to associative visual cortex, bypassing the primary visual cortex. PMID:26483655

  7. Lengthening of replanted or revascularized lower limbs: is length discrepancy a contraindication for limb salvage?

    PubMed

    Parmaksizoglu, Fatih; Beyzadeoglu, Tahsin

    2002-08-01

    Some replantation cases require substantial bone shortening for primary closure. Leg-length discrepancy can be restored by lengthening of the replanted or revascularized extremities. Between 1991 and 2000, four patients with four total and two subtotal below-knee amputations had replantation or revascularization for their severely damaged extremities. All of them had extensive debridement, vascular repair, bone shortening and nerve repair for sensibility of their soles. One of the replanted extremities failed and had to undergo below-knee amputation because of sepsis. No other infection or vascular complications were encountered following the replantations or revascularizations. After bony consolidation, four legs were lengthened; for elimination of length discrepancy in three cases, and for obtaining balanced body proportion in one case in which the other leg was also amputated. In all procedures, a unilateral dynamic axial external fixator was used. The lengthening was performed from the proximal tibial metaphysis, with a subperiosteal osteotomy. Evaluation of injury according to the Mangled Extremity Severity Score (MESS) would encourage the surgeon to avoid salvage surgery with a shortened extremity, because of the required debridement of soft tissue and bone. These authors think the amount of limb shortening is not a major criterion in evaluating a traumatic total or subtotal below-knee amputation for salvage replantation or revascularization. A knee that has stable joint motion and the possibility of preservation of sensibility of the sole broadens the scope of indications for limb salvage, even with deliberate shortening that can be restored by lengthening; length discrepancy is not a contraindication for limb salvage.

  8. [Facial surgery].

    PubMed

    Meningaud, Jean-Paul

    2010-11-20

    The patient who has to sustain facial surgery is doubly concerned by the functional issues of his case and his cosmetic appearance. Fortunately, in the recent period of time, huge advancements have been done permitting to offer a solution in more and more difficult situations. The aim of the present article is to give a panorama of facial plastic surgery for non-specialized physicians. The main aspects of the specialty are approached through the surgical techniques born from the progress of technology and biology. This paper treats issues of orthognatic surgery, endoscopic techniques, osteogenic distraction, different types of graft, cosmetic surgery, skin expander-balloons.

  9. Congenital pseudoarthrosis of the tibia: healing by lengthening over a rod without compression of the nonunion. A preliminary report.

    PubMed

    Muhammad Abdul Jamil, Muhammad Kamal; Abdul Rashid, Abdul Halim; Ibrahim, Sharaf

    2013-05-01

    This preliminary report is on two patients with congenital pseudoarthrosis of the tibia who had a persistent nonunion following intramedullary rodding and bone grafting. We do not advocate repeated surgery to achieve union. When limb length discrepancy becomes greater than 5 cm, we proceeded with an Ilizarov procedure with the primary aim of equalizing limb length rather than achieving union. Healing of the pseudoarthrosis occurred in both patients after lengthening over the intramedullary rod without compression of the nonunion site. We believe that union occurs because of hyperaemia during the lengthening. This approach minimizes the repeated surgeries that are usually needed and thus ensures a more normal childhood without frequent hospitalizations.

  10. Facial transplantation: A concise update

    PubMed Central

    Barrera-Pulido, Fernando; Gomez-Cia, Tomas; Sicilia-Castro, Domingo; Garcia-Perla-Garcia, Alberto; Gacto-Sanchez, Purificacion; Hernandez-Guisado, Jose-Maria; Lagares-Borrego, Araceli; Narros-Gimenez, Rocio; Gonzalez-Padilla, Juan D.

    2013-01-01

    Objectives: Update on clinical results obtained by the first worldwide facial transplantation teams as well as review of the literature concerning the main surgical, immunological, ethical, and follow-up aspects described on facial transplanted patients. Study design: MEDLINE search of articles published on “face transplantation” until March 2012. Results: Eighteen clinical cases were studied. The mean patient age was 37.5 years, with a higher prevalence of men. Main surgical indication was gunshot injuries (6 patients). All patients had previously undergone multiple conventional surgical reconstructive procedures which had failed. Altogether 8 transplant teams belonging to 4 countries participated. Thirteen partial face transplantations and 5 full face transplantations have been performed. Allografts are varied according to face anatomical components and the amount of skin, muscle, bone, and other tissues included, though all were grafted successfully and remained viable without significant postoperative surgical complications. The patient with the longest follow-up was 5 years. Two patients died 2 and 27 months after transplantation. Conclusions: Clinical experience has demonstrated the feasibility of facial transplantation as a valuable reconstructive option, but it still remains considered as an experimental procedure with unresolved issues to settle down. Results show that from a clinical, technical, and immunological standpoint, facial transplantation has achieved functional, aesthetic, and social rehabilitation in severely facial disfigured patients. Key words:Face transplantation, composite tissue transplantation, face allograft, facial reconstruction, outcomes and complications of face transplantation. PMID:23229268

  11. Muscle strength and knee range of motion after femoral lengthening

    PubMed Central

    Bhave, Anil; Shabtai, Lior; Woelber, Erik; Apelyan, Arman; Paley, Dror; Herzenberg, John E

    2017-01-01

    Background and purpose Femoral lengthening may result in decrease in knee range of motion (ROM) and quadriceps and hamstring muscle weakness. We evaluated preoperative and postoperative knee ROM, hamstring muscle strength, and quadriceps muscle strength in a diverse group of patients undergoing femoral lengthening. We hypothesized that lengthening would not result in a significant change in knee ROM or muscle strength. Patients and methods This prospective study of 48 patients (mean age 27 (9–60) years) compared ROM and muscle strength before and after femoral lengthening. Patient age, amount of lengthening, percent lengthening, level of osteotomy, fixation time, and method of lengthening were also evaluated regarding knee ROM and strength. The average length of follow-up was 2.9 (2.0–4.7) years. Results Mean amount of lengthening was 5.2 (2.4–11.0) cm. The difference between preoperative and final knee flexion ROM was 2° for the overall group. Congenital shortening cases lost an average of 5% or 6° of terminal knee flexion, developmental cases lost an average of 3% or 4°, and posttraumatic cases regained all motion. The difference in quadriceps strength at 45° preoperatively and after lengthening was not statistically or clinically significant (2.7 Nm; p = 0.06). Age, amount of lengthening, percent lengthening, osteotomy level, fixation time, and lengthening method had no statistically significant influence on knee ROM or quadriceps strength at final follow-up. Interpretation Most variables had no effect on ROM or strength, and higher age did not appear to be a limiting factor for femoral lengthening. Patients with congenital causes were most affected in terms of knee flexion. PMID:27892743

  12. Fixator-assisted nailing and consecutive lengthening over an intramedullary nail for the correction of tibial deformity.

    PubMed

    Bilen, F E; Kocaoglu, M; Eralp, L; Balci, H I

    2010-01-01

    We report the results of using a combination of fixator-assisted nailing with lengthening over an intramedullary nail in patients with tibial deformity and shortening. Between 1997 and 2007, 13 tibiae in nine patients with a mean age of 25.4 years (17 to 34) were treated with a unilateral external fixator for acute correction of deformity, followed by lengthening over an intramedullary nail with a circular external fixator applied at the same operating session. At the end of the distraction period locking screws were inserted through the intramedullary nail and the external fixator was removed. The mean amount of lengthening was 5.9 cm (2 to 8). The mean time of external fixation was 90 days (38 to 265). The mean external fixation index was 15.8 days/cm (8.9 to 33.1) and the mean bone healing index was 38 days/cm (30 to 60). One patient developed an equinus deformity which responded to stretching and bracing. Another developed a drop foot due to a compartment syndrome, which was treated by fasciotomy. It recovered in three months. Two patients required bone grafting for poor callus formation. We conclude that the combination of fixator-assisted nailing with lengthening over an intramedullary nail can reduce the overall external fixation time and prevent fractures and deformity of the regenerated bone.

  13. Facial reanimation according to the postresection defect during lateral skull base surgery.

    PubMed

    Leonetti, John P; Nadimi, Sahar; Marzo, Sam J; Anderson, Douglas; Vandevender, Darl

    2016-12-01

    The vast majority of benign tumors of the cerebellopontine angle, temporal bone, and parotid gland can be successfully resected without permanent injury to the facial nerve. Malignant tumors or recurrent disease may require facial nerve sacrifice, especially if preoperative facial paresis is present. This article will present case examples of the various methods to reconstruct facial animation after lateral skull base resections that require sacrifice of cranial nerve VII, and the associated mimetic facial musculature. Facial mimetic outcome after reanimation was graded using the House-Brackmann scale. Primary neurorrhaphy or interposition grafting may be performed when both the proximal and distal portions of the facial nerve are available and viable facial musculature is present. If only the distal facial nerve and viable facial musculature are available, a split hypoglossal to facial nerve anastomosis is used. A proximal facial nerve to microvascular free flap is performed when the proximal facial nerve is available without distal nerve or viable musculature. A cross-facial to microvascular free flap is performed when the proximal and distal facial nerve and facial musculature are unavailable. The above methods resulted in a House-Brackmann score of III/VI in all case examples postoperatively. The method of facial reanimation used depends on the availability of viable proximal facial nerve, the location of healthy, tumor-free distal facial nerve, and the presence of functioning facial mimetic musculature.

  14. [Facial pain].

    PubMed

    Makhinov, K A; Barinov, A N; Zhestikova, M G; Mingazova, L R; Parkhomenko, E V

    2015-01-01

    Diagnosis and treatment of facial pain is a problem for physicians of different specialties (neurologists, dentists, surgeons, oculists, otolaryngologists and psychiatrists). A classification of this pathology is far from ideal and an interdisciplinary comprehensive approach is needed. Current approaches to etiotropic, symptomatic and pathogenetic treatment of patients with most frequent variants of orofacial pain are presented.

  15. Fibular lengthening by Ilizarov method secondary to shortening by osteochondroma of distal tibia.

    PubMed

    Johnston, A J; Andrews, C T

    2008-04-01

    Osteochondroma is the most common benign bone tumour. They most commonly affect the long tubular bones and almost half of osteochondromata are found around the knee. Osteochondroma arising from the distal metaphysis of the tibia typically result in a valgus deformity of the ankle joint secondary to relative shortening of the fibula. This case describes the use of Ilizarov technique for fibular lengthening following excision of a distal tibial osteochondroma. A 12-year-old girl presented with a 3-year history of a large swelling affecting the lateral aspect of the right distal tibia. Plain radiographs confirmed a large sessile osteochondroma arising from the postero-lateral aspect of the distal tibia with deformity of the fibula and 15 mm of fibular shortening. The patient underwent excision through a postero-lateral approach and subsequent fibular lengthening by Ilizarov technique. The patient made excellent recovery with removal of frame after 21 weeks and had made a full recovery with normal ankle function by 6 months. The Ilizarov method is a commonly accepted method of performing distraction osteogenesis for limb inequalities; however, this is mainly for the tibia, femur and humerus. We are unaware of any previous cases using the Ilizarov method for fibular lengthening. This case demonstrates the success of the Ilizarov method in restoring both fibular length and normal ankle anatomy.

  16. Effects of facial hard tissue surgery on facial aesthetics: changes in facial content and frames.

    PubMed

    Choi, Jin-Young; Lee, Sang-Hoon; Baek, Seung-Hak

    2012-11-01

    Aesthetic units of the face can be divided into facial content (FC; eyes, nose, lips, and mouth), anterior facial frame (AFF; a contour line from the trichion, the temporal line of the frontal bone, the lateral orbital rim, the most lateral line of the anterior part of the zygomatic body, the anterior border of the masseter muscle, to the inferior border of the chin), and posterior facial frame (PFF; a contour line from the hairline, the zygomatic arch, to the ramus and gonial angle area of the mandible). The size and shape of each FC and the balance and proportion between FCs create a unique appearance for each person. The facial form can be determined through the combination of AFF and PFF. In the Asian population, clinicians frequently encounter problems of FC (eg, acute nasolabial angle, protrusive and everted lips, nonconsonant lip line, or lip canting), AFF (eg, midface hypoplasia, protrusive and asymmetric chin, vertical deficiency/excess of the anterior maxilla and symphysis, or prominent zygoma), and PFF (eg, square mandibular angle). These problems can be efficiently and effectively corrected through the combination of hard tissue surgery such as anterior segmental osteotomy, genioplasty, mandibular angle reduction, malarplasty, and orthognathic surgery. Therefore, the purposes of this article were to introduce the concepts of FC, AFF, and PFF, and to explain the effects of facial hard tissue surgery on facial aesthetics.

  17. Bilateral humeral lengthening in achondroplasia with unilateral external fixators: is it safe and does it improve daily life?

    PubMed

    Balci, H I; Kocaoglu, M; Sen, C; Eralp, L; Batibay, S G; Bilsel, K

    2015-11-01

    A retrospective study was performed in 18 patients with achondroplasia, who underwent bilateral humeral lengthening between 2001 and 2013, using monorail external fixators. The mean age was ten years (six to 15) and the mean follow-up was 40 months (12 to 104). The mean disabilities of the arm, shoulder and hand (DASH) score fell from 32.3 (20 to 40) pre-operatively to 9.4 (6 to 14) post-operatively (p = 0.037). A mean lengthening of 60% (40% to 95%) was required to reach the goal of independent perineal hygiene. One patient developed early consolidation, and fractures occurred in the regenerate bone of four humeri in three patients. There were three transient radial nerve palsies. Humeral lengthening increases the independence of people with achondroplasia and is not just a cosmetic procedure.

  18. Facial Morphogenesis of the Earliest Europeans

    PubMed Central

    Lacruz, Rodrigo S.; de Castro, José María Bermúdez; Martinón-Torres, María; O’Higgins, Paul; Paine, Michael L.; Carbonell, Eudald; Arsuaga, Juan Luis; Bromage, Timothy G.

    2013-01-01

    The modern human face differs from that of our early ancestors in that the facial profile is relatively retracted (orthognathic). This change in facial profile is associated with a characteristic spatial distribution of bone deposition and resorption: growth remodeling. For humans, surface resorption commonly dominates on anteriorly-facing areas of the subnasal region of the maxilla and mandible during development. We mapped the distribution of facial growth remodeling activities on the 900–800 ky maxilla ATD6-69 assigned to H. antecessor, and on the 1.5 My cranium KNM-WT 15000, part of an associated skeleton assigned to African H. erectus. We show that, as in H. sapiens, H. antecessor shows bone resorption over most of the subnasal region. This pattern contrasts with that seen in KNM-WT 15000 where evidence of bone deposition, not resorption, was identified. KNM-WT 15000 is similar to Australopithecus and the extant African apes in this localized area of bone deposition. These new data point to diversity of patterns of facial growth in fossil Homo. The similarities in facial growth in H. antecessor and H. sapiens suggest that one key developmental change responsible for the characteristic facial morphology of modern humans can be traced back at least to H. antecessor. PMID:23762314

  19. [Hemodynamics in soft tissues after upper third of the leg lengthening by Ilizarov osteosynthesis technique].

    PubMed

    Kononovich, N A; Petrovskaia, N V

    2013-02-01

    An experimental study has been performed. The leg was lengthened in 12 adult mongrel dogs by transosseous distraction osteosynthesis in the zone of upper third of the leg bone shaft by 14-18% of the segment length using the rate of 1.0 mm for 4 times. The formation of mechanically strong shaft part occurred after 35 days after device fixation. Under created conditions the unidirectional cyclic changes of blood circulation and morphofunctional state occurred in soft tissue segment, that were more marked in the extensor muscle group. Implementation of preventive-and-treatment measures directed to improvement of vascular elastotonic properties allowed to decrease the degree of disordering hemodynamics of the lengthened limb. This will have a positive effect on the final clinical outcome.

  20. Bilateral traumatic facial paralysis. Case report.

    PubMed

    Undabeitia, Jose; Liu, Brian; Pendleton, Courtney; Nogues, Pere; Noboa, Roberto; Undabeitia, Jose Ignacio

    2013-01-01

    Although traumatic injury of the facial nerve is a relatively common condition in neurosurgical practice, bilateral lesions related to fracture of temporal bones are seldom seen. We report the case of a 38-year-old patient admitted to Intensive Care Unit after severe head trauma requiring ventilatory support (Glasgow Coma Scale of 7 on admission). A computed tomography (CT) scan confirmed a longitudinal fracture of the right temporal bone and a transversal fracture of the left. After successful weaning from respirator, bilateral facial paralysis was observed. The possible aetiologies for facial diplegia differ from those of unilateral injury. Due to the lack of facial asymmetry, it can be easily missed in critically ill patients, and both the high resolution CT scan and electromyographic studies can be helpful for correct diagnosis.

  1. Histopathological incidence of facial canal dehiscence in otosclerosis.

    PubMed

    Nomiya, Shigenobu; Cureoglu, Sebahattin; Kariya, Shin; Morita, Norimasa; Nomiya, Rie; Nishizaki, Kazunori; Paparella, Michael M

    2011-09-01

    The objective of this study was to evaluate the histopathological incidence of facial canal dehiscence in otosclerosis cases compared with non-otosclerotic controls. 133 temporal bones from 84 otosclerosis (35 unilateral otosclerosis, 49 bilateral otosclerosis) cases were compared to 102 age-matched normal temporal bones from 70 subjects (38 unilateral normal cases, 32 bilateral normal cases). Temporal bones were serially sectioned in the horizontal plane at a thickness of 20 μm, and were stained with hematoxylin and eosin. We evaluated the location and the invasion of otosclerosis to the facial canal and incidence of facial canal dehiscence under light microscopy. Facial canal was subdivided into four portions: (1) the geniculate ganglion, (2) the tensor tympani muscle, (3) the oval window, and (4) mastoid. The incidence of facial canal dehiscence in otosclerosis [66 temporal bones (49.6%)] was significantly lower than normal controls [67 control temporal bones (65.7%)] in the oval window area (P = 0.019). Temporal bones with otosclerotic invasion to the thin bone of the canal were significantly less likely to have dehiscence [10 temporal bones (31.3%)] compared to the otosclerotic bones without invasion [56 temporal bones (55.5%)] (P = 0.025). There was no significant difference in the incidence of facial canal dehiscence between temporal bones with and without otosclerosis in the entire segment of facial nerve. Our findings in this study suggest that otosclerotic lesions have the potential to close dehiscence of the facial canal in the oval window area.

  2. Composite Bone and Soft Tissue Loss Treated with Distraction Histiogenesis

    DTIC Science & Technology

    2010-01-01

    Mahuluxmivala, J., Nadarajah, R., Allen, P. W., et al. Ilizarov external fixator: acute shortening and lengthening versus bone transport in the management of...Presented at the Limb Lengthening and Reconstruction Society Annual Meeting 2006,William Beaumont Army Medical Center, Texas Tech University Health... lengthening by the Ilizarov technique. Clin. Orthop. Relat. Res. 250:81– 104, 1990. 28 JOURNAL OF SURGICAL ORTHOPAEDIC ADVANCES

  3. [The history of facial paralysis].

    PubMed

    Glicenstein, J

    2015-10-01

    Facial paralysis has been a recognized condition since Antiquity, and was mentionned by Hippocratus. In the 17th century, in 1687, the Dutch physician Stalpart Van der Wiel rendered a detailed observation. It was, however, Charles Bell who, in 1821, provided the description that specified the role of the facial nerve. Facial nerve surgery began at the end of the 19th century. Three different techniques were used successively: nerve anastomosis, (XI-VII Balance 1895, XII-VII, Korte 1903), myoplasties (Lexer 1908), and suspensions (Stein 1913). Bunnell successfully accomplished the first direct facial nerve repair in the temporal bone, in 1927, and in 1932 Balance and Duel experimented with nerve grafts. Thanks to progress in microsurgical techniques, the first faciofacial anastomosis was realized in 1970 (Smith, Scaramella), and an account of the first microneurovascular muscle transfer published in 1976 by Harii. Treatment of the eyelid paralysis was at the origin of numerous operations beginning in the 1960s; including palpebral spring (Morel Fatio 1962) silicone sling (Arion 1972), upperlid loading with gold plate (Illig 1968), magnets (Muhlbauer 1973) and transfacial nerve grafts (Anderl 1973). By the end of the 20th century, surgeons had at their disposal a wide range of valid techniques for facial nerve surgery, including modernized versions of older techniques.

  4. Gastrocnemius or Achilles Lengthening at Time of Trauma Fixation.

    PubMed

    Benirschke, Stephen K; Kramer, Patricia Ann

    2017-03-01

    Gastrocnemius equinus is a frequent comorbidity with traumatic injuries of the foot and ankle. Gastrocnemius lengthening at the time of definitive treatment facilitates obtaining and maintaining an anatomic reduction of the injury. The lengthening procedure is accomplished in 5 steps and results in fewer long-term, problematic sequelae.

  5. [Facial palsy and leontiasis ossea of the pyramid (author's transl)].

    PubMed

    Aesch, B

    1977-01-01

    The author presents a boy which has repeated facial palsies since his second year of life. The clinical examination showed: conduction deafness, radiological sclerosis of the bones of the basis of the skull, normal values of chemical blood analysis. Both facial nerves are operated in the mastoid and middle ear portions. The histological examination of the mastoid bone reveals a leontiasis ossea. The histological structure of the bone are described in detail and the differential diagnosis with other bone diseases of the cranial bones is discussed.

  6. Limb lengthening in children using the Ilizarov method.

    PubMed

    Bonnard, C; Favard, L; Sollogoub, I; Glorion, B

    1993-08-01

    By limb lengthening with the Ilizarov method on 24 children with an average age of 11 years, the average lengthening was 50 mm. The results were judged by the healing index and the corticotomy index. The average time for lengthening was 50 days. The healing index was on average 35 days per centimeter. Five complications were noticed during the first stage of the surgical procedure. During the lengthenings, eight cases of joint stiffness were observed, and in five normal biomechanical axes of the limb were modified. Only one abnormal biomechanical axis was perfectly corrected of eight present before surgery. There were three wire-tract infections. Only 13 of 26 patients were without any complications. The Ilizarov method had a lower rate of complication than the Wagner technique, however. Open corticotomy, as modified by De Bastiani, may accomplish lengthenings with somewhat fewer complications.

  7. Early and late fracture following extensive limb lengthening in patients with achondroplasia and hypochondroplasia.

    PubMed

    Kitoh, H; Mishima, K; Matsushita, M; Nishida, Y; Ishiguro, N

    2014-09-01

    Two types of fracture, early and late, have been reported following limb lengthening in patients with achondroplasia (ACH) and hypochondroplasia (HCH). We reviewed 25 patients with these conditions who underwent 72 segmental limb lengthening procedures involving the femur and/or tibia, between 2003 and 2011. Gender, age at surgery, lengthened segment, body mass index, the shape of the callus, the amount and percentage of lengthening and the healing index were evaluated to determine predictive factors for the occurrence of early (within three weeks after removal of the fixation pins) and late fracture (> three weeks after removal of the pins). The Mann‑Whitney U test and Pearson's chi-squared test for univariate analysis and stepwise regression model for multivariate analysis were used to identify the predictive factor for each fracture. Only one patient (two tibiae) was excluded from the analysis due to excessively slow formation of the regenerate, which required supplementary measures. A total of 24 patients with 70 limbs were included in the study. There were 11 early fractures in eight patients. The shape of the callus (lateral or central callus) was the only statistical variable related to the occurrence of early fracture in univariate and multivariate analyses. Late fracture was observed in six limbs and the mean time between removal of the fixation pins and fracture was 18.3 weeks (3.3 to 38.4). Lengthening of the tibia, larger healing index, and lateral or central callus were related to the occurrence of a late fracture in univariate analysis. A multivariate analysis demonstrated that the shape of the callus was the strongest predictor for late fracture (odds ratio: 19.3, 95% confidence interval: 2.91 to 128). Lateral or central callus had a significantly larger risk of fracture than fusiform, cylindrical, or concave callus. Radiological monitoring of the shape of the callus during distraction is important to prevent early and late fracture of lengthened

  8. Can beauty be ignored? Effects of facial attractiveness on covert attention.

    PubMed

    Sui, Jie; Liu, Chang Hong

    2009-04-01

    Facial beauty has important social and biological implications. Research has shown that people tend to look longer at attractive than at unattractive faces. However, little is known about whether an attractive face presented outside foveal vision can capture attention. The effect of facial attractiveness on covert attention was investigated in a spatial cuing task. Participants were asked to judge the orientation of a cued target presented to the left or right visual field while ignoring a task-irrelevant face image flashed in the opposite field. The presentation of attractive faces significantly lengthened task performance. The results suggest that facial beauty automatically competes with an ongoing cognitive task for spatial attention.

  9. Pulsed low-intensity ultrasound: a new salvage procedure for delayed unions and nonunions after leg lengthening in children.

    PubMed

    Gebauer, Dieter; Correll, Johannes

    2005-01-01

    From 1998 to 2001, 112 lengthening procedures with or without deformity correction were performed in 108 children by external fixation with the Ilizarov method. Of these cases, 16.9% did not lead to a solid bone consolidation. Two children were operated the second time, mainly because of the parent's decision. Seventeen delayed unions or nonunions in 13 children were treated with low-intensity pulsed ultrasound. All 17 cases healed within 3 to 12 months without any risk of surgical intervention.

  10. Custom Knee Device for Knee Contractures After Internal Femoral Lengthening.

    PubMed

    Bhave, Anil; Shabtai, Lior; Ong, Peck-Hoon; Standard, Shawn C; Paley, Dror; Herzenberg, John E

    2015-07-01

    The development of knee flexion contractures is among the most common problems and complications associated with lengthening the femur with an internal device or external fixator. Conservative treatment strategies include physical therapy, serial casting, and low-load prolonged stretching with commercially available splinting systems. The authors developed an individually molded, low-cost custom knee device with polyester synthetic conformable casting material to treat knee flexion contractures. The goal of this study was to evaluate the results of treatment with a custom knee device and specialized physical therapy in patients who had knee flexion contracture during femoral lengthening with an intramedullary lengthening femoral nail. This retrospective study included 23 patients (27 limbs) who underwent femoral lengthening with an internal device for the treatment of limb length discrepancy. All patients had a knee flexion contracture raging from 10° to 90° during the lengthening process and were treated with a custom knee device and specialized physical therapy. The average flexion contracture before treatment was 36°. The mean amount of lengthening was 5.4 cm. After an average of 3.8 weeks of use of the custom knee device, only 2 of 27 limbs (7.5%) had not achieved complete resolution of the flexion contracture. The average final extension was 1.4°. Only 7 of 27 limbs (26%) required additional soft tissue release. The custom knee device is an inexpensive and effective method for treating knee flexion contracture after lengthening with an internal device.

  11. Measuring Facial Movement

    ERIC Educational Resources Information Center

    Ekman, Paul; Friesen, Wallace V.

    1976-01-01

    The Facial Action Code (FAC) was derived from an analysis of the anatomical basis of facial movement. The development of the method is explained, contrasting it to other methods of measuring facial behavior. An example of how facial behavior is measured is provided, and ideas about research applications are discussed. (Author)

  12. Tibial lengthening for unilateral Crowe type-IV developmental dysplasia of the hip

    PubMed Central

    Wan, Jun; Zhang, Xiang-Sheng; Ling, Lin; Fan, Jing; Li, Zhi-Hong

    2014-01-01

    Background: Developmental dysplasia of the hip (DDH) is associated with chronic pain and limping which especially has a negative impact on the patients’ daily activities, body image, and self-esteem. Although total hip arthroplasty remains the first choice for treatment of DDH in adults, minimally invasive alternative approaches are being increasingly favored both by the surgeon and the patients with severe DDH. This study aimed to evaluate the outcome of these patients treated with a mono-lateral external fixator-based tibial lengthening procedure. Materials and Methods: During the period of month between June 1999 and January 2006, 13 (mean ages 20.8 years) adult patients with unilateral Crowe type-IV DDH were treated by tibial lengthening using a mono-lateral external fixator over an intramedullary nail. Bone healing, infection, gait correction and improvement in body image were assessed during postoperative followup. Patients’ overall health status at the end of followup was assessed using the short form-36 (SF-36) health survey. Results: Patients were followed up for an average of 7.3 years. Successful bone healing was observed in all 13 patients and no further surgeries were indicated. A mean external fixation index of 12.4 days/cm was achieved. Bone formation fell in good to excellent categories with a mean consolidation index of 50.1 days/cm. Pin-tract infections were observed in two patients. The degree of limping was reduced from severe or moderate preoperatively to mild postoperatively. Neither equinus deformity nor painful degenerative osteoarthritis and hip dysfunction were observed in any of the patients studied. The SF-36 questionnaire survey showed that all patients were satisfied with their outcomes. Conclusions: Tibial lengthening may effectively correct gait and satisfactorily improve body image in young patients with unilateral Crowe type-IV DDH. Mono-lateral external fixator allows for accelerated postoperative rehabilitation and optimal

  13. The facial skeleton: Armor to the brain?

    PubMed Central

    Patil, Satishkumar G.; Patil, Bindu S.; Joshi, Udupikrishna; Allurkar, Soumya; Japatti, Sharanabasappa; Munnangi, Ashwini

    2016-01-01

    Background: With the development of urban setting worldwide, the major issue of concern is the increase in the mortality rate in the population due to road traffic accidents. The face, being the most exposed region is susceptible to injuries and maybe associated with injuries to the adjacent neuro-cranium. The literature has conflicting views on the relationship between facial fractures and head injuries with some authors opining that the facial skeleton cushions the brain while some other authors claim that the facial fractures act as indicators for head injuries. Objectives: To analyze the correlation between the facial fractures and head injuries and to assess if the facial skeleton acts to protect the brain from injury. Patients and Methods: A prospective study that included patients who reported to the emergency department of Basaveswar Teaching and General Hospital, Gulbarga, during 2 years, between August 2013 and July 2015 was conducted. A total of 100 patients with facial fractures were enrolled in the study. Results: Head injuries were sustained by 51 patients in the study. Maximum number of patients was in the age group of 20–29 with a male to female ratio of 10.1:1. The mandible was the most frequently fractured bone in the facial skeleton followed by the zygomatico-maxillary complex. A majority (96%) of patients with head injuries had fractures of either the upper third or the middle third of the face. Contusions and pneumocephalus were the most common head injury encountered. The Glasgow Coma Scale score was significantly lower in patients with associated head injuries as compared to those patients with facial trauma alone. The mortality rate in the study was 2% with both the victims having sustained middle third and upper third fractures respectively with associated head injuries. Conclusion: The facial skeleton does not act to cushion the brain from injury but, in fact, the facial trauma victims should be considered potential head injury patients

  14. Impact of pedicle-lengthening osteotomy on spinal canal volume and neural foramen size in three types of lumbar spinal stenosis

    PubMed Central

    Li, P.; Qian, L.; Wu, W. D.; Wu, C. F.

    2016-01-01

    Objectives Pedicle-lengthening osteotomy is a novel surgery for lumbar spinal stenosis (LSS), which achieves substantial enlargement of the spinal canal by expansion of the bilateral pedicle osteotomy sites. Few studies have evaluated the impact of this new surgery on spinal canal volume (SCV) and neural foramen dimension (NFD) in three different types of LSS patients. Methods CT scans were performed on 36 LSS patients (12 central canal stenosis (CCS), 12 lateral recess stenosis (LRS), and 12 foraminal stenosis (FS)) at L4-L5, and on 12 normal (control) subjects. Mimics 14.01 workstation was used to reconstruct 3D models of the L4-L5 vertebrae and discs. SCV and NFD were measured after 1 mm, 2 mm, 3 mm, 4 mm, or 5 mm pedicle-lengthening osteotomies at L4 and/or L5. One-way analysis of variance was used to examine between-group differences. Results In the intact state, SVC and NFD were significantly larger in the control group compared with the LSS groups (P<0.05). After lengthening at L4, the percentage increase in SCV (per millimetre) was LRS>CCS>FS>Control. After lengthening at L5 and L4-L5, the percentage increase in SCV (per millimetre) was LRS>FS>CCS>Control. After lengthening at L4 and L4-L5, the percentage increase in NFD (per millimetre) was FS>CCS>LRS>Control. After lengthening at L5, the percentage increase in NFD (per millimetre) was CCS>LRS>control>FS. Conclusions LRS patients are the most suitable candidates for treatment with pedicle-lengthening osteotomy. Lengthening L4 pedicles produced larger percentage increases in NFD than lengthening L5 pedicles (p < 0.05). Lengthening L4 pedicles may be the most effective option for relieving foraminal compression in LSS patients. Cite this article: P. Li, L. Qian, W. D. Wu, C. F. Wu, J. Ouyang. Impact of pedicle-lengthening osteotomy on spinal canal volume and neural foramen size in three types of lumbar spinal stenosis. Bone Joint Res 2016;5:239–246. DOI: 10.1302/2046-3758.56.2000469. PMID:27340140

  15. Peak power of muscles injured by lengthening contractions.

    PubMed

    Widrick, Jeffrey J; Barker, Tyler

    2006-10-01

    Excessive or extreme lengthening contractions have a well-characterized depressive effect on skeletal muscle isometric force. In addition to producing force, active muscles must often shorten in order to meet the power requirements of locomotion and other physical activities. However, the impact of lengthening contractions on muscle power is poorly understood. We evaluated the effect of 20 isometric contractions or 20 lengthening contractions (20% strain at 1.5 fiber lengths/s) on the force-velocity-power relationships of mouse soleus muscles in vitro at 35 degrees C. Pre- and posttreatment data were obtained as the muscles shortened through their optimal length (Lo). The isometric treatment did not alter Lo, the curvature of the force-velocity relationship (a/Po), or soleus maximal shortening velocity (Vmax), whereas peak force (Po) displayed a slow, time-dependent decline of 10% across the experiments. Following the lengthening treatment, Lo increased by 6%, a/Po increased by 22%, and Vmax and Po fell by 24% and 26%, respectively. Under optimal conditions for producing power, muscles damaged by lengthening contractions attained 22% less force and shortened 20% more slowly than before damage. Consequently, soleus peak power fell 37% after lengthening, a 2.5-fold greater decline than noted for the isometric treatment. Under the conditions studied here, the excessive power loss following lengthening contractions was due to force and velocity deficits of approximately equal relative magnitude. Because power represents the ability of the muscle to perform work, reductions in both force and shortening velocity should be considered when evaluating and treating lengthening-induced skeletal muscle injuries.

  16. Disseminated Intravascular Coagulation after Surgery for Facial Injury

    PubMed Central

    Tachibana, Hirohiko; Ishikawa, Shigeo; Yusa, Kazuyuki; Kitabatake, Kenichirou; Iino, Mitsuyoshi

    2016-01-01

    A case of disseminated intravascular coagulation (DIC) presenting after surgery for facial trauma associated with multiple facial bone fractures is described. With regard to the oral and maxillofacial region, DIC has been described in the literature following head trauma, infection, and metastatic disease. Until now, only 5 reports have described DIC after surgery for facial injury. DIC secondary to facial injury is thus rare. The patient in this case was young and had no medical history. Preoperative hemorrhage or postoperative septicemia may thus induce DIC. PMID:27313913

  17. The lateral column lengthening and medial column stabilization procedures.

    PubMed

    Chi, T D; Toolan, B C; Sangeorzan, B J; Hansen, S T

    1999-08-01

    The results of medial column stabilization, lateral column lengthening, and combined medial and lateral procedures were reviewed in the treatment of adult acquired flatfoot secondary to posterior tibialis tendon insufficiency. All bony procedures were accompanied by transfer of the flexor digitorum longus tendon to the medial cuneiform or stump of the posterior tibialis tendon and tendoachilles lengthening or gastrocnemius recession. Medial column fusion was performed for naviculocuneiform and cuneiform first metatarsal sag; lateral column lengthening was performed for calcaneovalgus deformity with a flat pitch angle; and combined procedures were performed for complex combined deformities. At 1 to 4 year followup of 65 feet, 88% of the feet that had lateral column lengthening, 80% that had medial column stabilization, and 88% of the feet that had medial and lateral procedures had a decrease in pain or were pain free. The lateral talar first metatarsal angle improved by 16 degrees in the patients in the lateral column lengthening group, 20 degrees in the patients in the medial column stabilization group, and 24 degrees in the patients in the combined medial and lateral procedures group. The anteroposterior talonavicular coverage angle improved by 14 degrees in the patients in the lateral column lengthening group, 10 degrees in the patients in the medial column stabilization group, and 14 degrees in the patients in the combined medial and lateral procedures group. These techniques effectively correct deformity without disrupting the essential joints of the hindfoot and midfoot.

  18. Lengthening of short stumps for functional use of prostheses.

    PubMed

    Orhun, H; Saka, G; Bilgic, E; Kavakh, B

    2003-08-01

    The length of a stump plays an important role when using a prosthesis. It is essential to have an adequate length in the stump in order to apply the prosthesis. Therefore, it is necessary to attempt to lengthen short stumps. The authors have reviewed the results in 2 patients who had such lengthening of stumps one due to traumatic amputation of the forearm at 6.25 cm distally from the elbow and the other due to congenital deficiency of the radius and ulna treated by the Ilizarov techinque to improve the fitting of prostheses. Sixty percent (60%) and 40% lengthening was achieved respectively. At the end of the lengthening process, sufficient stump length for the prosthesis was achieved. There were no major complications. As a result, it is believed stump lengthening is a valuable method for cosmetic and functional use of the prosthesis. The Ilizarov Technique is an effective method of lengthening of a stump and it does not require a tissue expander in selected patients. Patients have been able to use their prosthesis 6 months after surgery.

  19. [Progressive facial hemiatrophy].

    PubMed

    Naumbaev, A N; Sharipov, A Sh; Iakhontov, B V

    1991-01-01

    The authors describe a case of progressive facial hemiatrophy in a woman aged 26 years, coming from the Isfarin region of Tadzhikistan. The patient views herself as being ill for 14 years, since the moment of an epileptic attack with tonic and clonic convulsions. Approximately at the same time she noted a small dry ulcer on the left on the vertex. The ulcer slowly increased, followed by skin atrophy. The disease progressed for 4 to 5 years. At present to the left there are folds in the form of scars on the face. The skin is thinned, united with the bones in the frontal and parietal areas, the subcutaneous fat is atrophic. The lips and nose at the left are subatrophic. Negligible enophthalmos, hemiatrophy of the tongue at the left. Alopecia. A certain deterioration of memory and reduction of the critical attitude are recorded. The patient is in a state of euphoria. Left-sided anosmia. The left auricular floor is subatrophic, hearing is almost lacking. Diffuse elevation of the tendinous reflexes of the limbs on the left side. X-ray signs of osteoporosis of the bones of the cranial vault on the left.

  20. Lengthening and deformity correction about the knee using a magnetic internal lengthening nail

    PubMed Central

    Fragomen, Austin T.; Rozbruch, S. Robert

    2017-01-01

    Introduction: The introduction of the internal lengthening nail (ILN) has changed the treatment of complex malalignment and shortening about the knee. Acute correction of the deformity and gradual lengthening through this osteotomy site has greatly simplified postoperative recovery. This manuscript is a review of the techniques that are currently being used in surgery. Methods: The article is broken into two sections: distal femur osteotomy and tibia osteotomy. Each is addressed separately since they have different personalities. Also included are topics of particular interest that surface in ongoing conferences regarding the ILN. This work is a mix of expert opinion and best practice supported by peer reviewed publications on the topic. Results: Most published series demonstrate excellent results with the ILN. Certain precautions are reiterated including avoiding mechanical failure, need for a percutaneous osteotomy, need for over-reaming, and the need for blocking screws. Discussion: Current controversies will be brought to light and discussed. The reader should find this aspect particularly helpful in navigating this rapidly evolving field. PMID:28322717

  1. Lengthening Spring Season in Southwestern North America

    NASA Astrophysics Data System (ADS)

    Gutzler, D. S.

    2014-12-01

    Climate is changing rapidly in southwestern North America during the Spring season, a critically important transition season in terms of hydrology, ecosystem dynamics, and water resource management. Major rivers are snow-fed in mountainous headwaters but then flow through a monsoonal region with a Summer precipitation maximum; Spring is the dry season in between snowmelt and monsoon onset and is the principal wildfire season in the Southwest. Evaporation during the warm, dry Spring represents a major hydrologic loss in the surface water budget and is a principal cause of projections of significant decreases in post-snowmelt streamflow, during the first half of the growing season when demand for surface water for irrigated agriculture is highest. As temperatures increase, snowpack is expected to decrease and melt earlier, leading to a smaller and earlier peak in snowmelt runoff. Recent climate model projections suggest that monsoon onset should occur later in the year, delaying the summer rainy season. Each of these effects contributes to projections of a lengthening Spring season, at both the beginning and end of Spring. A longer, warmer Spring season is associated with significant surface drying and increased wildfire risk in the 21st Century across the Southwest. So far changes are observed at the beginning of spring in terms of temperature (increasing) and snowpack (decreasing). Detection of other changes, including metrics of the end of spring, has not been easy, in part due to the huge natural variability of precipitation that affects hydrologic variables in conjunction with temperature. This presentation describes efforts to diagnose and document observed changes in the transitions into and out of the Spring dry season in the Southwest, in variables such as temperature, snowmelt date, timing and magnitude of streamflow, and monsoon onset date.

  2. Facial Injuries and Disorders

    MedlinePlus

    Face injuries and disorders can cause pain and affect how you look. In severe cases, they can affect sight, ... your nose, cheekbone and jaw, are common facial injuries. Certain diseases also lead to facial disorders. For ...

  3. Biomechanics of external fixation and limb lengthening.

    PubMed

    Younger, Alastair S E; Morrison, James; MacKenzie, William G

    2004-09-01

    Surgeons who use external fixators for foot and ankle conditions need to understand the biomechanical principles to ensure good outcomes. Fixators can be used for fracture fixation, correction of contractures, distraction osteogenesis, and distraction arthroplasty. A two-ring fixator with wire fixation remains the gold standard with which all other frames are compared. Small changes in mechanical characteristics can have major implications on new bone or cartilage formation.

  4. Facial paralysis in children.

    PubMed

    Reddy, Sashank; Redett, Richard

    2015-04-01

    Facial paralysis can have devastating physical and psychosocial consequences. These are particularly severe in children in whom loss of emotional expressiveness can impair social development and integration. The etiologies of facial paralysis, prospects for spontaneous recovery, and functions requiring restoration differ in children as compared with adults. Here we review contemporary management of facial paralysis with a focus on special considerations for pediatric patients.

  5. Fibula-related complications during bilateral tibial lengthening

    PubMed Central

    2012-01-01

    Background and purpose Complications related to the fibula during distraction osteogenesis could cause malalignment. Most published studies have analyzed only migration of the fibula during lengthening, with few studies examining the effects of fibular complications. Patients and methods We retrospectively reviewed 120 segments (in 60 patients) between 2002 and 2009. All patients underwent bilateral tibial lengthening of more than 5 cm. The mean follow-up time was 4.9 (2.5–6.9) years. Results The average lengthening percentage was 34% (21–65). The ratio of mean fibular length to tibial length was 1.05 (0.91–1.11) preoperatively and 0.83 (0.65–0.95) postoperatively. The mean proximal fibular migration (PFM) was 15 (4–31) mm and mean distal fibular migration (DFM) was 9.7 (0–24) mm. Premature consolidation occurred in 10 segments, nonunion occurred in 12, and angulation of fibula occurred in 8 segments after lengthening. Valgus deformities of the knee occurred in 10 segments. Interpretation PFM induced valgus deformity of the knee, and premature consolidation of the fibula was associated with the distal migration of the proximal fibula. These mechanical malalignments could sometimes be serious enough to warrant surgical correction. Thus, during lengthening repeated radiographic examinations of the fibula are necessary to avoid complications. PMID:22329670

  6. Facial fractures from dog bite injuries.

    PubMed

    Tu, Alexander H; Girotto, John A; Singh, Navin; Dufresne, Craig R; Robertson, Bradley C; Seyfer, Alan E; Manson, Paul N; Iliff, Nicholas

    2002-04-01

    Dog bites are commonly associated with soft-tissue injury to the face but rarely result in facial fractures. This article reports six new cases of facial fractures associated with dog bites and reviews additional cases reported in the literature. The demographics of the patients attacked, the location of facial fractures, and the characteristics of associated soft-tissue injuries or complications developing from the dog bite are described. With six new cases and 10 from the literature, this article reviewed a total of 16 cases involving 27 facial fractures. Eighty-seven percent of the cases involved children less than 16 years of age. The periorbital or nasal bones were involved in 69 percent of the cases. Lacerations were the most frequently associated soft-tissue injury. Additional injuries included facial nerve damage, lacrimal duct damage requiring stenting and reconstruction, ptosis from levator transection, and blood loss requiring transfusion. Although facial fractures are not commonly considered to be associated with dog bite injuries, the index of suspicion for a fracture should be raised when the injury occurs in a child, particularly when injury occurs near the orbit, nose, and cheek.

  7. The Accordion Maneuver: A Noninvasive Strategy for Absent or Delayed Callus Formation in Cases of Limb Lengthening

    PubMed Central

    Makhdom, Asim M.; Cartaleanu, Adrian Sever; Rendon, Juan Sebastian; Villemure, Isabelle; Hamdy, Reggie C.

    2015-01-01

    The distraction osteogenesis (DO) technique has been used worldwide to treat many orthopaedic conditions. Although successful, absent or delayed callus formation in the distraction gap can lead to significant morbidities. An alternate cycle of distraction-compression (accordion maneuver) is one approach to accelerate bone regeneration. The primary aim of our study is to report our experience with the accordion maneuver during DO and to provide a detailed description of this technique, as performed in our center. The secondary aim is to present a review of the literature regarding the use of accordion maneuver. We reviewed the database of all patients undergoing limb lengthening from the year of 1997 to 2012. Four patients (6.15%) out of 65 showed poor bone regenerate in their tibiae and therefore accordion maneuver was applied for a mean of 6.75 weeks. Of these, three patients have had successful outcome with this technique. The literature showed that this technique is successful approach to trigger bone healing. However, details of how and when to apply this combination of distraction-compression forces were lacking. In conclusion, the accordion technique is safe noninvasive approach to promote bone formation, thus avoiding more invasive surgical procedures in cases of poor callus formation in limb lengthening. PMID:26557996

  8. Nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly.

    PubMed

    Patterson, Ryan W; Seitz, William H

    2010-04-01

    Symbrachydactyly describes a spectrum of congenital hand differences consisting of digital loss resulting in fused short fingers. As the principles for distraction lengthening have evolved, the technique of nonvascularized toe phalangeal transfer to the hand with shortened digits has provided patients with improved outcomes. Nonvascularized toe phalanx to hand transplant with distraction lengthening restores functional length to a skeletally deficient, poorly functioning hand while maintaining an overlying layer of vascular and sensate tissue. The primary goal is improvement of digital length to enhance mechanical advantage and prehension. We describe the technique of nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly, including the following steps: nonvascularized proximal toe phalanx harvest, toe phalanx transfer to hand, pin placement, osteotomy, and closure.

  9. Stretching Skeletal Muscle: Chronic Muscle Lengthening through Sarcomerogenesis

    PubMed Central

    Zöllner, Alexander M.; Abilez, Oscar J.; Böl, Markus; Kuhl, Ellen

    2012-01-01

    Skeletal muscle responds to passive overstretch through sarcomerogenesis, the creation and serial deposition of new sarcomere units. Sarcomerogenesis is critical to muscle function: It gradually re-positions the muscle back into its optimal operating regime. Animal models of immobilization, limb lengthening, and tendon transfer have provided significant insight into muscle adaptation in vivo. Yet, to date, there is no mathematical model that allows us to predict how skeletal muscle adapts to mechanical stretch in silico. Here we propose a novel mechanistic model for chronic longitudinal muscle growth in response to passive mechanical stretch. We characterize growth through a single scalar-valued internal variable, the serial sarcomere number. Sarcomerogenesis, the evolution of this variable, is driven by the elastic mechanical stretch. To analyze realistic three-dimensional muscle geometries, we embed our model into a nonlinear finite element framework. In a chronic limb lengthening study with a muscle stretch of 1.14, the model predicts an acute sarcomere lengthening from 3.09m to 3.51m, and a chronic gradual return to the initial sarcomere length within two weeks. Compared to the experiment, the acute model error was 0.00% by design of the model; the chronic model error was 2.13%, which lies within the rage of the experimental standard deviation. Our model explains, from a mechanistic point of view, why gradual multi-step muscle lengthening is less invasive than single-step lengthening. It also explains regional variations in sarcomere length, shorter close to and longer away from the muscle-tendon interface. Once calibrated with a richer data set, our model may help surgeons to prevent muscle overstretch and make informed decisions about optimal stretch increments, stretch timing, and stretch amplitudes. We anticipate our study to open new avenues in orthopedic and reconstructive surgery and enhance treatment for patients with ill proportioned limbs, tendon

  10. Mandibular distraction lengthening in the severely hypoplastic mandible: a problematic case with tongue aplasia.

    PubMed

    Havlik, R J; Bartlett, S P

    1994-11-01

    Distraction lengthening is a technique that was initially developed for correction of lower limb length discrepancies. It has recently been adapted to maxillofacial problems and has gained increasing popularity in this application. This report illustrates the principles involved in mandibular distraction lengthening and offers possible solutions to potentially limiting clinical problems. First, conventional technique dictates that a distinct periosteal sleeve is necessary for distraction osteogenesis to occur. However, in this case, distraction was performed through an area of scar tissue in which the native periosteum was destroyed. The ability to extend the use of the technique of distraction successfully to suboptimal clinical situations may broaden the indications for its use. Second, fixator instability is a potentially common problem in these cases because of the forces involved in distraction osteogenesis and the duration of the process. However, mechanical rigidity is essential consolidation (typically requiring twice as long as the distraction phase). Fixator instability can be successfully salvaged during the mineralization phase of bony healing through the use of an onlay corticocancellous bone "plate," which resorbs as the distraction gap gains strength. This report highlights one of the main advantages of the distraction process: the expansion of the soft-tissue matrix of the face.

  11. Surgical Treatment of Facial Paralysis

    PubMed Central

    2009-01-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (<3 weeks duration), intermediate duration facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy. PMID:19434284

  12. Vestibular Schwannoma Atypically Invading Temporal Bone

    PubMed Central

    Park, Soo Jeong; Yang, Na-Rae

    2015-01-01

    Vestibular schwannoma (VS) usually present the widening of internal auditory canal (IAC), and these bony changes are typically limited to IAC, not extend to temporal bone. Temporal bone invasion by VS is extremely rare. We report 51-year-old man who revealed temporal bone destruction beyond IAC by unilateral VS. The bony destruction extended anteriorly to the carotid canal and inferiorly to the jugular foramen. On histopathologic examination, the tumor showed typical benign schwannoma and did not show any unusual vascularity or malignant feature. Facial nerve was severely compressed and distorted by tumor, which unevenly eroded temporal bone in surgical field. Vestibular schwannoma with atypical invasion of temporal bone can be successfully treated with combined translabyrinthine and lateral suboccipiral approach without facial nerve dysfunction. Early detection and careful dissection of facial nerve with intraoperative monitoring should be considered during operation due to severe adhesion and distortion of facial nerve by tumor and eroded temporal bone. PMID:25932298

  13. Deformity correction of knee and leg lengthening by Ilizarov method in hypophosphatemic rickets: outcomes and significance of serum phosphate level.

    PubMed

    Choi, In Ho; Kim, Jae Kwang; Chung, Chin Youb; Cho, Tae-Joon; Lee, Seok Hyun; Suh, Seong Woo; Whang, Kuhn Sung; Park, Hui Wan; Song, Kwang Soon

    2002-01-01

    The authors evaluated 14 patients with hypophosphatemic rickets who underwent correction of a knee deformity along with a leg lengthening by the Ilizarov method. Deformity correction alone was performed in 8 femora and 4 tibiae-fibulae, and concomitant deformity correction and limb lengthening (>1.0 cm) in 9 femora and 19 tibiae-fibulae. The healing index correlated with the biochemical parameters. Knee deformities were satisfactorily corrected in all patients except one. There was a statistically significant negative correlation between the healing index and the serum phosphate level: those who had a serum phosphate level higher than 2.5 mg/dL showed a relatively rapid regenerate bone healing compared with those with less than 2.5 mg/dL. The authors conclude that a serum phosphate level of 2.5 mg/dL as a cut-off point should be considered in deciding whether deformity correction alone or with a concomitant leg lengthening should be undertaken.

  14. Leg lengthening by the Ilizarov technique for patients with sequelae of poliomyelitis.

    PubMed

    Huang, S C

    1997-04-01

    Limb length discrepancy is common in patients with sequelae of poliomyelitis. However, treatment of this problem is difficult and complicated. From 1988 to 1993, 71 patients with sequelae of poliomyelitis were treated with leg lengthening by modifications of the Ilizarov technique. Their median age at surgery was 26.4 years (range, 11.6-38.1 yr). Patients were divided into four groups according to the method of treatment, with femoral lengthening in 18 patients, combined femoral and tibial lengthening in 6, tibial lengthening in 35, and tibial lengthening along and intramedullary locking nail in 12. At follow-up of 2 to 6.7 years, the combined femoral/tibial group had the greatest gain in length. Treatment time in the Ilizarov device was shortest in the tibial lengthening with locking nail group. The lengthening index, which was defined as days in the Ilizarov device required for each centimeter of lengthening (days/cm), was lowest in the tibial lengthening with locking nail group, followed by the combined femoral/tibial lengthening group. Complications such as soft tissue contracture, callus fracture and residual deformities were most common in the combined femoral/tibial lengthening group and the femoral lengthening group. Complications were least common in the tibial lengthening with locking nail group. The satisfaction rate was highest in the tibial lengthening with locking nail group. We found that in leg lengthening for patients with sequelae of poliomyelitis, callus maturation was slow, and patients tended to develop contractures despite physiotherapy, bracing or joint fixation. Concomitant and secondary surgery were frequently required to treat associated problems or residual deformities. Lengthening along an intramedullary locking nail can significantly shorten the treatment time with relatively few complications.

  15. Facial nerve canal dehiscence in chronic otitis media without cholesteatoma.

    PubMed

    Nomiya, Shigenobu; Kariya, Shin; Nomiya, Rie; Morita, Norimasa; Nishizaki, Kazunori; Paparella, Michael M; Cureoglu, Sebahattin

    2014-03-01

    The information on incidence of the facial nerve canal dehiscence in chronic otitis media is important for surgeons. The purpose of this study is to disclose the histopathologic findings of facial nerve canal dehiscence in human temporal bones with chronic otitis media. We divided the human temporal bones into two groups (age 4 years, and under 4 years of age). We evaluated the incidence and the area of the facial nerve canal dehiscence in chronic otitis media under light microscopy. Age-matched normal control temporal bones were also examined. In the age group of 4 years, 68.9 % of temporal bones with chronic otitis media and 71.9 % of controls had the facial nerve canal dehiscence. There was no significant difference between them (P = 0.61). The area of the dehiscence in temporal bones with chronic otitis media was not statistically different from controls (P = 0.53). In the age group under 4 years, 88.2 % of temporal bones with chronic otitis media and 76.5 % of controls had the dehiscence. No significant difference was found between them (P = 0.66). The area of the dehiscence in temporal bones with chronic otitis media was not statistically different from controls in the age group under 4 years (P = 0.43). In chronic otitis media, the incidence of facial nerve canal dehiscence was high and was not statistically different from controls. These results suggest that there is no association between chronic otitis media and the presence of facial nerve canal dehiscence.

  16. [Facial tics and spasms].

    PubMed

    Potgieser, Adriaan R E; van Dijk, J Marc C; Elting, Jan Willem J; de Koning-Tijssen, Marina A J

    2014-01-01

    Facial tics and spasms are socially incapacitating, but effective treatment is often available. The clinical picture is sufficient for distinguishing between the different diseases that cause this affliction.We describe three cases of patients with facial tics or spasms: one case of tics, which are familiar to many physicians; one case of blepharospasms; and one case of hemifacial spasms. We discuss the differential diagnosis and the treatment possibilities for facial tics and spasms. Early diagnosis and treatment is important, because of the associated social incapacitation. Botulin toxin should be considered as a treatment option for facial tics and a curative neurosurgical intervention should be considered for hemifacial spasms.

  17. Fixator-assisted tibial lengthening over a plate in a patient with sequelae of poliomyelitis.

    PubMed

    Tosun, Haci Bayram; Serbest, Sancar; Uludag, Abuzer; Gumustas, Seyitali; Celik, Suat

    2016-11-01

    There are many techniques for limb lengthening. Lengthening over a plate is an alternative choice of fixation in children or when nailing is difficult. We present a new technique for tibial lengthening with using a monolateral external fixator over a lengthening plate.Lengthening over an intramedullary nail is a commonly used method in patients with short stature or limb-length discrepancy. However, in patients with a narrow and excessively sclerotic intramedullary cavity in the pediatric age group where the skeletal system has not yet fully developed, difficulties have been observed in lengthening methods with nailing.Therefore, in these cases, the use of lengthening techniques over a plate is an alternative treatment option. Nevertheless, in lengthening techniques over a plate, if one side of the osteotomy area cannot be fixed, associated mechanical axis problems have been reported.We applied tibia lengthening with external fixator assistance over a custom-made lengthening plate in a patient with sequelae of poliomyelitis. This new lengthening technique applied over a plate could be the solution to the problems observed in other lengthening techniques over a plate.

  18. Holistic facial expression classification

    NASA Astrophysics Data System (ADS)

    Ghent, John; McDonald, J.

    2005-06-01

    This paper details a procedure for classifying facial expressions. This is a growing and relatively new type of problem within computer vision. One of the fundamental problems when classifying facial expressions in previous approaches is the lack of a consistent method of measuring expression. This paper solves this problem by the computation of the Facial Expression Shape Model (FESM). This statistical model of facial expression is based on an anatomical analysis of facial expression called the Facial Action Coding System (FACS). We use the term Action Unit (AU) to describe a movement of one or more muscles of the face and all expressions can be described using the AU's described by FACS. The shape model is calculated by marking the face with 122 landmark points. We use Principal Component Analysis (PCA) to analyse how the landmark points move with respect to each other and to lower the dimensionality of the problem. Using the FESM in conjunction with Support Vector Machines (SVM) we classify facial expressions. SVMs are a powerful machine learning technique based on optimisation theory. This project is largely concerned with statistical models, machine learning techniques and psychological tools used in the classification of facial expression. This holistic approach to expression classification provides a means for a level of interaction with a computer that is a significant step forward in human-computer interaction.

  19. Facial expression and sarcasm.

    PubMed

    Rockwell, P

    2001-08-01

    This study examined facial expression in the presentation of sarcasm. 60 responses (sarcastic responses = 30, nonsarcastic responses = 30) from 40 different speakers were coded by two trained coders. Expressions in three facial areas--eyebrow, eyes, and mouth--were evaluated. Only movement in the mouth area significantly differentiated ratings of sarcasm from nonsarcasm.

  20. The effect of tibial diaphyseal lengthening on the longitudinal growth of the tibia.

    PubMed

    Cai, Gang; Yang, Lang; Saleh, Michael; Coulton, Les

    2007-11-01

    Limb lengthening by tibial callotasis is usually performed in the metaphysis but may cause growth inhibition. Is diaphyseal lengthening more advantageous? Sixteen immature rabbits underwent 30% diaphyseal lengthening by tibial callotasis. The tibial length was measured on radiographs at the end of the distraction period and after an additional 5 weeks. The proximal and distal growth plates were assessed histomorphometrically. Osteotomy stimulated tibial elongation; however, combined with diaphyseal lengthening the stimulation was suppressed resulting in longitudinal growth that matched the control side. In longer lengthenings of limbs diaphyseal callotasis may be more advantageous than metaphyseal by not inhibiting longitudinal growth.

  1. Limb lengthening and peripheral nerve function—factors associated with deterioration of conduction

    PubMed Central

    2013-01-01

    Background and purpose Limb lengthening is performed for a diverse range of orthopedic problems. A high rate of complications has been reported in these patients, which include motor and sensory loss as a result of nerve damage. We investigated the effect of limb lengthening on peripheral nerve function. Patients and methods 36 patients underwent electrophysiological testing at 3 points: (1) preoperatively, (2) after application of external fixator/corticotomy but before lengthening, and (3) after lengthening. The limb-length discrepancy was due to a congenital etiology (n = 19), a growth disturbance (n = 9), or a traumatic etiology (n = 8). Results 2 of the traumatic etiology patients had significant changes evident on electrophysiological testing preoperatively. They both deteriorated further with lengthening. 7 of the 21 patients studied showed deterioration in nerve function after lengthening, but not postoperatively, indicating that this was due to the lengthening process and not to the surgical procedure. All of these patients had a congenital etiology for their leg-length discrepancy. Interpretation As detailed electrophysiological tests were carried out before surgery, after surgery but before lengthening, and finally after completion of lengthening, it was possible to distinguish between the effects of the operation and the effects of lengthening on nerve function. The results indicate that the etiology, site (femur or tibia), and nerve (common peroneal or tibial) had a bearing on the risk of nerve injury and that these factors had a far greater effect than the total amount of lengthening. PMID:24171677

  2. Deformity correction and massive lengthening on a centralized fibula with the Ilizarov technique.

    PubMed

    Kawoosa, Altaf A; Butt, Mohammad F; Halwai, Manzoor A

    2008-10-01

    Lengthening beyond 25% of the original segment length is an orthopaedic challenge. Substantial lengthening is fraught with complications such as joint contractures, refractures, nerve injuries and prolonged periods of consolidation. We report a case of massive lengthening in a 17-year-old boy in whom a 20 cm lengthening (57% lengthening) and complex deformity correction was performed on a centralized fibula using the Ilizarov technique, with an excellent result. A total of 17 months were taken to complete the process of lengthening and consolidation at a healing index of 0.85 months/cm. Besides a minor pin tract infection, there were no major complications. We believe that with meticulous pre operative planning and follow-up the extent of lengthening can be extended in cases of severe limb length discrepancy.

  3. Development and Validation of Eye Injury and Facial Fracture Criteria for the Focus Headform

    DTIC Science & Technology

    2008-12-01

    Injury Tolerance Development In order to assess the severity of blows to various regions of the face, the skull is segmented into various sensing...areas consistent with the anthropometric regions of the human skull . Five facial bones are monitored for injury with the frontal, zygoma, and maxilla...response to actual skin, and an underlying rigid skull . Average facial skin thickness was taken from previously published studies of facial skin

  4. Spontaneous Facial Mimicry in Response to Dynamic Facial Expressions

    ERIC Educational Resources Information Center

    Sato, Wataru; Yoshikawa, Sakiko

    2007-01-01

    Based on previous neuroscientific evidence indicating activation of the mirror neuron system in response to dynamic facial actions, we hypothesized that facial mimicry would occur while subjects viewed dynamic facial expressions. To test this hypothesis, dynamic/static facial expressions of anger/happiness were presented using computer-morphing…

  5. Could lengthening minocycline therapy better treat early syphilis?

    PubMed

    Shao, Li-Li; Guo, Rui; Shi, Wei-Jie; Liu, Yuan-Jun; Feng, Bin; Han, Long; Liu, Quan-Zhong

    2016-12-01

    Syphilis is a sexually transmitted disease caused by Treponema pallidum. Minocycline, a representative tetracycline derivative, has the greatest antimicrobial activity among all tetracyclines. There are few reports about treating syphilis with minocycline because there is a lack of efficacy data from controlled trials. We compared the rates of serological cure in patients with early syphilis who were treated with minocycline or benzathine penicillin G (BPG).During the study period, a total of 40 syphilis patients received the BPG treatment, which was a single intramuscular dose of 2.4 million units of BPG, and 156 patients were treated with minocycline; 77 patients were placed in the 2-week, standard minocycline therapy group and received 100 mg of minocycline orally, twice daily for 14 days, and 79 patients were placed in the 4-week, lengthened minocycline therapy group and received 100 mg of minocycline orally, twice daily for 28 days. The outcome of interest was the rate of serological cure in these patients.At the end of the 2-year follow-up, the serological cure rate of the 4-week, lengthened minocycline therapy group (87.34%) was higher than that of both the 2-week, standard minocycline therapy group (72.73%) and the BPG treatment group (77.50%). In addition, the curative effect of the 4-week, lengthened minocycline therapy was significantly greater than that of the 2-week, standard minocycline therapy in patients who were aged >40 years; exhibited an initial rapid plasma reagin titer ≥1: 32; or exhibited secondary syphilis (P = 0.000, 0.008, 0.000; <0.05).Minocycline appears to be an effective agent for treating early syphilis, especially when applied as a 4-week, lengthened therapy.

  6. Could lengthening minocycline therapy better treat early syphilis?

    PubMed Central

    Shao, Li-Li; Guo, Rui; Shi, Wei-Jie; Liu, Yuan-Jun; Feng, Bin; Han, Long; Liu, Quan-Zhong

    2016-01-01

    Abstract Syphilis is a sexually transmitted disease caused by Treponema pallidum. Minocycline, a representative tetracycline derivative, has the greatest antimicrobial activity among all tetracyclines. There are few reports about treating syphilis with minocycline because there is a lack of efficacy data from controlled trials. We compared the rates of serological cure in patients with early syphilis who were treated with minocycline or benzathine penicillin G (BPG). During the study period, a total of 40 syphilis patients received the BPG treatment, which was a single intramuscular dose of 2.4 million units of BPG, and 156 patients were treated with minocycline; 77 patients were placed in the 2-week, standard minocycline therapy group and received 100 mg of minocycline orally, twice daily for 14 days, and 79 patients were placed in the 4-week, lengthened minocycline therapy group and received 100 mg of minocycline orally, twice daily for 28 days. The outcome of interest was the rate of serological cure in these patients. At the end of the 2-year follow-up, the serological cure rate of the 4-week, lengthened minocycline therapy group (87.34%) was higher than that of both the 2-week, standard minocycline therapy group (72.73%) and the BPG treatment group (77.50%). In addition, the curative effect of the 4-week, lengthened minocycline therapy was significantly greater than that of the 2-week, standard minocycline therapy in patients who were aged >40 years; exhibited an initial rapid plasma reagin titer ≥1: 32; or exhibited secondary syphilis (P = 0.000, 0.008, 0.000; <0.05). Minocycline appears to be an effective agent for treating early syphilis, especially when applied as a 4-week, lengthened therapy. PMID:28033297

  7. Muscle length and lengthening velocity in voluntary crouch gait.

    PubMed

    van der Krogt, Marjolein M; Doorenbosch, Caroline A M; Harlaar, Jaap

    2007-10-01

    The purpose of this study was to explore how origin-insertion length and lengthening velocity of hamstring and psoas muscle change as a result of crouch gait. The second purpose was to study the effect of changes in walking speed, in crouch, on muscle lengths and velocities. Eight healthy female subjects walked on a treadmill both normally and in crouch. In the crouch condition, subjects walked at three different walking speeds. 3D kinematic data were collected and muscle lengths and velocities were calculated using musculoskeletal modeling. It was found that voluntary walking in crouch resulted in shorter psoas length compared to normal, but not in shorter hamstrings length. Moreover, crouch gait did not result in slower muscle lengthening velocities compared to normal gait. These results do not support the role of hamstrings shortness or spasticity in causing crouch gait. Decreasing walking speed clearly reduced muscle lengths and lengthening velocities. Therefore, patients with short or spastic muscles are more likely to respond by walking slower than by walking in crouch. Also, differences in walking speed should be avoided as a confounding factor when comparing patient groups with controls.

  8. Deformity correction followed by lengthening with the Ilizarov method.

    PubMed

    Tsuchiya, Hiroyuki; Uehara, Kenji; Abdel-Wanis, Mohamed E; Sakurakichi, Keisuke; Kabata, Tamon; Tomita, Katsuro

    2002-09-01

    Deformity combined with shortening of 18 lower limb segments of 17 patients was treated with the Ilizarov method. Limb lengthening was done at the same treatment (monofocal treatment) or a separate osteotomy (bifocal treatment) was done after acute or gradual correction of the deformity using the Ilizarov hinge system. The external fixation time, amount of deformity correction, length gained, and incidence of complications were examined. Results were compared between monofocal versus bifocal treatment groups and between femoral versus tibial procedures. The average deformity corrected was 22.3 degrees, and the average lengthening was 44.4 mm. The external fixation index was 49.3 days/cm on average, ranging from 24.4 to 90 days/cm, and the mean duration of external fixation was 198 days, ranging from 77 to 352 days. Major complications requiring surgical treatment, such as premature consolidation and fracture, were seen in four patients. There were no statistically significant differences between the results for monofocal and bifocal treatment or treatment indices for femoral and tibial operations. The Ilizarov method was very effective for treatment of limb deformity combined with shortening. Monofocal treatment might be better if the total amounts of lengthening required are short to reduce surgical invasion. Longer treatment indices for tibial operations could not be verified from the current study.

  9. Deep intramedullary infection in tibial lengthening over an intramedullary nail.

    PubMed

    Kim, Seung-Ju; Cielo Balce, Gracia; Huh, Young-Jae; Song, Sang-Yoon; Song, Hae-Ryong; Kim, Seung-Ju

    2011-08-01

    Tibial lengthening over an intramedullary (IM) device is associated with a risk of deep intramedullary infection; there is so far no guideline for decision making between early removal and delayed removal of the nail. Tibial lengthening over an intramedullary nail/Rush pin was performed in 118 limb segments (63 patients) from 2004 to 2008 in our institution. Fifty five patients had bilateral tibial lengthening. Ninety nine of the 118 segments went on to healing without infection, while 13 segments developed superficial infection and 6 segments developed deep infection. Among 6 patients with deep infection, 4 patients underwent early removal of the nail when deep infection signs and symptoms occurred and 2 patients underwent delayed removal of the nail at 11 months. The 6 segments with deep infection differed significantly with respect t to the callus pattern (p < 0.05) and density (p = 0.0001) from those without infection and with superficial infection. In this small sugroup, removal of the nail was delayed in two patients as there was visible callus bridging at more than one cortex, and deep infection subsided after local drainage.

  10. Safety and efficacy of botox injection in alleviating post-operative pain and improving quality of life in lower extremity limb lengthening and deformity correction

    PubMed Central

    Hamdy, Reggie C; Montpetit, Kathleen; Ruck-Gibis, Joanne; Thorstad, Kelly; Raney, Ellen; Aiona, Michael; Platt, Robert; Finley, Allen; Mackenzie, William; McCarthy, James; Narayanan, Unni

    2007-01-01

    Background Distraction osteogenesis is the standard treatment for the management of lower limb length discrepancy of more than 3 cm and bone loss secondary to congenital anomalies, trauma or infection. This technique consists of an osteotomy of the bone to be lengthened, application of an external fixator, followed by gradual and controlled distraction of the bone ends. Although limb lengthening using the Ilizarov distraction osteogenesis principle yields excellent results in most cases, the technique has numerous problems and is not well tolerated by many children. The objective of the current study is to determine if Botulinum Toxin A (BTX-A), which is known to possess both analgesic and paralytic actions, can be used to alleviate post-operative pain and improve the functional outcome of children undergoing distraction osteogenesis. Methods/Design The study design consists of a multi centre, randomized, double-blinded, placebo-controlled trial. Patients between ages 5–21 years requiring limb lengthening or deformity correction using distraction will be recruited from 6 different sites (Shriners Hospital for Children in Montreal, Honolulu, Philadelphia and Portland as well as DuPont Hospital for Children in Wilmington, Delaware and Hospital for Sick Children in Toronto, Ont). Approximately 150 subjects will be recruited over 2 years and will be randomized to either receive 10 units per Kg of BTX-A or normal saline (control group) intraoperatively following the surgery. Functional outcome effects will be assessed using pain scores, medication dosages, range of motion, flexibility, strength, mobility function and quality of life of the patient. IRB approval was obtained from all sites and adverse reactions will be monitored vigorously and reported to IRB, FDA and Health Canada. Discussion BTX-A injection has been widely used world wide with no major side effects reported. However, to the best of our knowledge, this is the first time BTX-A is being used under the

  11. Controversies in Contemporary Facial Reanimation.

    PubMed

    Kim, Leslie; Byrne, Patrick J

    2016-08-01

    Facial palsy is a devastating condition with profound functional, aesthetic, and psychosocial implications. Although the complexity of facial expression and intricate synergy of facial mimetic muscles are difficult to restore, the goal of management is to reestablish facial symmetry and movement. Facial reanimation surgery requires an individualized treatment approach based on the cause, pattern, and duration of facial palsy while considering patient age, comorbidities, motivation, and goals. Contemporary reconstructive options include a spectrum of static and dynamic procedures. Controversies in the evaluation of patients with facial palsy, timing of intervention, and management decisions for dynamic smile reanimation are discussed.

  12. Limb lengthening and deformity correction in children using hexapodal external fixation: preliminary results for 36 cases.

    PubMed

    Blondel, B; Launay, F; Glard, Y; Jacopin, S; Jouve, J -L; Bollini, G

    2009-10-01

    Limb deformities in children can be corrected using different techniques, notably external fixation following the Ilizarov principles. However, correction can be difficult in cases of multiple deformities. In 1994, Charles Taylor developed a new computer-assisted hexapodal external fixator system to treat these pathologies, the Taylor Spatial Frame. The objective of this study was to evaluate the results obtained with this technique in treating lower-limb deformities in children. Thirty-six patients were included in this prospective study, with a mean age of 11.1 years. The etiologies were distributed into six groups: congenital pathologies in 17 cases, fractures in five cases, post-traumatic pathologies in two cases, postinfectious sequelae in three cases, achondroplasia in three cases, and other causes in the last six cases. A total of 67 deformities in the three spatial planes were found in the entire group of patients. The procedure consisted of lengthening, correcting the axis, or both simultaneously. All the patients were managed with the same protocol: placement of an external fixator, AP and lateral X-rays, and planning of the correction using dedicated software. In this group of 36 patients, the fixator was worn for a mean 183 days; when lengthening was performed, a mean 4.3cm was gained with a healing index of 38.2 days/cm. Of the 67 initial deformities, 91% were corrected. The most frequently encountered complications were a superficial infection in 22.2% of the cases; one deep infection was also noted as well as three bone regenerate fractures. Use of this computer-assisted fixation system seems effective in treating complex deformities of the limbs in children, and allows treating several deformities simultaneously.

  13. Peripheral facial palsy, the only presentation of a primitive neuroectodermal tumor of the skull base

    PubMed Central

    Kim, Hyung Jin; Kang, Ben; Joo, Eun Young; Kim, Eun Young; Kwon, Young Se

    2015-01-01

    Introduction Peripheral facial palsy is rarely caused by primary neoplasms, which are mostly constituted of tumors of the central nervous system, head and neck, and leukemia. Presentation of case A 2-month-old male infant presented with asymmetric facial expression for 3 weeks. Physical examination revealed suspicious findings of right peripheral facial palsy. Computed tomography of the temporal bone revealed a suspicious bone tumor centered in the right petrous bone involving surrounding bones with extension into the middle ear cavity and inner ear. Subtotal resection of the tumor was performed due to crucial structures adjacent the mass. Histopathology and immunohistochemistry of the resected tumor was consistent with primitive neuroectodermal tumor. Conclusion We report a rare case of a primitive neuroectodermal tumor located at the skull base presenting with only peripheral facial palsy. PMID:26710328

  14. Surgically assisted rapid orthodontic lengthening of the maxilla in primates--a pilot study.

    PubMed

    Altuna, G; Walker, D A; Freeman, E

    1995-05-01

    Orthodontic and surgical treatment of patients with maxillary retrusion and/or midface hypoplasia is challenging. This study was designed to show that the maxilla can be successfully lengthened by surgical assisted rapid orthopedic movement, using the principles of distraction osteogenesis. Three experimental and three control adolescent cynomolgus primates were used in this study. Metallic markers were placed in the cranial base and the maxilla and cephalometric x-ray films were taken. An orthodontic appliance was constructed with a Glen-Ross screw (Dentaurum, Newtown, Pa.) oriented anteroposteriorly. Anterior supraapical osteotomies of the maxilla were carried out. Bilateral horizontal and interdental osteotomies were created between the first premolars and the canine; the anterior six tooth dental-osseo segment was completely mobilized in all animals. Beginning 1 week after surgery, the orthodontic appliance was opened a quarter turn every 2 days until the anterior segment was advanced by 4 mm in two animals and 6 mm in one animal. Animals were killed at 6, 8, and 12 weeks after completion of the maxillary orthopedic advancement. Computerized tomographic scans of the maxillae were completed, and the specimens were then prepared by routine histologic methods for examination by light microscopy. The computerized tomographic scans showed bone deposition in the osteotomy sites, which was confirmed by histologic observations. Since this technique demonstrated repair by bone rather than soft connective tissue in the osteotomy sites, this procedure could be a useful method of treating midface retrusion.

  15. Comparison between upper and lower limb lengthening in patients with achondroplasia: a retrospective study.

    PubMed

    Kim, S-J; Agashe, M V; Song, S-H; Choi, H-J; Lee, H; Song, H-R

    2012-01-01

    Lengthening of the humerus is now an established technique. We compared the complications of humeral lengthening with those of femoral lengthening and investigated whether or not the callus formation in the humerus proceeds at a higher rate than that in the femur. A total of 24 humeral and 24 femoral lengthenings were performed on 12 patients with achondroplasia. We measured the pixel value ratio (PVR) of the lengthened area on radiographs and each radiograph was analysed for the shape, type and density of the callus. The quality of life (QOL) of the patients after humeral lengthening was compared with that prior to surgery. The complication rate per segment of humerus and femur was 0.87% and 1.37%, respectively. In the humerus the PVR was significantly higher than that of the femur. Lower limbs were associated with an increased incidence of concave, lateral and central callus shapes. Humeral lengthening had a lower complication rate than lower-limb lengthening, and QOL increased significantly after humeral lengthening. Callus formation in the humerus during the distraction period proceeded at a significantly higher rate than that in the femur. These findings indicate that humeral lengthening has an important role in the management of patients with achondroplasia.

  16. Cosmetic Facial Surgery

    PubMed Central

    Adamson, Peter A.

    1987-01-01

    Canadians have committed themselves to a healthier lifestyle, and many are seeking to look as well as they feel. For patients with realistic expectations, modern techniques of cosmetic facial surgery can enhance appearance and be of psychological benefit. Today most procedures can be done under local anesthesia on an out-patient basis. Facial contour defects can be improved by means of procedures such as rhinoplasty, mentoplasty, otoplasty and malarplasty. Facial rejuvenation surgery to decrease the signs of aging includes the forehead lift, eyebrow and eyelid lift, rhytidectomy, liposuction and chemical peeling. Newer controversial trends in cosmetic facial surgery include collagen implantation and fat transfer for contour defects, and eyelid tattooing. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6 PMID:21263984

  17. Traumatic facial nerve injury.

    PubMed

    Lee, Linda N; Lyford-Pike, Sofia; Boahene, Kofi Derek O

    2013-10-01

    Facial nerve trauma can be a devastating injury resulting in functional deficits and psychological distress. Deciding on the optimal course of treatment for patients with traumatic facial nerve injuries can be challenging, as there are many critical factors to be considered for each patient. Choosing from the great array of therapeutic options available can become overwhelming to both patients and physicians, and in this article, the authors present a systematic approach to help organize the physician's thought process.

  18. Classifying Facial Actions

    PubMed Central

    Donato, Gianluca; Bartlett, Marian Stewart; Hager, Joseph C.; Ekman, Paul; Sejnowski, Terrence J.

    2010-01-01

    The Facial Action Coding System (FACS) [23] is an objective method for quantifying facial movement in terms of component actions. This system is widely used in behavioral investigations of emotion, cognitive processes, and social interaction. The coding is presently performed by highly trained human experts. This paper explores and compares techniques for automatically recognizing facial actions in sequences of images. These techniques include analysis of facial motion through estimation of optical flow; holistic spatial analysis, such as principal component analysis, independent component analysis, local feature analysis, and linear discriminant analysis; and methods based on the outputs of local filters, such as Gabor wavelet representations and local principal components. Performance of these systems is compared to naive and expert human subjects. Best performances were obtained using the Gabor wavelet representation and the independent component representation, both of which achieved 96 percent accuracy for classifying 12 facial actions of the upper and lower face. The results provide converging evidence for the importance of using local filters, high spatial frequencies, and statistical independence for classifying facial actions. PMID:21188284

  19. Penetrating trauma to the facial skeleton by pickaxe - case report.

    PubMed

    Neskoromna-Jędrzejczak, Aneta; Bogusiak, Katarzyna; Przygoński, Aleksander; Timler, Dariusz

    2016-01-01

    Number of deaths related with injuries suffered as a result of experienced traumas is increasing. Penetrating traumas of the facial skeleton occur relatively rarely and much more often concern rather children than adults. Epidemiology relating this kind of trauma differs depending on the region of the world. In Poland, gunshot injuries as well as traumas caused by explosions of firecrackers or fireworks amount only to a slight percentage among all facial skeleton traumas, and the most common reason for penetrating traumas lies in accidents or assault with the use of sharp, narrow and long objects that easily enter bones of the facial skeleton. The present study reported the case of 50-year-old man who suffered from trauma of the facial skeleton, which resulted from foreign body (pickaxe) penetration into the subtemporal area, zygomatic arch and the right orbital cavity. The surgical treatment method and final outcome was presented and discussed.

  20. Implant-retained craniofacial prostheses for facial defects

    PubMed Central

    Federspil, Philipp A.

    2012-01-01

    Craniofacial prostheses, also known as epistheses, are artificial substitutes for facial defects. The breakthrough for rehabilitation of facial defects with implant-retained prostheses came with the development of the modern silicones and bone anchorage. Following the discovery of the osseointegration of titanium in the 1950s, dental implants have been made of titanium in the 1960s. In 1977, the first extraoral titanium implant was inserted in a patient. Later, various solitary extraoral implant systems were developed. Grouped implant systems have also been developed which may be placed more reliably in areas with low bone presentation, as in the nasal and orbital region, or the ideally pneumatised mastoid process. Today, even large facial prostheses may be securely retained. The classical atraumatic surgical technique has remained an unchanged prerequisite for successful implantation of any system. This review outlines the basic principles of osseointegration as well as the main features of extraoral implantology. PMID:22073096

  1. Autograft versus sterilized allograft for lateral calcaneal lengthening osteotomies

    PubMed Central

    Müller, Sebastian A.; Barg, Alexej; Vavken, Patrick; Valderrabano, Victor; Müller, Andreas M.

    2016-01-01

    Abstract Sterilized allografts may be less resistant to collapse and prone to nonunion leading to loss of correction in open wedge osteotomies. These adverse events usually occur at early time points (i.e., < 9 months postoperatively). The goal of this study was to compare sterilized allografts to autologous grafts in respect to secondary loss of hindfoot alignment and graft incorporation after lateral calcaneal lengthening osteotomies. Fifty patients (22 F/ 28 M, age: 16–69 years) who had undergone 50 lateral calcaneal lengthening osteotomies for adult flatfoot deformity were included in this retrospective study. Cortical sterilized allografts were used in 25 patients, autologous grafts in the remaining 25. Patients’ preoperative, 6 and 12 weeks, and 6 to 9 months follow-up weight-bearing radiographs of the affected foot were analyzed by 2 blinded radiologists: on each radiograph, graft incorporation, the talo-first metatarsal angle (TFMA), the talo-navicular coverage angle (TNCA), and the calcaneal pitch angle (CPA) were assessed. Loss of hindfoot alignment was defined as an increase of the TFMA or the TNCA or a decrease of the CPA, each by 5°. Inter- and intraclass correlation coefficients for TFMA, TNCA, and CPA measurements ranged from 0.93 to 0.99. At all follow-up visits, the ratio of patients with loss of hindfoot alignment and graft incorporation was not significantly different between the allograft and autograft group. However, loss of correction was associated with failure of graft incorporation. Compared with autografts, sterilized allografts do not increase the risk for loss of hindfoot alignment in lateral column lengthening of the calcaneus. With respect to mechanical resistance, allografts thus mean an equal and valid alternative without risk of donor site morbidities. PMID:27472719

  2. Temporohyoid osteoarthropathy and unilateral facial nerve paralysis in a horse

    PubMed Central

    Yadernuk, Lisa M.

    2003-01-01

    A 13-year-old broodmare was referred for weight loss and left facial nerve paralysis. Bilateral temporohyoid osteoarthropathy was diagnosed based on proliferation of the temporohyoid joints and stylohyoid bones on radiographs and guttural pouch endoscopy. The left side was more severely affected. Treatment resulted in little or no improvement. PMID:14703087

  3. Complex reconstruction of facial deformity and function after severe gunshot injury: one case report

    PubMed Central

    Wang, Weijian; Duan, Jianmin; Wang, Qiao; Kuang, Wei

    2015-01-01

    In this report, we described clinical outcomes of a multi-stage surgery integrating multiple techniques in restoration of facial morphology and function of a 17-year-old boy with severe gunshot injuries. This multi-stage surgery was applied in treatment of one rare case of gunshot-caused complicated facial deformities involving most parts of the face (labrum, left nose wing, nasal columella, nasal septum, maxillary alveolar process, hard palate, soft palate, bilateral maxillary bones, left zygoma, suborbital bone defects) and clinical efficacy upon restoring facial form and function were retrospectively evaluated. The patient was diagnosed with massive facial defects and deformities caused by gunshot, which led to feeding difficulty, severe articulation disorders and serious facial disfigurement. To reconstruct facial form and restore functions of mastication and articulation, multiple examinations and surgical procedures including mirror imaging, rapid prototyping technique, porous titanium implants, microscopic surgical technique, dental implants, osteomyocutaneous flap, muscular flap, shifting and repairing of adjacent tissue flaps and free bone graft reconstruction were undertaken. Postoperatively, reconstruction of severe facial disfigurement and restoring basic functions including articulation and feeding for the first time and relatively sound clinical outcomes have been obtained, which may add clinical evidence to the treatment of similar cases of severe facial deformities. PMID:25785151

  4. [Bilateral simultaneous limb lengthening of patients with short stature using the Ilizarov method].

    PubMed

    Tesiorowski, Maciej; Zarzycka, Maja; Kacki, Wojciech; Jasiewicz, Barbara

    2002-01-01

    Limb lengthening of patients with short stature is a complex orthopaedic problem. In these cases treatment is a long-term, multistage procedure. This paper presents the results of lower limb lengthening using the Ilizarov technique. The material consists of 5 cases, in which 10 stages of bilateral simultaneous lengthening of the femur and opposite tibia were performed. Follow-up was on average 3.1 years. Problems, obstacles and complications were typical for limb lengthening procedures and did not differ from the results presented by other authors. Success of treatment depends on the patient's full co-operation, adequate motivation and knowledge of the principles of therapy.

  5. Recurrence of a Unicameral Bone Cyst in the Femoral Diaphysis

    PubMed Central

    Kim, Hyun Se; Lim, Kyung Sup; Seo, Sung Wook; Jang, Seung Pil

    2016-01-01

    Diaphyseal unicameral bone cysts of the long bone are generally known to originate near the growth plate and migrate from the metaphysis to the diaphysis during skeletal growth. In the case of unicameral bone cysts of diaphyseal origin, recurrence at the same location is extremely rare. We report a case of recurrence of a unicameral bone cyst in the diaphysis of the femur that developed 8 years after treatment with curettage and bone grafting. We performed bone grafting and lengthening of the affected femur with an application of the Ilizarov apparatus over an intramedullary nail to treat the cystic lesion and limb length discrepancy simultaneously. PMID:27904734

  6. Facial nerve palsy due to birth trauma

    MedlinePlus

    Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... infant's facial nerve is also called the seventh cranial nerve. It can be damaged just before or at ...

  7. Facial transplantation surgery introduction.

    PubMed

    Eun, Seok-Chan

    2015-06-01

    Severely disfiguring facial injuries can have a devastating impact on the patient's quality of life. During the past decade, vascularized facial allotransplantation has progressed from an experimental possibility to a clinical reality in the fields of disease, trauma, and congenital malformations. This technique may now be considered a viable option for repairing complex craniofacial defects for which the results of autologous reconstruction remain suboptimal. Vascularized facial allotransplantation permits optimal anatomical reconstruction and provides desired functional, esthetic, and psychosocial benefits that are far superior to those achieved with conventional methods. Along with dramatic improvements in their functional statuses, patients regain the ability to make facial expressions such as smiling and to perform various functions such as smelling, eating, drinking, and speaking. The ideas in the 1997 movie "Face/Off" have now been realized in the clinical field. The objective of this article is to introduce this new surgical field, provide a basis for examining the status of the field of face transplantation, and stimulate and enhance facial transplantation studies in Korea.

  8. Propylthiouracil, but not other antithyroid treatments, lengthens hamster circadian period

    SciTech Connect

    Morin, L.P. )

    1988-07-01

    Two experiments were performed to evaluate the role of the thyroid gland as a mediator of circadian rhythms in the hamster. In experiment 1, the antithyroid drug propylthiouracil (PTU) lengthened the circadian period ({tau}), increased thyroid weight, and eliminated detectable thyroxine (T{sub 4}) and triiodothyronine (T{sub 3}) from blood. A low-iodine diet greatly reduced T{sub 4} levels but had no effect on T{sub 3} or {tau}. Treatment with 500 {mu}Ci of {sup 131}I failed to alter any parameter of physiology or thythmicity measured. In this experiment, some animals in the low-iodine and PTU groups had greatly reduced testes sizes, and testses size was inversely correlated with change in {tau}. In experiment 2, T{sub 4} and T{sub 3} levels detected 11 wk after surgical thyroidectomy were significantly less than those found in sham-operated ammals, but concentrations of the two hormones varied widely across the thyroidectomized group. Thyroidectomy did not increase {tau} either 4 or 11 wk after surgery, nor was there evidence from individuals that level of thyroid function was associated with change in {tau}. The results from these experiments suggest that diminished thyroid function is not causal of lengthened circadian period.

  9. Outcome analysis of sports-related multiple facial fractures.

    PubMed

    Hwang, Kun; You, Sun Hye; Lee, Hong Sik

    2009-05-01

    In this paper, we report a retrospective study of 236 patients with facial bone fractures from various sports who were treated at the Department of Plastic and Reconstructive Surgery, Inha University Hospital, Incheon, South Korea, between February 1996 and April 2007. The medical records of these patients were reviewed and analyzed to determine the clinical characteristics and treatment of the sports-related facial bone fractures. The highest frequency of sports-related facial bone fractures was in the age group 11 to 20 years (40.3%); there was a significant male predominance in all age groups (13.75:1). The most common causes of the injury were soccer (38.1%), baseball (16.1%), basketball (12.7%), martial arts (6.4%), and skiing or snowboarding (11%). Fractures of the nasal bone were the most common in all sports; mandible fractures were common in soccer and martial arts, orbital bone fractures were common in baseball, basketball, and ice sports, and fractures of the zygoma were frequently seen in soccer and martial arts. The main causes of the sports injuries were direct body contact (50.8%), and the most commonly associated soft tissue injuries were found in the head and neck regions (92.3%). Nasal bone fractures were the most common (54.2%), and tripod fractures were the most common type of complex injuries (4.2%). The complication rate was 3.0%. Long-term epidemiological data regarding the natural history of sports-related facial bone fractures are important for the evaluation of existing preventative measures and for the development of new methods of injury prevention and treatment.

  10. Bone graft

    MedlinePlus

    Autograft - bone; Allograft - bone; Fracture - bone graft; Surgery - bone graft; Autologous bone graft ... Fuse joints to prevent movement Repair broken bones (fractures) that have bone loss Repair injured bone that ...

  11. Lengthening Over an Existing Intramedullary Nail In Cases of Post-traumatic Femoral Shortening. Technical Note. Case Series Study

    PubMed Central

    Boutsiadis, Achilleas; Iosifidou, Eirini; Nikolaos, Xilouris; Hatzokos, Ippokratis

    2016-01-01

    Background: Intramedullary (IM) nailing is the method of choice for the treatment of most femoral shaft fractures. However, despite successful solid union, great initial fracture comminution can lead to significant leg length discrepancy affecting normal gait mechanics. Femoral osteotomy and distraction osteogenesis over the pre-existing IM nail could restore this limb inequality. Methods: Five patients with an average post-traumatic femoral shortening of 3.83 cm were presented in our department with the nail in situ. Limb lengthening was achieved with the application of a distal hybrid external rail frame over the pre-existing nail. We assumed that the choice of a distal external fixator ring with wires could facilitate the procedure and minimize the possibility of friction–contact problems with the large diameter nail. Results: The amount of length discrepancy, calculated preoperatively, was restored in all patients. The mean time in frame was 57.6 days and the external fixator index 16.978 d/cm. The mean time of total healing was 152.6 days and the average bone-healing index 44.9d/cm. No deep infection or hardware loosening was observed. One superficial pin track infection was treated successfully with oral antibiotics. Conclusion: This technique utilizes the principles and advantages of lengthening over an IM nail, avoids the necessity of nail removal and minimizes the complication rates and the overall time for complete recovery. PMID:27053972

  12. Facial reanimation after facial nerve injury using hypoglossal to facial nerve anastomosis: the gruppo otologico experience.

    PubMed

    Tanbouzi Husseini, Sami; Kumar, David Victor; De Donato, Giuseppe; Almutair, Tamama; Sanna, Mario

    2013-12-01

    To evaluate the results of facial nerve reanimation after facial nerve injury by means of hypoglossal to facial nerve anastomosis. Retrospective case review. Private neuro-otologic and cranial base quaternary referral center. Sixty patients underwent hypoglossal to facial nerve anastomosis for facial nerve reanimation between April 1987 and December 2010. Only forty patients completed a minimal follow up of 24 months at the time of evaluation and were included in the study population. Facial nerve paralysis was present for a mean duration of 11.3 months (range 2-42 months) and all the patients had a HB grade VI prior their surgery. Final facial nerve motor function. The most common cause of facial paralysis was vestibular Schwannoma surgery. All the patients achieved a postoperative HB grade III or IV after a mean follow-up time of 20 months. The facial movements were detected after a period that ranged from ranged from 5 to 9 months. Only 4 patients suffered from difficulties during eating and drinking and three of them had associated lower cranial nerve deficit. Despite the various techniques in facial reanimation following total facial nerve paralysis, the end to end of hypoglossal to facial nerve anastomosis remains one of the best treatments in cases of viable distal facial stump and nonatrophic musculature.

  13. [Idiopathic facial paralysis].

    PubMed

    Wolf, S R

    1998-09-01

    Although acute idiopathic facial paresis is often labelled "Bell's palsy", historical studies show that Nicolaus Anton Friedreich (1761-1836) from Würzburg was the first physician to describe the typical symptoms of the disorder in 1797, approximately 24 years prior to the paper published by Sir Charles Bell. Diagnostics has now improved to the extent that acute idiopathic facial palsy can more frequently be assigned to etiologies caused by inflammatory disorders. Herpes simplex virus type I and Borrelia burgdorferi are particularly relevant. Underestimation of the degree of paresis is, particularly in children, a drawback of the clinical examination. "Incomplete eyelid closure" is not a reliable indicator of remaining nerve function. For this reason complete electromyography (EMG) is recommended in all cases of severe facial paresis. Since electroneurography does not reliably reflect the degree of denervation present, needle EMG is preferred. The therapy of the facial palsy of unclear etiology is still not well defined. Nevertheless, we recommend that a combined treatment should be used early, at least in patients with disfiguring pareses. Combinations may consist of cortisone, virostatic agents and hemorrheologic substances and possibly antibiotics. Surgical decompression of the facial nerve remains controversial, since positive surgical results lack statistical support. Individual instructions for facial exercises, massage and muscle relaxation can support rehabilitation and possibly reduce the production of pathological synkinesia. Electrical stimulation should not be used. There are a number of possibilities available to reduce the effects of misdirected reinnervation, especially the use of botulinum-A-toxin. However, intensive diagnosis and therapy in the early phase of paresis are decisive in obtaining a favorable outcome. Further refinements in rehabilitation and comparative multicenter controlled studies are still required for future improvements in

  14. [Correction of the position of the cilia in facial paralysis: Technical note].

    PubMed

    Caillot, A; Labbé, D

    2015-06-01

    Facial paralysis is a incapacitating pathology that we treat with lengthening temporalis myoplasty for reanimation of the smile. To treat lagophthalmia, we use the extension of the levator of the upper eyelid according Tessier and the asymmetric external blepharorraphy. These techniques can optionally be combined with other techniques, as needed. However, many patients are embarrassed by the appearance of the lashes of the upper eyelid homolateral side facial paralysis. The cilia are lowered and horizontalised, creating a functional disorder by partial "amputation" of the visual field and aesthetic inconvenience. We describe a surgical technique to correct the malposition of the lashes. This technique can be carried out independently or in the lengthening of the temporal myoplasty or another surgical procedure on the eye. In case of extension of the levator of the upper eyelid, the technique we propose requires no additional incision. This is a simple technique and increases very little surgical time. It is fast, little or no morbid, reproducible and provides a significant improvement in the aesthetic and functional patient. This simple technique allows to provide both aesthetic and functional refinement for patients with facial paralysis sequelae.

  15. Expression of nerve growth factor and its receptor in distracted tibial nerve after limb lengthening.

    PubMed

    Shao, Heng; Shu, Hengsheng; Wang, Chunmei; Yuan, Wu; Li, Yunsheng

    2013-02-01

    Despite many experimental and clinical studies conducted on distraction osteogenesis (DO) in the past decade, changes in the surrounding tissues that occur after the procedure remains poorly understood. To study the biochemical changes of recovery in nerve tissues upon DO-induced nerve injury, we prepared a rabbit model of tibia lengthening to observe the expression pattern of nerve growth factor (NGF) and low-affinity NGF receptor (p75NGFR) in the distracted tibial nerve. The distracted tibial nerve was harvested at various time points during the consolidation period of new bone formation and immunohistochemical staining was performed to detect the expression of NGF and p75NGFR. The expression levels of NGF and p75NGFR were found to be different at various times after DO. The changes in expression of these two cellular factors show similar tendencies with significantly elevated expression in Schwann cells at 7 and 14 days after distraction, but low or undetectable levels of expression at 0, 28, and 56 days. These results suggest that NGF and p75NGFR may play important roles in the adaptive process of the distracted nerve. NGF and p75NGFR are autocrine growth factors present in the distracted nerve during the early consolidation period. NGF interacts with p75NGFR to promote damage repair and reconstruction of nerves. Together, this study furthers the understanding of the relative mechanisms of nerve repair, as well as provides a further basis for the clinical application of neurotrophins.

  16. [Combined crown lengthening surgery with restorative therapy for inducing papilla growth: a case report].

    PubMed

    Le, Di; Hu, Wen-jie; Zhang, Hao

    2013-04-18

    A young lady with unsatisfied restorations of upper anterior teeth and swollen gum wanted to improve aesthetics. Oral examination showed that 12-22 were provisional crowns with normal occlusion, poorly gingival contour and gummy smile. The gingiva was red, light swollen and bleeding on probing. X-ray showed the roots of 11, 21 were short and the alveolar bone absorbed. After the periodontal initial treatment, an ideal location of gingival margin was determined. Then, an esthetic periodontal surgery was performed to recover the biology width and the gingival margin was fitted with the anterior teeth. The temporary restorations were made twice to guide the gingiva growth by changing the shape of the restorations and moving up the contact points of the restorations. The ceramic crowns were completed 3 months after the operation. The gummy smile disappeared and the gingival margin was filled well with the upper anterior ceramic crowns. The 14-month follow-up presented a satisfied effect. Crown lengthening surgery combined restorative therapy could lead papilla to grow well. This process is beneficial for the future treatment plan and clinical esthetic evaluation.

  17. Z-lengthening of the Achilles Tendon with Transverse Skin Incision

    PubMed Central

    Oh, Jong Seok; Lee, Jong Seo; Lee, Tae Hoon

    2014-01-01

    Background The risk of various complications after Achilles tendon lengthening is mainly related to the length of surgical exposure and the lengthening method. A comprehensive technique to minimize the complications is required. Methods The treatment of Achilles tendon tightness in 57 patients (95 ankles) were performed by using a short transverse incision on a skin crease of the heel and by Z-lengthening of the tendon. In the severe cases, two or three transverse incisions were required for greater lengthening of the tendon, and a serial cast or Ilizarov apparatus was applied for the gradual correction. The results of these 95 ankles were compared to those of 18 ankles, which underwent percutaneous sliding lengthening, and to the 19 ankles, which received Z-lengthening with a medial longitudinal incision. Results The functional and cosmetic satisfaction was achieved among those who underwent the tendon lengthening with the new technique. The mean American Orthopaedic Foot & Ankle Society (AOFAS) score improved from 56.1 to 81.8. The second operations to correct recurrence were performed in the two cerebral palsy patients. Conclusions The new technique has a low rate of complications such as scarring, adhesion, total transection, excessive lengthening, and recurrence of shortening. The excellent cosmesis and the short operation time are the additional advantages. PMID:24900904

  18. Limb lengthening in fibular hemimelia type II: can it be an alternative to amputation?

    PubMed

    Zarzycki, Daniel; Jasiewicz, Barbara; Kacki, Wojciech; Koniarski, Arkadiusz; Kasprzyk, Marcin; Zarzycka, Maja; Tesiorowski, Maciej

    2006-03-01

    The purpose of our study was to analyze limb lengthening in fibular hemimelia type II. Ten patients underwent 16 tibia lengthenings. The mean tibia shortening was 5.8 cm. We used the Ilizarov technique in all cases. The mean follow-up time was 7.2 years. The mean lengthening was 23% of the former length. The healing index was 50.8 days/cm. In the final examination six patients were skeletally mature, equal limb length and functional foot positioning were achieved in four of them. Complications were observed during 14 lengthenings (87.5%). Although lengthening in fibular hemimelia is difficult, elongation with axis and foot correction may offer an alternative to amputation.

  19. Facial Paralysis Reconstruction.

    PubMed

    Razfar, Ali; Lee, Matthew K; Massry, Guy G; Azizzadeh, Babak

    2016-04-01

    Facial nerve paralysis is a devastating condition arising from several causes with severe functional and psychological consequences. Given the complexity of the disease process, management involves a multispecialty, team-oriented approach. This article provides a systematic approach in addressing each specific sequela of this complex problem.

  20. Children and Facial Trauma

    MedlinePlus

    ... up after Facial trauma: A prospective study. Otolaryngol Head Neck Surg 1997: 117:72-75 Kim MK, Buchman ... trauma in children: An urban hospital’s experience. Otolaryngoly–Head Neck Surgery 2000: 123: 439-43 Patient Health Home ...

  1. [Ultrastructural features of femoral artery myocytes during experimental leg lengthening].

    PubMed

    Ir'ianov, Iu M; Migalkin, N S; Kniazeva, L M

    1984-11-01

    Femoral arteries in mature dogs have been studied electron microscopically at various stages of the shin lengthening performed after G. A. Ilizarov method. Certain ultrastructural signs demonstrating biosynthetic and secretory activation of myocytes directed to intensification of elastogenetic processes have been revealed. Immature elastic fibers are forming around myocytes as aggregations of microfibrils, later accumulations of amorphous material appear in them. On the 28th, 42d days of distraction, hyperproduction of intra- and extracellular vesicles is noted, as well as that of intracellular matrix. Cytoplasmic islets of myocytes and intercellular connections increase in number. In the subintimal layer, of the tunica media and at its border with adventitium, longitudinally situating fasciculi of smooth muscle cells are forming. The myocytic ultrastructural peculiarities noted, the new formations of elastic elements depend, at early stages of the experiment, on changes of regional hemodynamics, and at advanced stages - also on the effect of longitudinally acting tension stress.

  2. Alternative lengthening of telomeres: remodeling the telomere architecture.

    PubMed

    Conomos, Dimitri; Pickett, Hilda A; Reddel, Roger R

    2013-01-01

    To escape from the normal limits on proliferative potential, cancer cells must employ a means to counteract the gradual telomere attrition that accompanies semi-conservative DNA replication. While the majority of human cancers do this by up-regulating telomerase enzyme activity, most of the remainder use a homologous recombination-mediated mechanism of telomere elongation known as alternative lengthening of telomeres (ALT). Many molecular details of the ALT pathway are unknown, and even less is known regarding the mechanisms by which this pathway is activated. Here, we review current findings about telomere structure in ALT cells, including DNA sequence, shelterin content, and heterochromatic state. We speculate that remodeling of the telomere architecture may contribute to the emergence and maintenance of the ALT phenotype.

  3. Physiological role of stalk lengthening in Caulobacter crescentus

    PubMed Central

    Klein, Eric A; Schlimpert, Susan; Hughes, Velocity; Brun, Yves V; Thanbichler, Martin; Gitai, Zemer

    2013-01-01

    The Gram-negative bacterium Caulobacter crescentus forms a thin polar stalk, which mediates its attachment to solid surfaces. Whereas stalks remain short (1 µm) in nutrient-rich conditions, they lengthen dramatically (up to 30 µm) upon phosphate starvation. A long-standing hypothesis is that the Caulobacter stalk functions as a nutrient scavenging “antenna” that facilitates phosphate uptake and transport to the cell body. The mechanistic details of this model must be revisited, given our recent identification of a protein-mediated diffusion barrier, which prevents the exchange of both membrane and soluble proteins between the stalk extension and the cell body. In this report, we discuss the potential of stalks to facilitate nutrient uptake and propose additional physiological roles for stalk elongation in Caulobacter cells. PMID:23986806

  4. Facial diplegia: a clinical dilemma.

    PubMed

    Chakrabarti, Debaprasad; Roy, Mukut; Bhattacharyya, Amrit K

    2013-06-01

    Bilateral facial paralysis is a rare clinical entity and presents as a diagnostic challenge. Unlike its unilateral counterpart facial diplegia is seldom secondary to Bell's palsy. Occurring at a frequency of 0.3% to 2% of all facial palsies it often indicates ominous medical conditions. Guillian-Barre syndrome needs to be considered as a differential in all given cases of facial diplegia where timely treatment would be rewarding. Here a case of bilateral facial palsy due to Guillian-Barre syndrome with atypical presentation is reported.

  5. Intraoperative measurement of limb lengthening during total hip arthroplasty

    PubMed Central

    Papadopoulos, Dimitrios Vasileiou; Koulouvaris, Panagiotis; Aggelidakis, Georgios Charalambos; Tsantes, Andreas Georgios; Lykissas, Marios Georgios; Mavrodontidis, Alexandros

    2017-01-01

    Background: Limb length discrepancy (LLD) after total hip arthroplasty (THA) is a common problem which cannot be completely resolved. Many techniques have been described in order to minimize postoperative LLD, but most of these techniques are difficult to apply. Ideal technique must be simple and accurate. The most simple technique using a suture tied on the skin has well-known limitations, but its accuracy has not been evaluated before. Materials and Methods: Sixty THAs in sixty patients (mean age 71 years, 1:1 male to female ratio) with hip osteoarthritis (37 cases in the right, and 23 cases in the left side) were studied in this prospective study. In all surgeries, the intraoperataive measurement of limb lengthening was performed using a suture tied on the skin of the lateral pelvis. The accuracy of this technique and correlation between intraoperative and postoperative radiological measurements of lengthening were evaluated. Results: The mean preoperative LLD was –7.5 mm while the mean postoperative LLD was 1.58 mm. The accuracy of this technique, defined as the mean difference between the intraoperative and postoperative measurements was 1.8 mm. A strong correlation between these two measurements was noticed (r = 0.86). Conclusion: The accuracy and correlation index of this simple technique were similar to those of other techniques. The studied technique is quite accurate when attention is given to certain details, such as the amount of tension applied on the suture, the position of the tied point on the skin, and the position of the leg during measurements.

  6. Male facial anthropometry and attractiveness.

    PubMed

    Soler, Caries; Kekäläinen, Jukka; Núñez, Manuel; Sancho, María; Núñez, Javier; Yaber, Iván; Gutiérrez, Ricardo

    2012-01-01

    The symmetry and masculinity of the face are often considered important elements of male facial attractiveness. However, facial preferences are rarely studied on natural faces. We studied the effect of these traits and facial metric parameters on facial attractiveness in Spanish and Colombian raters. In total, 13 metric and 11 asymmetry parameters from natural, unmanipulated frontal face photographs of 50 Spanish men were measured with the USIA semiautomatic anthropometric software. All raters (women and men) were asked to rank these images as potential long-term partners for females. In both sexes, facial attractiveness was negatively associated with facial masculinity, and preference was not associated with facial symmetry. In Spanish raters, both sexes preferred male traits that were larger in the right side of the face, which may reflect a human tendency to prefer a certain degree of facial asymmetry. We did not find such preference in Colombian raters, but they did show stronger preference for facial femininity than Spanish raters. Present results suggest that facial relative femininity, which is expected to signal, eg good parenting and cooperation skills, may be an important signal of mate quality when females seek long-term partners. Facial symmetry appears unimportant in such long-term mating preferences.

  7. Facial asymmetry: a case report of localized linear scleroderma patient with muscular strain and spasm.

    PubMed

    Kim, Jae-Hyung; Lee, Suck-Chul; Kim, Chul-Hoon; Kim, Bok-Joo

    2015-12-01

    Facial asymmetry is found in patients with or without cosmetic facial alterations. Some patients have facial asymmetry that manifests underlying skeletal problems, while others have only limited soft-tissue facial asymmetry. Orthognathic surgery brings about a dermatic change, as soft tissue covers underlying bones. Limited soft-tissue asymmetry, meanwhile, is difficult to correct. The treatment modalities for the creation or restoration of an esthetically pleasing appearance were autogenous fat grafts, cartilage graft, and silicon injections. A young female patient had right-side facial asymmetry. The clinical assessment involved visual inspection of the face and palpation to differentiate soft tissue and bone. Although the extra-oral examination found facial asymmetry with skin atrophy, the radiographic findings revealed no mandibular atrophy or deviation. She was diagnosed as localized scleroderma with muscle spasm. In conclusion, facial asymmetry patients with skeletal asymmetry can be esthetically satisfied by orthognathic surgery; however, facial atrophy patients with skin or subdermal tissue contraction need treatment by cosmetic dermatological surgery and orthodontic correction.

  8. Bone tumor

    MedlinePlus

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor; Bone tumor - benign ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  9. An aggressive chondroblastoma of the knee treated with resection arthrodesis and limb lengthening using the Ilizarov technique.

    PubMed

    Tomić, Slavko; Lesić, Aleksandar; Bumbasirević, Marko; Sopta, Jelena; Rakocević, Zoran; Atkinson, Henry D

    2010-07-28

    This case report describes the management of a 15 year old male with a biologically aggressive chondroblastoma of the knee. Following CT, bone scan, angiography and an open biopsy, the diagnosis was confirmed histologically and immunohistochemically. The patient underwent a 13 cm en-bloc excision of the knee, and knee arthrodesis with simultaneous bone transport using an Ilizarov ring fixator. Following 136 days of bone transport, the patient achieved radiological and clinical bony union after a total frame time of 372 days. He then commenced 50% partial weight-bear in a protective knee brace and gradually worked up to full weight-bearing by 4 months. The patient developed superficial pin tract infections around the k-wires on 2 occasions; these settled with a cephalosporin antibiotic spray and local dressings. At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site. The patient is able to fully weight bear and stand independently on the operated leg. Knee arthrodesis with simultaneous limb-lengthening is an effective treatment modality following en-bloc resection of an aggressive chondroblastoma. The case is discussed with reference to the literature.

  10. Retinotopy of facial expression adaptation.

    PubMed

    Matsumiya, Kazumichi

    2014-01-01

    The face aftereffect (FAE; the illusion of faces after adaptation to a face) has been reported to occur without retinal overlap between adaptor and test, but recent studies revealed that the FAE is not constant across all test locations, which suggests that the FAE is also retinotopic. However, it remains unclear whether the characteristic of the retinotopy of the FAE for one facial aspect is the same as that of the FAE for another facial aspect. In the research reported here, an examination of the retinotopy of the FAE for facial expression indicated that the facial expression aftereffect occurs without retinal overlap between adaptor and test, and depends on the retinal distance between them. Furthermore, the results indicate that, although dependence of the FAE on adaptation-test distance is similar between facial expression and facial identity, the FAE for facial identity is larger than that for facial expression when a test face is presented in the opposite hemifield. On the basis of these results, I discuss adaptation mechanisms underlying facial expression processing and facial identity processing for the retinotopy of the FAE.

  11. Prophylactic titanium elastic nailing (TEN) following femoral lengthening (Lengthening then rodding) with one or two nails reduces the risk for secondary interventions after regenerate fractures: a cohort study in monolateral vs. bilateral lengthening procedures

    PubMed Central

    2013-01-01

    Background Femoral fracture rates of up to 30% have been reported following lengthening procedures using fixators. “Lengthening then rodding” uses one or two titanium elastic nails (TENs) for prophylactic intramedullary nailing to reduce this complication. The aim of the study was to decide if usage of only one TEN is safe or has it a higher risk of getting a fracture? And we asked if there is a difference between patients with monolateral or bilateral lengthening procedures according to their fracture rate? Methods One or two TENs were implanted in two groups of patients (monolateral and bilateral) after femoral lengthening procedures. The regenerate quality was classified using the Li system and fractures were categorized using the Simpson and Kenwright classification. The follow-up period was at least 1 year after removal of the frame. Results Sixty-seven patients with 101 femoral lengthening procedures were included in 2007–2011. Group A included 34 patients with bilateral lengthening due to congenital short stature. Group B consisted of 33 patients with congenital disorders with leg length discrepancies. Seven fractures in six patients were seen in group A and five fractures in group B. One patient had residual shortening of 1 cm, and 11 fractures healed without relevant deviation (< 5°) or shortening (< 5 mm). A soft-tissue infection in one patient led to early removal of one TEN. Conclusions Fractures occurred in both groups of patients in total in 12 of the 101 cases (12%). The rate of secondary interventions was markedly reduced. Usage of one or two TENs did not influence the fracture rate. PMID:24156728

  12. Realistic facial animation generation based on facial expression mapping

    NASA Astrophysics Data System (ADS)

    Yu, Hui; Garrod, Oliver; Jack, Rachael; Schyns, Philippe

    2014-01-01

    Facial expressions reflect internal emotional states of a character or in response to social communications. Though much effort has been taken to generate realistic facial expressions, it still remains a challenging topic due to human being's sensitivity to subtle facial movements. In this paper, we present a method for facial animation generation, which reflects true facial muscle movements with high fidelity. An intermediate model space is introduced to transfer captured static AU peak frames based on FACS to the conformed target face. And then dynamic parameters derived using a psychophysics method is integrated to generate facial animation, which is assumed to represent natural correlation of multiple AUs. Finally, the animation sequence in the intermediate model space is mapped to the target face to produce final animation.

  13. Cross-facial nerve grafting for facial reanimation.

    PubMed

    Peng, Grace Lee; Azizzadeh, Babak

    2015-04-01

    Dynamic facial reanimation is the gold standard treatment for a paralyzed face. Over the last century, multiple nerves have been utilized for grafting to the facial nerve in an attempt to produce improved movement. However, in recent years, the use of cross facial nerve grafting with a second stage gracilis free flap has gained popularity due to the ability to generate a spontaneous smile and facial movement. Preoperative history taking and careful examination, as well as pre-surgical planning, are imperative to whether cross facial nerve grafting with a second stage gracilis free flap is appropriate for the patient. A sural nerve graft is ideal given the accessibility of the nerve, the length, as well as the reliability and ease of the nerve harvest. The nerve can be harvested using a small incision, which leaves the patient with minimal post operative morbidity. In this chapter, we highlight the pearls and pitfalls of cross facial nerve grafting.

  14. How precise is the PRECICE compared to the ISKD in intramedullary limb lengthening?

    PubMed Central

    Vogt, Björn; Tretow, Henning L; Schuhknecht, Britta; Gosheger, Georg; Horter, Melanie J; Rödl, Robert

    2014-01-01

    Background and purpose The PRECICE intramedullary limb lengthening system uses a new technique with a magnetic rod and a motorized external remote controller (ERC) with rotational magnetic field. We evaluated the reliability and safety of the PRECICE system. Methods We compared our preliminary results with PRECICE in 24 patients (26 nails) with the known difficulties in the use of mechanical lengthening devices such as the ISKD. We used the Paley classification for evaluation of problems, obstacles, and complications. Results 2 nails were primarily without function, and 24/26 nails lengthened over the desired distance. Lengthening desired was 38 mm and lengthening obtained was 37 mm. There were 2 nail breakages, 1 in the welding seam and 1 because of a fall that occurred during consolidation. ERC usage was problematic mostly in patients with femoral lengthening. Adjustment of the ERC was necessary in 10 of 24 cases. 15 cases had implant-associated problems, obstacles were seen in 5 cases, and complications were seen in each of 4 cases. Interpretaion The reliability of the PRECICE system is comparable to that of other intramedullary lengthening devices such as the ISKD. The motorized external remote controller and its application by the patients is a weak point of the system and needs strict supervision. PMID:24758320

  15. Reactive oxygen species generation is not different during isometric and lengthening contractions of mouse muscle.

    PubMed

    Sloboda, Darcée D; Brooks, Susan V

    2013-10-01

    Skeletal muscles can be injured by lengthening contractions, when the muscles are stretched while activated. Lengthening contractions produce structural damage that leads to the degeneration and regeneration of damaged muscle fibers by mechanisms that have not been fully elucidated. Reactive oxygen species (ROS) generated at the time of injury may initiate degenerative or regenerative processes. In the present study we hypothesized that lengthening contractions that damage the muscle would generate more ROS than isometric contractions that do not cause damage. To test our hypothesis, we subjected muscles of mice to lengthening contractions or isometric contractions and simultaneously monitored intracellular ROS generation with the fluorescent indicator 5-(and-6)-chloromethyl-2',7'-dichlorodihydrofluorescein (CM-DCFH), which is oxidized by ROS to form the fluorescent product CM-DCF. We found that CM-DCF fluorescence was not different during or shortly after lengthening contractions compared with isometric controls, regardless of the amount of stretch and damage that occurred during the lengthening contractions. The only exception was that after severe stretches, the increase in CM-DCF fluorescence was impaired. We conclude that lengthening contractions that damage the muscle do not generate more ROS than isometric contractions that do not cause damage. The implication is that ROS generated at the time of injury are not the initiating signals for subsequent degenerative or regenerative processes.

  16. Sequelae of radiation facial epilation (North American Hiroshima maiden syndrome)

    SciTech Connect

    Rosen, I.B.; Walfish, P.G. )

    1989-12-01

    Radiation for benign problems of the head and neck area has been uniformly recognized as unacceptable practice. This includes epilation for facial hirsutism. Twelve such patients, recently encountered, have characteristic radiodermatitis facies and have demonstrated multisite neoplastic involvement--including skin, thyroid, parathyroid, salivary gland, oral cavity, facial skeleton, and breast--and have also undergone extensive dermatologic treatment of complications of radiodermatitis. There was one cancer death, and three patients are alive with cancer. Such patients have a superficial resemblance to the Hiroshima maiden group of young women who survived atomic bombing and experienced severe facial burns, necessitating extensive plastic surgery. As atomic survivors they are at increased risk for cancer of thyroid, salivary gland, lung, breast, bone marrow, and gastrointestinal tract. The North American Hiroshima maiden should warrant easy clinical recognition and require lifetime scrutiny for multisite neoplastic disease.

  17. Other facial neuralgias.

    PubMed

    O'Neill, Francis; Nurmikko, Turo; Sommer, Claudia

    2017-01-01

    Premise In this article we review some lesser known cranial neuralgias that are distinct from trigeminal neuralgia, trigeminal autonomic cephalalgias, or trigeminal neuropathies. Included are occipital neuralgia, superior laryngeal neuralgia, auriculotemporal neuralgia, glossopharyngeal and nervus intermedius neuralgia, and pain from acute herpes zoster and postherpetic neuralgia of the trigeminal and intermedius nerves. Problem Facial neuralgias are rare and many physicians do not see such cases in their lifetime, so patients with a suspected diagnosis within this group should be referred to a specialized center where multidisciplinary team diagnosis may be available. Potential solution Each facial neuralgia can be identified on the basis of clinical presentation, allowing for precision diagnosis and planning of treatment. Treatment remains conservative with oral or topical medication recommended for neuropathic pain to be tried before more invasive procedures are undertaken. However, evidence for efficacy of current treatments remains weak.

  18. The Facial Skeleton in Patients with Osteoporosis: A Field for Disease Signs and Treatment Complications

    PubMed Central

    Kyrgidis, Athanassios; Tzellos, Thrasivoulos-George; Toulis, Konstantinos; Antoniades, Konstantinos

    2011-01-01

    Osteoporosis affects all bones, including those of the facial skeleton. To date the facial bones have not drawn much attention due to the minimal probability of morbid fractures. Hearing and dentition loss due to osteoporosis has been reported. New research findings suggest that radiologic examination of the facial skeleton can be a cost-effective adjunct to complement the early diagnosis and the follow up of osteoporosis patients. Bone-mass preservation treatments have been associated with osteomyelitis of the jawbones, a condition commonly described as osteonecrosis of the jaws (ONJ). The facial skeleton, where alimentary tract mucosa attaches directly to periosteum and teeth which lie in their sockets of alveolar bone, is an area unique for the early detection of osteoporosis but also for the prevention of treatment-associated complications. We review facial bone involvement in patients with osteoporosis and we present data that make the multidisciplinary approach of these patients more appealing for both practitioners and dentists. With regard to ONJ, a tabular summary with currently available evidence is provided to facilitate multidisciplinary practice coordination for the treatment of patients receiving bisphosphonates. PMID:21403823

  19. Multiracial Facial Golden Ratio and Evaluation of Facial Appearance

    PubMed Central

    2015-01-01

    This study aimed to investigate the association of facial proportion and its relation to the golden ratio with the evaluation of facial appearance among Malaysian population. This was a cross-sectional study with 286 randomly selected from Universiti Sains Malaysia (USM) Health Campus students (150 females and 136 males; 100 Malaysian Chinese, 100 Malaysian Malay and 86 Malaysian Indian), with the mean age of 21.54 ± 1.56 (Age range, 18–25). Facial indices obtained from direct facial measurements were used for the classification of facial shape into short, ideal and long. A validated structured questionnaire was used to assess subjects’ evaluation of their own facial appearance. The mean facial indices of Malaysian Indian (MI), Malaysian Chinese (MC) and Malaysian Malay (MM) were 1.59 ± 0.19, 1.57 ± 0.25 and 1.54 ± 0.23 respectively. Only MC showed significant sexual dimorphism in facial index (P = 0.047; P<0.05) but no significant difference was found between races. Out of the 286 subjects, 49 (17.1%) were of ideal facial shape, 156 (54.5%) short and 81 (28.3%) long. The facial evaluation questionnaire showed that MC had the lowest satisfaction with mean score of 2.18 ± 0.97 for overall impression and 2.15 ± 1.04 for facial parts, compared to MM and MI, with mean score of 1.80 ± 0.97 and 1.64 ± 0.74 respectively for overall impression; 1.75 ± 0.95 and 1.70 ± 0.83 respectively for facial parts. In conclusion: 1) Only 17.1% of Malaysian facial proportion conformed to the golden ratio, with majority of the population having short face (54.5%); 2) Facial index did not depend significantly on races; 3) Significant sexual dimorphism was shown among Malaysian Chinese; 4) All three races are generally satisfied with their own facial appearance; 5) No significant association was found between golden ratio and facial evaluation score among Malaysian population. PMID:26562655

  20. The evolution of the Ilizarov technique: part 1: the history of limb lengthening.

    PubMed

    Jordan, Charles J; Goldstein, Rachel Y; McLaurin, Toni M; Grant, Alfred

    2013-01-01

    The history of limb-lengthening surgery can be traced back to the nineteenth century. Since that time, the orthopaedic community has made tremendous progress in performing successful lengthening procedures. Among the important contributors to the field, Dr. Gavril Ilizarov remains one of the most significant innovators. Because of advancements over the past century, limb lengthening has become a viable method of treating severe bony deformities and defects. This article, the first of a two-part series, reviews the history of distraction osteosynthesis.

  1. Facial expression, size, and clutter: Inferences from movie structure to emotion judgments and back.

    PubMed

    Cutting, James E; Armstrong, Kacie L

    2016-04-01

    The perception of facial expressions and objects at a distance are entrenched psychological research venues, but their intersection is not. We were motivated to study them together because of their joint importance in the physical composition of popular movies-shots that show a larger image of a face typically have shorter durations than those in which the face is smaller. For static images, we explore the time it takes viewers to categorize the valence of different facial expressions as a function of their visual size. In two studies, we find that smaller faces take longer to categorize than those that are larger, and this pattern interacts with local background clutter. More clutter creates crowding and impedes the interpretation of expressions for more distant faces but not proximal ones. Filmmakers at least tacitly know this. In two other studies, we show that contemporary movies lengthen shots that show smaller faces, and even more so with increased clutter.

  2. [The pursuit of facial harmony].

    PubMed

    van Hooft, E; Becking, A G; van Spronsen, P H; Tuinzing, D B

    2010-01-01

    In the treatment of patients with an oro-facial anomaly the functioning of the masticatory system and aesthetic aspects play a role. Recently, the software programme 'Facial Harmony', which analyzes the soft tissue contour of the face, appeared. Using this programme, a research project was carried out to find out if the result of the surgical treatment of 40 patients with an oro-facial anomaly satisfied the,facial harmony requirements. Only 65% of the treatment results met the requirements. It was especially the patients who had been treated for mandibular deficiency with mandibular and horizontal lines meeting at a wide angle who showed no facial harmony. Only 30% of those patients demonstrated facial harmony postoperatively. If the surgical treatment had been completed by a genioplasty, this percentage would very probably have risen to 85.

  3. Correction of Facial Deformity in Sturge–Weber Syndrome

    PubMed Central

    Yamaguchi, Kazuaki; Lonic, Daniel; Chen, Chit

    2016-01-01

    Background: Although previous studies have reported soft-tissue management in surgical treatment of Sturge–Weber syndrome (SWS), there are few reports describing facial bone surgery in this patient group. The purpose of this study is to examine the validity of our multidisciplinary algorithm for correcting facial deformities associated with SWS. To the best of our knowledge, this is the first study on orthognathic surgery for SWS patients. Methods: A retrospective chart review included 2 SWS patients who completed the surgical treatment algorithm. Radiographic and clinical data were recorded, and a treatment algorithm was derived. Results: According to the Roach classification, the first patient was classified as type I presenting with both facial and leptomeningeal vascular anomalies without glaucoma and the second patient as type II presenting only with a hemifacial capillary malformation. Considering positive findings in seizure history and intracranial vascular anomalies in the first case, the anesthetic management was modified to omit hypotensive anesthesia because of the potential risk of intracranial pressure elevation. Primarily, both patients underwent 2-jaw orthognathic surgery and facial bone contouring including genioplasty, zygomatic reduction, buccal fat pad removal, and masseter reduction without major complications. In the second step, the volume and distribution of facial soft tissues were altered by surgical resection and reposition. Both patients were satisfied with the surgical result. Conclusions: Our multidisciplinary algorithm can systematically detect potential risk factors. Correction of the asymmetric face by successive bone and soft-tissue surgery enables the patients to reduce their psychosocial burden and increase their quality of life. PMID:27622111

  4. Magnetically retained silicone facial prosthesis.

    PubMed

    Venugopalan, S; Ariga, P; Aggarwal, P; Viswanath, A

    2014-01-01

    Patients with orocutaneous fistulas suffer from discomfort in terms of facial esthetics, food spill over and lack of psychological confidence to present them socially. Prosthetic camouflaging of facial defects and use of silicone maxillofacial material are the alternatives to the surgical retreatment. Silicone elastomers provide more options to clinician for customization of the facial prosthesis which is simple, esthetically good when coupled with bio magnets for retention.

  5. Complications of Ilizarov leg lengthening: a comparative study between patients with leg length discrepancy and short stature.

    PubMed

    Vargas Barreto, B; Caton, J; Merabet, Z; Panisset, J C; Pracros, J P

    2007-10-01

    The Ilizarov technique has been used to treat severe limb length discrepancy and short stature. However, complications of this treatment are frequent. Between 1984 and 2001, 57 patients (94 tibias) had an Ilizarov procedure for limb lengthening. Twenty patients had limb discrepancy and 37 had short stature. Their mean age was 20.2 years (range 15-34). The average limb lengthening was 8.37 cm (range 3.2-14.7), which was equivalent to 26% (range 9.2-60%) average tibial lengthening. A total of 90 complications were observed. Thirty-three unplanned procedures were required during the lengthening programme. Two patients stopped the lengthening programme. There was no difference in the complications in leg lengthening using Ilizarov technique between the group of patients with leg length discrepancy and the group with short stature. A good knowledge of the Ilizarov technique is necessary to perform a lengthening programme with a low rate of complications.

  6. Pediatric facial transplantation: Ethical considerations

    PubMed Central

    Flynn, Jennifer; Shaul, Randi Zlotnik; Hanson, Mark D; Borschel, Gregory H; Zuker, Ronald

    2014-01-01

    Facial transplantation is becoming increasingly accepted as a method of reconstructing otherwise unreconstructable adult faces. As this modality is made more available, we must turn our attention to pediatric patients who may benefit from facial transplantation. In the current article, the authors present and briefly examine the most pressing ethical challenges posed by the possibility of performing facial transplantation on pediatric patients. Furthermore, they issue a call for a policy statement on pediatric facial transplantation. The present article may serve as a first step in that direction, highlighting ethical issues that would need to be considered in the creation of such a statement. PMID:25114614

  7. Fat grafting in facial rejuvenation.

    PubMed

    Marten, Timothy J; Elyassnia, Dino

    2015-04-01

    Patients with significant facial atrophy and age-related loss of facial fat generally achieve suboptimal improvement from both surface treatments of facial skin and surgical lifts. Restoring lost facial volume by fat grafting is a powerful technique that is now acknowledged by most plastic surgeons and other physicians engaged in treating the aging face as one of the most important advances in aesthetic surgery. Properly performed, the addition of fat to areas of the face that have atrophied because of age or disease can produce a significant and sustained improvement in appearance that is unobtainable by other means.

  8. [Prosopagnosia and facial expression recognition].

    PubMed

    Koyama, Shinichi

    2014-04-01

    This paper reviews clinical neuropsychological studies that have indicated that the recognition of a person's identity and the recognition of facial expressions are processed by different cortical and subcortical areas of the brain. The fusiform gyrus, especially the right fusiform gyrus, plays an important role in the recognition of identity. The superior temporal sulcus, amygdala, and medial frontal cortex play important roles in facial-expression recognition. Both facial recognition and facial-expression recognition are highly intellectual processes that involve several regions of the brain.

  9. Radial forcing and Edgar Allan Poe's lengthening pendulum

    NASA Astrophysics Data System (ADS)

    McMillan, Matthew; Blasing, David; Whitney, Heather M.

    2013-09-01

    Inspired by Edgar Allan Poe's The Pit and the Pendulum, we investigate a radially driven, lengthening pendulum. We first show that increasing the length of an undriven pendulum at a uniform rate does not amplify the oscillations in a manner consistent with the behavior of the scythe in Poe's story. We discuss parametric amplification and the transfer of energy (through the parameter of the pendulum's length) to the oscillating part of the system. In this manner, radial driving can easily and intuitively be understood, and the fundamental concept applied in many other areas. We propose and show by a numerical model that appropriately timed radial forcing can increase the oscillation amplitude in a manner consistent with Poe's story. Our analysis contributes a computational exploration of the complex harmonic motion that can result from radially driving a pendulum and sheds light on a mechanism by which oscillations can be amplified parametrically. These insights should prove especially valuable in the undergraduate physics classroom, where investigations into pendulums and oscillations are commonplace.

  10. Bone scanning in otolaryngology.

    PubMed

    Noyek, A M

    1979-09-01

    Modern radionuclide bone scanning has introduced a new concept in physiologic and anatomic diagnostic imaging to general medicine. As otolaryngologists must diagnose and treat disease in relation to the bony and/or cartilaginous supporting structures of the neurocranium and upper airway, this modality should be included in the otolaryngologist's diagnostic armamentarium. It is the purpose of this manuscript to study the specific applications of bone scanning to our specialty at this time, based on clinical experience over the past three years. This thesis describes the development of bone scanning in general (history of nuclear medicine and nuclear physics; history of bone scanning in particular). General concepts in nuclear medicine are then presented; these include a discussion of nuclear semantics, principles of radioactive emmissions, the properties 99mTc as a radionuclide, and the tracer principle. On the basis of these general concepts, specific concepts in bone scanning are then brought forth. The physiology of bone and the action of the bone scan agents is presented. Further discussion considers the availability and production of the bone scan agent, patient factors, the gamma camera, the triphasic bone scan and the ultimate diagnostic principle of the bone scan. Clinical applications of bone scanning in otolaryngology are then presented in three sections. Proven areas of application include the evaluation of malignant tumors of the head and neck, the diagnosis of temporomandibular joint disorders, the diagnosis of facial fractures, the evaluation of osteomyelitis, nuclear medicine imaging of the larynx, and the assessment of systemic disease. Areas of adjunctive or supplementary value are also noted, such as diagnostic imaging of meningioma. Finally, areas of marginal value in the application of bone scanning are described.

  11. Is There a Relationship between Nutrition, Facial Development, and Crowding of the Teeth?

    PubMed

    Tyszkowski, Monika

    2016-01-01

    Nutrition plays an important role, especially key vitamins D3 and K2 which are necessary for proper dentofacial development and food consistency influence on crowding and dental arches narrowing. Changes in our dentition and facial appearance are caused by changing our diet from primitive hunter gatherer to a more modern industrialized agriculture. Nutrition and its impact on epigeneticaly- mediated mechanisms continuously shape our phenotype which impacts overall health and can reverse the path for overall health and facial bone development. Orthodontics and nutrition both play a role in following nature's path to reestablishing facial balance and dental arches proportions to accommodate all 32 teeth.

  12. Transformation of Face Transplants: Volumetric and Morphologic Graft Changes Resemble Aging After Facial Allotransplantation.

    PubMed

    Kueckelhaus, M; Turk, M; Kumamaru, K K; Wo, L; Bueno, E M; Lian, C G; Alhefzi, M; Aycart, M A; Fischer, S; De Girolami, U; Murphy, G F; Rybicki, F J; Pomahac, B

    2016-03-01

    Facial allotransplantation restores normal anatomy to severely disfigured faces. Although >30 such operations performed worldwide have yielded promising short-term results, data on long-term outcomes remain scarce. Three full-face transplant recipients were followed for 40 months. Severe changes in volume and composition of the facial allografts were noted. Data from computed tomography performed 6, 18 and 36 months after transplantation were processed to separate allograft from recipient tissues and further into bone, fat and nonfat soft tissues. Skin and muscle biopsies underwent diagnostic evaluation. All three facial allografts sustained significant volume loss (mean 19.55%) between 6 and 36 months after transplant. Bone and nonfat soft tissue volumes decreased significantly over time (17.22% between months 6 and 18 and 25.56% between months 6 and 36, respectively), whereas fat did not. Histological evaluations showed atrophy of muscle fibers. Volumetric and morphometric changes in facial allografts have not been reported previously. The transformation of facial allografts in this study resembled aging through volume loss but differed substantially from regular aging. These findings have implications for risk-benefit assessment, donor selection and measures counteracting muscle and bone atrophy. Superior long-term outcomes of facial allotransplantation will be crucial to advance toward future clinical routine.

  13. Forearm lengthening by distraction osteogenesis in children: a report of 22 cases.

    PubMed

    Hill, R A; Ibrahim, T; Mann, H A; Siapkara, A

    2011-11-01

    We present our experience of forearm lengthening in children with various conditions performed by a single surgeon between 1995 and 2009. A total of 19 children with a mean age of 9.8 years (2.1 to 15.9) at the time of surgery had 22 forearm lengthenings using either an Ilizarov/spatial and Ilizarov circular frame or a monolateral external fixator. The patients were divided into two groups: group A, in whom the purpose of treatment was to restore the relationship between the radius and the ulna, and group B, in whom the objective was to gain forearm length. The mean follow-up after removal of the frame was 26 months (13 to 53). There were ten patients (11 forearms) in group A with a mean radioulnar discrepancy of 2.4 cm (1.5 to 3.3) and nine patients (11 forearms) in group B. In group A, the mean lengthening achieved was 2.7 cm (1.0 to 5.5), with a lengthening index of 11.1 weeks/cm. Equalisation or overcorrection of the discrepancy was achieved in seven of 11 forearms, but lengthening was only partially successful at preventing subluxation or dislocation of the radial head. In group B, the mean lengthening achieved was 3.8 cm (1.9 to 6.8), with a lengthening index of 7.25 weeks/cm. Common complications in both groups were pin-site infection and poor regenerate formation. Forearm lengthening by distraction osteogenesis is a worthwhile procedure in children that can improve cosmesis and function, particularly in patients with shortening of both radius and ulna.

  14. Children's Facial Trustworthiness Judgments: Agreement and Relationship with Facial Attractiveness

    PubMed Central

    Ma, Fengling; Xu, Fen; Luo, Xianming

    2016-01-01

    This study examined developmental changes in children's abilities to make trustworthiness judgments based on faces and the relationship between a child's perception of trustworthiness and facial attractiveness. One hundred and one 8-, 10-, and 12-year-olds, along with 37 undergraduates, were asked to judge the trustworthiness of 200 faces. Next, they issued facial attractiveness judgments. The results indicated that children made consistent trustworthiness and attractiveness judgments based on facial appearance, but with-adult and within-age agreement levels of facial judgments increased with age. Additionally, the agreement levels of judgments made by girls were higher than those by boys. Furthermore, the relationship between trustworthiness and attractiveness judgments increased with age, and the relationship between two judgments made by girls was closer than those by boys. These findings suggest that face-based trait judgment ability develops throughout childhood and that, like adults, children may use facial attractiveness as a heuristic cue that signals a stranger's trustworthiness. PMID:27148111

  15. Children's Facial Trustworthiness Judgments: Agreement and Relationship with Facial Attractiveness.

    PubMed

    Ma, Fengling; Xu, Fen; Luo, Xianming

    2016-01-01

    This study examined developmental changes in children's abilities to make trustworthiness judgments based on faces and the relationship between a child's perception of trustworthiness and facial attractiveness. One hundred and one 8-, 10-, and 12-year-olds, along with 37 undergraduates, were asked to judge the trustworthiness of 200 faces. Next, they issued facial attractiveness judgments. The results indicated that children made consistent trustworthiness and attractiveness judgments based on facial appearance, but with-adult and within-age agreement levels of facial judgments increased with age. Additionally, the agreement levels of judgments made by girls were higher than those by boys. Furthermore, the relationship between trustworthiness and attractiveness judgments increased with age, and the relationship between two judgments made by girls was closer than those by boys. These findings suggest that face-based trait judgment ability develops throughout childhood and that, like adults, children may use facial attractiveness as a heuristic cue that signals a stranger's trustworthiness.

  16. Facial nerve rerouting in skull base surgery.

    PubMed

    Parhizkar, Nooshin; Hiltzik, David H; Selesnick, Samuel H

    2005-08-01

    Facial nerve rerouting techniques were developed to facilitate re-section of extensive tumors occupying the skull base. Facial nerve rerouting has its own limitations and risks, requiring microsurgical expertise, additional surgical time, and often some degree of facial nerve paresis. This article presents different degrees of anterior and posterior facial nerve rerouting, techniques of facial nerve rerouting, and a comprehensive review of outcomes. It then reviews anatomic and functional preservation of the facial nerve in acoustic neuroma resection, technical aspects of facial nerve dissection, intracranial facial nerve repair options, and outcomes for successful acoustic neuroma surgery.

  17. HAMSTRING INJURY REHABILITATION AND PREVENTION OF REINJURY USING LENGTHENED STATE ECCENTRIC TRAINING: A NEW CONCEPT

    PubMed Central

    Tim, Tyler; McHugh, Malachy

    2012-01-01

    Back ground and Purpose: Hamstring injury is a common occurrence in sport and there has been limited success in reducing this rate of recurrence to date. Description of Topic with Related Evidence: High speed running requires eccentric strength when the hamstring muscles are in a lengthened state. The lengthened state occurs when the hip is in flexion and the lower leg moves into extension, thus lengthening the two joint hamstring muscle over both articulations upon which they act. There is evidence to suggest that athletes who have sustained a hamstring strain lack strength when the muscle is utilized during performance in a lengthened state. Purpose: To examine the risk factors contributing to such a high recurrence rate and propose a unique rehabilitation strategy addressing these factors in order to decrease the rate of reinjury. Discussion/Relation to Clinical Practice: Failing to increase an athlete's eccentric strength in a lengthened position after a hamstring injury may predispose an athlete to subsequent reinjury. Incorporating lengthened state eccentric training may help reduce the rate of reinjury. Level of Evidence: Level 5 PMID:22666648

  18. Craniofacial Bone Grafting: Wolff's Law Revisited

    PubMed Central

    Oppenheimer, Adam J.; Tong, Lawrence; Buchman, Steven R.

    2008-01-01

    Bone grafts are used for the reconstruction of congenital and acquired deformities of the facial skeleton and, as such, comprise a vital component of the craniofacial surgeon's armamentarium. A thorough understanding of bone graft physiology and the factors that affect graft behavior is therefore essential in developing a more intelligent use of bone grafts in clinical practice. This article presents a review of the basic physiology of bone grafting along with a survey of pertinent concepts and current research. The factors responsible for bone graft survival are emphasized. PMID:22110789

  19. Categorizing facial creases: A review.

    PubMed

    Hadi, Helmi; Wilkinson, Caroline M

    2017-02-01

    Ensuring uniformity in the nomenclature standardization of facial creases is important to enable the scholarly community to follow and debate the advancements in research. This review highlights the prevailing disparity in the nomenclature that refers to the same facial crease by researchers and laypeople, and suggests uniform names for the facial creases based on available literature. The previous and current trends in facial crease classification are also discussed. The nomenclature of the facial creases considered for this review include the following: the nasolabial fold, corner of the mouth lines, upper and lower lip creases around the mouth region, the mandibular folds, the bifid nose, the transverse nasal line, the vertical glabellar line, chin crease, the mental crease, four type of creases around the eyes, forehead creases, and periauricular creases. A figure illustrating the above facial creases is included as reference. It is hoped that the proposed standardization of nomenclature would ensure a more scientific referencing of facial creases enabling more effective scientific interaction among the scholarly community as well as the laypeople interested in the research and application of facial creases.

  20. Categorizing identity from facial motion.

    PubMed

    Girges, Christine; Spencer, Janine; O'Brien, Justin

    2015-01-01

    Advances in marker-less motion capture technology now allow the accurate replication of facial motion and deformation in computer-generated imagery (CGI). A forced-choice discrimination paradigm using such CGI facial animations showed that human observers can categorize identity solely from facial motion cues. Animations were generated from motion captures acquired during natural speech, thus eliciting both rigid (head rotations and translations) and nonrigid (expressional changes) motion. To limit interferences from individual differences in facial form, all animations shared the same appearance. Observers were required to discriminate between different videos of facial motion and between the facial motions of different people. Performance was compared to the control condition of orientation-inverted facial motion. The results show that observers are able to make accurate discriminations of identity in the absence of all cues except facial motion. A clear inversion effect in both tasks provided consistency with previous studies, supporting the configural view of human face perception. The accuracy of this motion capture technology thus allowed stimuli to be generated that closely resembled real moving faces. Future studies may wish to implement such methodology when studying human face perception.

  1. Alternative lengthening of telomeres does exist in various canine sarcomas.

    PubMed

    Kreilmeier, Theresa; Sampl, Sandra; Deloria, Abigail J; Walter, Ingrid; Reifinger, Martin; Hauck, Marlene; Borst, Luke B; Holzmann, Klaus; Kleiter, Miriam

    2017-03-01

    Alternative lengthening of telomeres (ALT) is a telomere maintenance mechanism (TMM) found in some human tumors such as sarcomas. Canine tumors are not characterized for ALT and the study aim was to identify if the ALT phenotype exists in canine sarcomas. Sixty-four canine sarcoma samples (20 snap-frozen, 44 FFPE) as well as six canine sarcoma cell lines were screened for ALT by C-circle assay. ALT was further evaluated by measuring telomere length via qPCR and telomere restriction-fragments including pulsed-field electrophoresis. ALT-associated proteins were validated by immunohistochemistry. Further, telomerase activity (TA) and gene expression were analyzed by TRAP and qPCR. DNA from 20 human neuroblastomas and 8 sarcoma cell lines served as comparative controls. ALT was detected in 9.4% (6/64) canine sarcomas including aggressive subtypes as hemangiosarcoma, osteosarcoma, and histiocytic sarcoma. C-circle levels were comparable with human ALT-positive controls. All ALT tumors demonstrated loss of ATRX expression and 5/6 showed strong p53 expression. TA was detected in 93% (14/15) snap-frozen samples including a sarcoma with ALT activity. This tumor showed long heterogeneous telomeres, and a high level of colocalization of DAXX with telomeres. One sarcoma was ALT and TA negative. All canine and human sarcoma cell lines were ALT negative. In this study, we demonstrated that canine sarcomas use ALT. As in humans, ALT was identified in aggressive sarcomas subtypes and coexisted with TA in one tumor. Overall, canine sarcomas seem to share many similarities with their human counterparts and appear an attractive model for comparative telomere research. © 2016 Wiley Periodicals, Inc.

  2. What Is Expected of the Facial Nerve in Michel Aplasia? Anatomic Variation

    PubMed Central

    Zarandy, Masoud Motasaddi; Kouhi, Ali; Kashany, Shervin Sharif; Rabiei, Sohrab; Hajimohamadi, Fatemeh; Rabbani-Anari, Mahtab

    2010-01-01

    We sought better understanding about the facial nerve anatomy in the rare inner ear Michel anomaly to help better define this aplasia and prevent potential complications in surgery on these patients. The data from computed tomography scans and magnetic resonance images of six Michel aplastic ears (three patients) were evaluated for a facial nerve course. Facial nerve course and anatomic landmarks were noted. Based on data obtained from this group of very rare patients, three different facial nerve anatomies were encountered. The first patient had normal-looking mastoid cells, normal middle ear ossicles, and a completely formed facial nerve canal through the middle ear. The second patient had pneumatized mastoid air cells despite an anomalous ossicular chain. This patient also had a facial nerve canal but not through the middle ear. In the third patient, although mastoid cells were present, neither ossicles nor a definite facial nerve canal could be detected. With guidance provided by the anatomy of the other parts of the ear, such as air cells and the ossicular chain, the danger zones posing a high probability of facial nerve injury can be predicted. Although all Michel aplasias may have aplastic petrous bone in common, there are some degrees of variation. PMID:21772803

  3. Management of Chronic Facial Pain

    PubMed Central

    Williams, Christopher G.; Dellon, A. Lee; Rosson, Gedge D.

    2009-01-01

    Pain persisting for at least 6 months is defined as chronic. Chronic facial pain conditions often take on lives of their own deleteriously changing the lives of the sufferer. Although much is known about facial pain, it is clear that those physicians who treat these conditions should continue elucidating the mechanisms and defining successful treatment strategies for these life-changing conditions. This article will review many of the classic causes of chronic facial pain due to the trigeminal nerve and its branches that are amenable to surgical therapies. Testing of facial sensibility is described and its utility introduced. We will also introduce some of the current hypotheses of atypical facial pain and headaches secondary to chronic nerve compressions and will suggest possible treatment strategies. PMID:22110799

  4. Bilateral cleft lip and palate: A morphometric analysis of facial skeletal form using cone beam computed tomography.

    PubMed

    Starbuck, John M; Ghoneima, Ahmed; Kula, Katherine

    2015-07-01

    Bilateral cleft lip and palate (BCLP) is caused by a lack of merging of maxillary and nasal facial prominences during development and morphogenesis. BCLP is associated with congenital defects of the oronasal facial region that can impair ingestion, mastication, speech, and dentofacial development. Using cone beam computed tomography (CBCT) images, 7- to 18-year old individuals born with BCLP (n = 15) and age- and sex-matched controls (n = 15) were retrospectively assessed. Coordinate values of three-dimensional facial skeletal anatomical landmarks (n = 32) were measured from each CBCT image. Data were evaluated using principal coordinates analysis (PCOORD) and Euclidean Distance Matrix Analysis (EDMA). PCOORD axes 1-3 explain approximately 45% of the morphological variation between samples, and specific patterns of morphological differences were associated with each axis. Approximately, 30% of facial skeletal measures significantly differ by confidence interval testing (α = 0.10) between samples. While significant form differences occur across the facial skeleton, strong patterns of differences are localized to the lateral and superioinferior aspects of the nasal aperture. In conclusion, the BCLP deformity significantly alters facial skeletal morphology of the midface and oronasal regions of the face, but morphological differences were also found in the upper facial skeleton and to a lesser extent, the lower facial skeleton. This pattern of strong differences in the oronasal region of the facial skeleton combined with differences across the rest of the facial complex underscores the idea that bones of the craniofacial skeleton are integrated.

  5. Disseminated granuloma faciale.

    PubMed

    Zargari, Omid

    2004-03-01

    A 40-year-old man presented in January 2001 with multiple purple plaques and nodules, which had been present on the back for approximately 3 years. The lesions had gradually extended over the face, trunk and proximal extremities. He had no symptoms except occasional mild pruritus. The patient was in good health and was on no medications. Physical examination revealed multiple violaceous to brown, indurated, 5-50-mm, round to oval plaques on the face, arms, shoulders, and back (Fig. 1), as well as a solitary lesion on the right thigh. Surface telangiectases were noted, especially on the shoulder lesions. There was no scaling or ulceration. Routine laboratory tests were unremarkable. In April 1999, another medical center performed a biopsy of what they thought was sarcoidosis. The results were reported as "possible angiolymphoid hyperplasia with eosinophilia." With the possibility of granuoma faciale (GF) in mind, another skin biopsy was obtained from a facial lesion. This revealed a diffuse, relatively dense infiltrate of neutrophils, eosinophils and mononuclear inflammatory cells in dermis with an obvious Grenz zone (Fig. 2). Pilar units were intact, and endothelial cell swelling was present (Fig. 3). Retrospective evaluation of the initial biopsy, taken from the back, revealed the same changes, and helped confirm the diagnosis of GF. The patient was treated with liquid nitrogen for 20 s followed immediately by intralesional triamcinolone acetonide (5 mg/ml). This treatment was repeated every 4 weeks for three courses, resulting in partial resolution of the lesions.

  6. Hemangioma of the Zygomatic Bone.

    PubMed

    Aykan, Andaç; Keleş, Musa Kemal; Bayram, Yalçin; Çiçek, Ali Fuat; Uysal, Yusuf; Sanal, Hatice Tuba; Zor, Fatih

    2016-03-01

    Benign masses arising from facial bones have been reported several times in the literature. Hemangiomas are one of the uncommon benign tumors. In this study, the authors aimed to present a rare patient of zygomatic intraosseos hemangioma and their management. A 40-year-old woman with a mass in her left lateral cantus admitted to our clinic. Preoperative computed tomography and magnetic resonance imaging revealed an osseos mass in her left zygoma. The authors conclude that it should be kept in mind that although they are very rare benign tumors, intraosseos hemangiomas can cause facial masses. Meticulous radiologic examination can give important clues for differential diagnosis before the surgery.

  7. The Facial Profile in the Context of Facial Aesthetics.

    PubMed

    Heppt, Werner J; Vent, Julia

    2015-10-01

    Beauty has been an intriguing issue since the evolving of a culture in mankind. Even the Neanderthals are believed to have applied makeover to enhance facial structures and thus underline beauty. The determinants of beauty and aesthetics have been defined by artists and scientists alike. This article will give an overview of the evolvement of a beauty concept and the significance of the facial profile. It aims at sharpening the senses of the facial plastic surgeon for analyzing the patient's face, consulting the patient on feasible options, planning, and conducting surgery in the most individualized way.

  8. Bone Biopsy

    MedlinePlus

    ... Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging guidance ... limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided procedure ...

  9. Facial neuropathy with imaging enhancement of the facial nerve: a case report

    PubMed Central

    Mumtaz, Sehreen; Jensen, Matthew B

    2014-01-01

    A young women developed unilateral facial neuropathy 2 weeks after a motor vehicle collision involving fractures of the skull and mandible. MRI showed contrast enhancement of the facial nerve. We review the literature describing facial neuropathy after trauma and facial nerve enhancement patterns with different causes of facial neuropathy. PMID:25574155

  10. Does Facial Resemblance Enhance Cooperation?

    PubMed Central

    Giang, Trang; Bell, Raoul; Buchner, Axel

    2012-01-01

    Facial self-resemblance has been proposed to serve as a kinship cue that facilitates cooperation between kin. In the present study, facial resemblance was manipulated by morphing stimulus faces with the participants' own faces or control faces (resulting in self-resemblant or other-resemblant composite faces). A norming study showed that the perceived degree of kinship was higher for the participants and the self-resemblant composite faces than for actual first-degree relatives. Effects of facial self-resemblance on trust and cooperation were tested in a paradigm that has proven to be sensitive to facial trustworthiness, facial likability, and facial expression. First, participants played a cooperation game in which the composite faces were shown. Then, likability ratings were assessed. In a source memory test, participants were required to identify old and new faces, and were asked to remember whether the faces belonged to cooperators or cheaters in the cooperation game. Old-new recognition was enhanced for self-resemblant faces in comparison to other-resemblant faces. However, facial self-resemblance had no effects on the degree of cooperation in the cooperation game, on the emotional evaluation of the faces as reflected in the likability judgments, and on the expectation that a face belonged to a cooperator rather than to a cheater. Therefore, the present results are clearly inconsistent with the assumption of an evolved kin recognition module built into the human face recognition system. PMID:23094095

  11. Improving outcomes in aesthetic facial reconstruction.

    PubMed

    Hofer, Stefan O P; Mureau, Marc A M

    2009-07-01

    Aesthetic facial reconstruction is a challenging art. Improving outcomes in aesthetic facial reconstruction requires a thorough understanding of the basic principles of the functional and aesthetic requirements for facial reconstruction. From there, further refinement and attention to detail can be provided. This paper discusses basic principles of aesthetic facial reconstruction.

  12. Prevention of facial fractures from night vision goggle impact.

    PubMed

    Manoogian, Sarah; Kennedy, Eric; Wilson, Kaitlin; Duma, Stefan

    2006-01-01

    Facial bone fractures in the military can result from direct loading of night vision goggles on the orbital region. Facial fracture research has shown that increasing the area over which the load is applied increases the load tolerance. The purpose of this study is to apply this concept to reducing the risk of facial bone fracture from night vision goggle impacts. The effectiveness of countermeasures in prevention of orbital fracture was evaluated using a vertical drop tower with two impact velocities of 2.6 m/s and 3.6 m/s. The countermeasure used was a rigid plastic custom face shield made from a plaster impression of each head. In addition to two human cadaver subjects, one male and one female, tests were completed on a Hybrid III 50th percentile dummy head. Three impacts to the dummy headform included no countermeasure, safety glasses, and a custom face shield. These tests yielded peak loads of 8700 N, 7500 N, and 5640 N respectively. Using the female subject, impacts were preformed successively until injury occurred. These two impacts to the subject wearing a custom face shield resulted in peak loads of 4025 N and 5158 N. The highest load corresponds to an impact velocity of 3.6 m/s and a nasal bone fracture. Two impacts to the male subject with a custom face shield resulted in peak loads of 4554 N and 5101 N with no injury. The final impact to the male subject had a peak load of 2010 N with complete orbital fracture due to the absence of a countermeasure. From these tests it is shown that facial fracture risk from night vision goggle impact can be reduced using a contoured rigid face shield.

  13. Facial melanoses: Indian perspective.

    PubMed

    Khanna, Neena; Rasool, Seemab

    2011-01-01

    Facial melanoses (FM) are a common presentation in Indian patients, causing cosmetic disfigurement with considerable psychological impact. Some of the well defined causes of FM include melasma, Riehl's melanosis, Lichen planus pigmentosus, erythema dyschromicum perstans (EDP), erythrosis, and poikiloderma of Civatte. But there is considerable overlap in features amongst the clinical entities. Etiology in most of the causes is unknown, but some factors such as UV radiation in melasma, exposure to chemicals in EDP, exposure to allergens in Riehl's melanosis are implicated. Diagnosis is generally based on clinical features. The treatment of FM includes removal of aggravating factors, vigorous photoprotection, and some form of active pigment reduction either with topical agents or physical modes of treatment. Topical agents include hydroquinone (HQ), which is the most commonly used agent, often in combination with retinoic acid, corticosteroids, azelaic acid, kojic acid, and glycolic acid. Chemical peels are important modalities of physical therapy, other forms include lasers and dermabrasion.

  14. Devil Facial Tumor Disease.

    PubMed

    Pye, R J; Woods, G M; Kreiss, A

    2016-07-01

    Devil facial tumor disease (DFTD) is an emergent transmissible cancer exclusive to Tasmanian devils (Sarcophilus harrisii) and threatening the species with extinction in the wild. Research on DFTD began 10 years ago, when nothing was known about the tumor and little about the devils. The depth of knowledge gained since then is impressive, with research having addressed significant aspects of the disease and the devils' responses to it. These include the cause and pathogenesis of DFTD, the immune response of the devils and the immune evasion mechanisms of the tumor, the transmission patterns of DFTD, and the impacts of DFTD on the ecosystem. This review aims to collate this information and put it into the context of conservation strategies designed to mitigate the impacts of DFTD on the devil and the Tasmanian ecosystem.

  15. The Half-Pin and the Pin Tract: A Survey of the Limb Lengthening and Reconstruction Society

    DTIC Science & Technology

    2013-09-01

    Tract:   A Survey of the  Limb   Lengthening    and Reconstruction Society Daniel J. Stinner, MD, Jospeh R. Hsu, MD, and Christopher Iobst, MD A lthough the...pin-tract infections in circular fixation by polling subject matter experts, members of the Limb Lengthening and Reconstruction Society (LLRS...correction, limb reconstruc- tion, and limb lengthening . The survey was designed to investigate surgeon preferences regarding type of hardware used, general

  16. Voluntary activation level and muscle fiber recruitment of human quadriceps during lengthening contractions.

    PubMed

    Beltman, J G M; Sargeant, A J; van Mechelen, W; de Haan, A

    2004-08-01

    Voluntary activation levels during lengthening, isometric, and shortening contractions (angular velocity 60 degrees/s) were investigated by using electrical stimulation of the femoral nerve (triplet, 300 Hz) superimposed on maximal efforts. Recruitment of fiber populations was investigated by using the phosphocreatine-to-creatine ratio (PCr/Cr) of single characterized muscle fibers obtained from needle biopsies at rest and immediately after a series of 10 lengthening, isometric, and shortening contractions (1 s on/1 s off). Maximal voluntary torque was significantly higher during lengthening (270 +/- 55 N.m) compared with shortening contractions (199 +/- 47 N.m, P < 0.05) but was not different from isometric contractions (252 +/- 47 N.m). Isometric torque was higher than torque during shortening (P < 0.05). Voluntary activation level during maximal attempted lengthening contractions (79 +/- 8%) was significantly lower compared with isometric (93 +/- 5%) and shortening contractions (92 +/- 3%, P < 0.05). Mean PCr/Cr values of all fibers from all subjects at rest were 2.5 +/- 0.6, 2.0 +/- 0.7, and 2.0 +/- 0.7, respectively, for type I, IIa, and IIax fibers. After 10 contractions, the mean PCr/Cr values for grouped fiber populations (regardless of fiber type) were all significantly different from rest (1.3 +/- 0.2, 0.7 +/- 0.3, and 0.8 +/- 0.6 for lengthening, isometric, and shortening contractions, respectively; P < 0.05). The cumulative distributions of individual fiber populations after either contraction mode were significantly different from rest (P < 0.05). Curves after lengthening contractions were less shifted compared with curves from isometric and shortening contractions (P < 0.05), with a smaller shift for the type IIax compared with type I fibers in the lengthening contractions. The results indicate a reduced voluntary drive during lengthening contractions. PCr/Cr values of single fibers indicated a hierarchical order of recruitment of all fiber

  17. Neural control of shortening and lengthening contractions: influence of task constraints

    PubMed Central

    Duchateau, Jacques; Enoka, Roger M

    2008-01-01

    Although the performance capabilities of muscle differ during shortening and lengthening contractions, realization of these differences during functional tasks depends on the characteristics of the activation signal discharged from the spinal cord. Fundamentally, the control strategy must differ during the two anisometric contractions due to the lesser force that each motor unit exerts during a shortening contraction and the greater difficulty associated with decreasing force to match a prescribed trajectory during a lengthening contraction. The activation characteristics of motor units during submaximal contractions depend on the details of the task being performed. Indexes of the strategy encoded in the descending command, such as coactivation of antagonist muscles and motor unit synchronization, indicate differences in cortical output for the two types of anisometric contractions. Furthermore, the augmented feedback from peripheral sensory receptors during lengthening contractions appears to be suppressed by centrally and peripherally mediated presynaptic inhibition of Ia afferents, which may also explain the depression of voluntary activation that occurs during maximal lengthening contractions. Although modulation of the activation during shortening and lengthening contractions involves both supraspinal and spinal mechanisms, the association with differences in performance cannot be determined without more careful attention to the details of the task. PMID:18955381

  18. Video-assisted gastrocnemius-soleus and hamstring lengthening in cerebral palsy patients.

    PubMed

    Poul, Jan; Tůma, Jirí; Bajerová, Jaroslava

    2008-03-01

    The aim of the study was to present the results of video-assisted fractional lengthening of the triceps surae muscle and the hamstrings in children with spastic cerebral palsy. In the period from September 2003 to December 2004, triceps surae muscle contractures were treated in 35 lower extremities (22 patients) and hamstring lengthening was performed in 12 knees (eight patients). The patients were between 4 and 10 years of age. Lengthening of the gastrocnemius-soleus was sufficient for achieving 10 degrees dorsiflexion of the foot in 31 of the 35 extremities. The short-term follow-up, at least 1 year after operation, did not reveal any complications. The hamstring lengthening resulted in full correction in nine knees; one endoscopic procedure required conversion to open surgery owing to bleeding. In one case, incomplete sciatic nerve palsy developed. Video-assisted gastrocnemius-soleus recession as well as video-assisted lengthening of the hamstrings proved to be fully efficient in the group reported here.

  19. Infant-directed speech: Final syllable lengthening and rate of speech

    NASA Astrophysics Data System (ADS)

    Church, Robyn; Bernhardt, Barbara; Shi, Rushen; Pichora-Fuller, Kathleen

    2005-04-01

    Speech rate has been reported to be slower in infant-directed speech (IDS) than in adult-directed speech (ADS). Studies have also found phrase-final lengthening to be more exaggerated in IDS compared with ADS. In our study we asked whether the observed overall slower rate of IDS is due to exaggerated utterance-final syllable lengthening. Two mothers of preverbal English-learning infants each participated in two recording sessions, one with her child, and another with an adult friend. The results showed an overall slower rate in IDS compared to ADS. However, when utterance-final syllables were excluded from the calculation, the speech rate in IDS and ADS did not differ significantly. The duration of utterance-final syllables differed significantly for IDS versus ADS. Thus, the overall slower rate of IDS was due to the extra-long final syllable occurring in relatively short utterances. The comparable pre-final speech rate for IDS and ADS further accentuates the final syllable lengthening in IDS. As utterances in IDS are typically phrases or clauses, the particularly strong final-lengthening cue could potentially facilitate infants' segmentation of these syntactic units. These findings are consistent with the existing evidence that pre-boundary lengthening is important in the processing of major syntactic units in English-learning infants.

  20. Sarcomere lengthening and tension drop in the latent period of isolated frog skeletal muscle fibers.

    PubMed

    Haugen, P; Sten-Knudsen, O

    1976-09-01

    A laser diffraction technique has been developed for registering small changes in sarcomere length. The technique is capable of resolving changes as small as 0.2 A in isolated frog skeletal muscle fibers. The small sarcomere lengthening that accompanies the drop in tension in the latent period of contraction was investigated. We suggest this lengthening be named latency elongation (LE). The LE is present in a completely slack fiber and must, therefore, be caused by a forcible lengthening process. Furthermore, the LE is dependent on the existence of an overlap between thin and tick filaments. The rate of elongation and the time interval between stimulation and maximum elongation may vary along the fiber. The maximum elongation was 3-5 A per sarcomere. At any instant the drop in tension is a product of the sum of sarcomere lengthenings along the fiber and the slope stiffness of the series elasticity. The latency relaxation (LR) could be registered in the sarcomere length range from 2.2 mum to 3.6-3.7 mum. The amplitude went through a sharp maximum at 3.0-3.1 mum. In the sarcomere length range from 2.2 to 2.8 mum the delay from onset to maximum LR was nearly proportional to the distance from the Z-line to the overlap zone. A working hypothesis is presented. It is suggested that the LE is caused by a lengthening of the thin filaments.

  1. Weakness in mouse masticatory muscles by repetitive contractions with forced lengthening.

    PubMed

    Hutchins, M O; Skjonsby, H S; Brazeau, G A; Parikh, U K; Jenkins, R M

    1995-02-01

    The etiology of myofascial tenderness and pain of masticatory muscles in humans is difficult to understand. Parafunctional oral habits such as tooth grinding or vigorous chewing are thought to be factors. The objective of this study was to determine if masticatory muscles are susceptible to weakness and injury induced by repetitive, dynamic, forced-lengthening contractions. Results would support the hypothesis that contraction-induced injuries could occur in hyperactive masticatory muscles of humans in response to parafunctional oral habits. Mice were anesthetized and randomly assigned to three groups: non-treated controls, treated by repetitive passive jaw opening, or treated by repetitive isometric tetanic contractions with lengthening by jaw opening. In each treatment group, masticatory muscle injury was evaluated by contractile tension, plasma creatine kinase, and muscle glycogen. Contractile tension was determined at different stimulation frequencies and was significantly decreased 5 min, 4 h, and 72 h after repetitive contraction/lengthening. Plasma creatine kinase was significantly elevated at 4 but not at 72 h post-treatment in mice subjected to repetitive contraction/lengthening. Masticatory muscle glycogen was not significantly different in any groups at 4 or 72 h post-treatment. These results indicate that contraction injuries can be induced in masticatory muscle of mice by forced lengthening contractions which simulate eccentric contractions.

  2. A review for pediatricians on limb lengthening and the Ilizarov method.

    PubMed

    Herbert, A J; Herzenberg, J E; Paley, D

    1995-02-01

    As recently as 1986, limb lengthening in children was considered by most North American orthopedic surgeons to be both dangerous and impractical. Previous attempts were plagued by unacceptably high rates of serious complications such as nerve palsy, deep infection, malunion, broken hardware, and stiff joints. With the recent introduction of the Russian Ilizarov method and apparatus for limb lengthening, a tremendous groundswell of interest has risen. Despite a steep learning curve, many Western centers have now reproduced Ilizarov's clinical results. The important advances over prior methods are partly biologic and partly hardware related. Ilizarov's principles require a minimally invasive, low-energy osteotomy, stable external fixation, a latency period before commencing distraction, and gradual lengthening of 1 mm/d in divided doses (0.25 mm four times per day). The article reviews the background of this new technique and provides an update on results reported over the past year. There is disagreement regarding precise indications for limb salvage (lengthening) of congenital limb deficiencies versus amputation. The role of extended lengthening in dwarfism also remains controversial.

  3. Alcohol abusive use increases facial trauma?

    PubMed Central

    Soares-Carneiro, Suzana-Célia-de-Aguiar; Matos da-Silva, Gessyca-Suielly-Melo; de-Barros-Caldas, Luciano-Cruz; Porto, Gabriela-Granja; Leal, Jefferson-Figueiredo; Catunda, Ivson

    2016-01-01

    Background Trauma is among the main death causes and morbidity in the world and is often related to the use of alcohol and its abuse has reached massive proportions, no matter if the country is developed or not, being considered as public health problem. Since there are very few randomized and prospective studies in literature about the association of facial trauma and the use of alcohol, this study aims to investigate the impact of alcohol use in facial trauma. Material and Methods This was a prospective and cross sectional study, involving facial trauma patients attended at Oral Maxillofacial Surgery Division of a State Hospital. Variables included patient´s profile, trauma etiology, facial region involved, type of injury and treatment and days of hospitalization. AUDIT test was applied to identify risks and damages of alcohol use and chemical dependence. Absolute distribution, uni and mutilvaried percentages were made for data evaluation. Pearson´s qui-squared and Fisher´s Exact tests were also used. Results One hundred patients were evaluated. The patient´s mean age was 33.50 years-old, 48% had between 17 and 29 years old, 28% had 30 to 39, and 24% 40 or more. Most of them were male (86%). The most frequent etiology was traffic accident (57%), the extraoral area was most committed (62%), the most frequent type of injury was fractures (78%) and the most affected bone was the mandible (36%). More than half of the patients (53%) had surgical treatment. 38% had their discharge from hospital right after the first attendance. The AUDIT most frequent answer was “moderate use” (46%) and use at risk (39%). There was significant difference between the use of alcohol (AUDIT) and hematoma (0.003) and number of days of hospitalization (p=0.005). Conclusions In this study it was not observed association between alcohol consumption using the AUDIT and trauma etiology, but patient victims of traffic accidents were classified as with risk in the scale. Most of the

  4. Cranial base topology and basic trends in the facial evolution of Homo.

    PubMed

    Bastir, Markus; Rosas, Antonio

    2016-02-01

    Facial prognathism and projection are important characteristics in human evolution but their three-dimensional (3D) architectonic relationships to basicranial morphology are not clear. We used geometric morphometrics and measured 51 3D-landmarks in a comparative sample of modern humans (N = 78) and fossil Pleistocene hominins (N = 10) to investigate the spatial features of covariation between basicranial and facial elements. The study reveals complex morphological integration patterns in craniofacial evolution of Middle and Late Pleistocene hominins. A downwards-orientated cranial base correlates with alveolar maxillary prognathism, relatively larger faces, and relatively larger distances between the anterior cranial base and the frontal bone (projection). This upper facial projection correlates with increased overall relative size of the maxillary alveolar process. Vertical facial height is associated with tall nasal cavities and is accommodated by an elevated anterior cranial base, possibly because of relations between the cribriform and the nasal cavity in relation to body size and energetics. Variation in upper- and mid-facial projection can further be produced by basicranial topology in which the midline base and nasal cavity are shifted anteriorly relative to retracted lateral parts of the base and the face. The zygomatics and the middle cranial fossae act together as bilateral vertical systems that are either projected or retracted relative to the midline facial elements, causing either midfacial flatness or midfacial projection correspondingly. We propose that facial flatness and facial projection reflect classical principles of craniofacial growth counterparts, while facial orientation relative to the basicranium as well as facial proportions reflect the complex interplay of head-body integration in the light of encephalization and body size decrease in Middle to Late Pleistocene hominin evolution. Developmental and evolutionary patterns of integration may

  5. Interaction between facial expression and color

    PubMed Central

    Nakajima, Kae; Minami, Tetsuto; Nakauchi, Shigeki

    2017-01-01

    Facial color varies depending on emotional state, and emotions are often described in relation to facial color. In this study, we investigated whether the recognition of facial expressions was affected by facial color and vice versa. In the facial expression task, expression morph continua were employed: fear-anger and sadness-happiness. The morphed faces were presented in three different facial colors (bluish, neutral, and reddish color). Participants identified a facial expression between the two endpoints (e.g., fear or anger) regardless of its facial color. The results showed that the perception of facial expression was influenced by facial color. In the fear-anger morphs, intermediate morphs of reddish-colored and bluish colored faces had a greater tendency to be identified as angry faces and fearful faces, respectively. In the facial color task, two bluish-to-reddish colored face continua were presented in three different facial expressions (fear-neutral-anger and sadness-neutral-happiness). Participants judged whether the facial color was reddish or bluish regardless of its expression. The faces with sad expression tended to be identified as more bluish, while the faces with other expressions did not affect facial color judgment. These results suggest that an interactive but disproportionate relationship exists between facial color and expression in face perception. PMID:28117349

  6. Facial asymmetry: a current review

    PubMed Central

    Thiesen, Guilherme; Gribel, Bruno Frazão; Freitas, Maria Perpétua Mota

    2015-01-01

    Abstract The term "asymmetry" is used to make reference to dissimilarity between homologous elements, altering the balance between structures. Facial asymmetry is common in the overall population and is often presented subclinically. Nevertheless, on occasion, significant facial asymmetry results not only in functional, but also esthetic issues. Under these conditions, its etiology should be carefully investigated in order to achieve an adequate treatment plan. Facial asymmetry assessment comprises patient's first interview, extra- as well as intraoral clinical examination, and supplementary imaging examination. Subsequent asymmetry treatment depends on patient's age, the etiology of the condition and on the degree of disharmony, and might include from asymmetrical orthodontic mechanics to orthognathic surgery. Thus, the present study aims at addressing important aspects to be considered by the orthodontist reaching an accurate diagnosis and treatment plan of facial asymmetry, in addition to reporting treatment of some patients carriers of such challenging disharmony. PMID:26691977

  7. Measurement of facial skin temperature.

    PubMed

    Ariyaratnam, S; Rood, J P

    1990-10-01

    It is essential to know the pattern of facial skin temperatures in normal subjects to be able to objectively assess differences in cases of nerve injury. Thirty healthy adults were selected at random to investigate the pattern of facial temperature using liquid crystal thermography and an electronic thermocouple system. The highest temperature of the face was in the forehead area (c, 34 degrees C) and the lowest (c. 32 degrees C) in the cheek area. If ambient temperature and humidity are controlled in a draught-free environment, symmetry of the facial skin temperature can be maintained. It is concluded that measurements of facial skin temperature may be used to investigate and assess lesions of peripheral branches of cranial nerves supplying the face.

  8. Facial Areas and Emotional Information

    ERIC Educational Resources Information Center

    Boucher, Jerry D.; Ekman, Paul

    1975-01-01

    Provides strong support for the view that there is no one area of the face which best reveals emotion, but that the value of the different facial areas in distinguishing emotions depends upon the emotion being judged. (Author)

  9. Measuring facial expression of emotion

    PubMed Central

    Wolf, Karsten

    2015-01-01

    Research into emotions has increased in recent decades, especially on the subject of recognition of emotions. However, studies of the facial expressions of emotion were compromised by technical problems with visible video analysis and electromyography in experimental settings. These have only recently been overcome. There have been new developments in the field of automated computerized facial recognition; allowing real-time identification of facial expression in social environments. This review addresses three approaches to measuring facial expression of emotion and describes their specific contributions to understanding emotion in the healthy population and in persons with mental illness. Despite recent progress, studies on human emotions have been hindered by the lack of consensus on an emotion theory suited to examining the dynamic aspects of emotion and its expression. Studying expression of emotion in patients with mental health conditions for diagnostic and therapeutic purposes will profit from theoretical and methodological progress. PMID:26869846

  10. Measuring facial expression of emotion.

    PubMed

    Wolf, Karsten

    2015-12-01

    Research into emotions has increased in recent decades, especially on the subject of recognition of emotions. However, studies of the facial expressions of emotion were compromised by technical problems with visible video analysis and electromyography in experimental settings. These have only recently been overcome. There have been new developments in the field of automated computerized facial recognition; allowing real-time identification of facial expression in social environments. This review addresses three approaches to measuring facial expression of emotion and describes their specific contributions to understanding emotion in the healthy population and in persons with mental illness. Despite recent progress, studies on human emotions have been hindered by the lack of consensus on an emotion theory suited to examining the dynamic aspects of emotion and its expression. Studying expression of emotion in patients with mental health conditions for diagnostic and therapeutic purposes will profit from theoretical and methodological progress.

  11. Facial nerve paralysis in children

    PubMed Central

    Ciorba, Andrea; Corazzi, Virginia; Conz, Veronica; Bianchini, Chiara; Aimoni, Claudia

    2015-01-01

    Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. It represents a serious clinical problem as it causes significant concerns in doctors because of its etiology, its treatment options and its outcome, as well as in little patients and their parents, because of functional and aesthetic outcomes. There are several described causes of facial nerve paralysis in children, as it can be congenital (due to delivery traumas and genetic or malformative diseases) or acquired (due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, in approximately 40%-75% of the cases, the cause of unilateral facial paralysis still remains idiopathic. A careful diagnostic workout and differential diagnosis are particularly recommended in case of pediatric facial nerve palsy, in order to establish the most appropriate treatment, as the therapeutic approach differs in relation to the etiology. PMID:26677445

  12. The Fate of Porous Hydroxyapatite Granules Used in Facial Skeletal Augmentation

    PubMed Central

    Jacobson, Steve R.; Lavoipierre, Alain M.; Huggins, Richard J.

    2010-01-01

    Facial appearance is largely determined by the morphology of the underlying skeleton. Hydroxyapatite is one of several materials available to enhance projection of the facial skeleton. This study evaluated the long-term maintenance of augmented bony projection when porous hydroxyapatite granules are used on the facial skeleton. Ten female patients aged 28–58 years were studied following aesthetic augmentation of the facial skeleton at 24 sites using porous hydroxyapatite granules. Postoperative CT scans at 3 months served as the baseline measurement and compared with scans taken at 1 and 2 years, with the thickness of the hydroxyapatite measured in axial and coronal planes. Thickness of original bone plus overlay of hydroxyapatite, thickness of the overlying soft tissue, and the overall projection (bone plus soft tissue) were recorded. It was found that 99.7% of the hydroxyapatite was maintained at 2 years, with no statistical difference (t test) from the baseline measurement. The overall projection (bony and soft tissue) was maintained as there was no evidence of native bone resorption or soft tissue atrophy. Radiographic results confirmed that the use of porous hydroxyapatite granules for enhancement of the facial skeleton is not only a predictable procedure, but maintains full bony projection at 2 years. PMID:20186415

  13. Generating Facial Expressions Using an Anatomically Accurate Biomechanical Model.

    PubMed

    Wu, Tim; Hung, Alice; Mithraratne, Kumar

    2014-11-01

    This paper presents a computational framework for modelling the biomechanics of human facial expressions. A detailed high-order (Cubic-Hermite) finite element model of the human head was constructed using anatomical data segmented from magnetic resonance images. The model includes a superficial soft-tissue continuum consisting of skin, the subcutaneous layer and the superficial Musculo-Aponeurotic system. Embedded within this continuum mesh, are 20 pairs of facial muscles which drive facial expressions. These muscles were treated as transversely-isotropic and their anatomical geometries and fibre orientations were accurately depicted. In order to capture the relative composition of muscles and fat, material heterogeneity was also introduced into the model. Complex contact interactions between the lips, eyelids, and between superficial soft tissue continuum and deep rigid skeletal bones were also computed. In addition, this paper investigates the impact of incorporating material heterogeneity and contact interactions, which are often neglected in similar studies. Four facial expressions were simulated using the developed model and the results were compared with surface data obtained from a 3D structured-light scanner. Predicted expressions showed good agreement with the experimental data.

  14. Contribution of G.A. Ilizarov to bone reconstruction: historical achievements and state of the art.

    PubMed

    Gubin, Alexander V; Borzunov, Dmitry Y; Marchenkova, Larisa O; Malkova, Tatiana A; Smirnova, Irina L

    2016-11-01

    Methodological solutions of Prof. G.A. Ilizarov are the core stone of the contemporary bone lengthening and reconstruction surgery. They have been acknowledged in the orthopaedic world as one of the greatest contributions to treating bone pathologies. The Ilizarov method of transosseous compression-distraction osteosynthesis has been widely used for managing bone non-union and defects, bone infection, congenital and posttraumatic limb length discrepancies, hand and foot disorders. The optimal conditions for implementing distraction and compression osteogenesis were proven by numerous experimental studies that Prof. G.A. Ilizarov organized and supervised at a large orthopaedic research institute in Kurgan. The tension stress effect on regeneration and growth of tissues was thoroughly investigated with radiographic, histological and biochemical methods. The impact of the Ilizarov method on the progress of bone lengthening and reconstruction surgery could be called revolutionary.

  15. Tibial lengthening using a reamed type intramedullary nail and an Ilizarov external fixator.

    PubMed

    Kim, Hayoung; Lee, Sang Ki; Kim, Kap Jung; Ahn, Jae Hoon; Choy, Won Sik; Kim, Yong In; Koo, Jea Yun

    2009-06-01

    The aim of this study was to evaluate the efficacy of tibial lengthening using a reamed type intramedullary nail and an Ilizarov external fixator for the treatment of leg length discrepancy or short stature. This retrospective study was performed on 18 tibiae (13 patients) in which attempts were made to reduce complications. We used an Ilizarov external fixator and a nail (10 mm diameter in 17 tibiae and 11 mm in one tibia) in combination. Average limb lengthening was 4.19 cm (range, 2.5-5.5). The mean duration of external fixation was 12.58 days per centimetre gain in length, and the mean consolidation index was 40.53 (range, 35.45-51.85). All distracted segments healed spontaneously without refracture or malalignment. Gradual limb lengthening using a reamed type intramedullary nail and circular external fixation in combination was found to be reliable and effective and reduced external fixation time with fewer complications.

  16. Facial injuries following hyena attack in rural eastern Ethiopia.

    PubMed

    Fell, M J; Ayalew, Y; McClenaghan, F C; McGurk, M

    2014-12-01

    Hyenas are effective hunters and will consider humans as potential prey if the need and opportunity arise. This study describes the circumstances of hyena attacks, the patterns of injuries sustained, and reconstruction in a resource-poor setting. As part of a charitable surgical mission to Ethiopia in 2012, 45 patients with facial deformities were reviewed, of whom four were victims of hyena attacks. A semi-structured interview was performed to ascertain the circumstances of the attack and the subsequent consequences. The age of the victims at the time of attack varied from 5 to 50 years. The attacks occurred when the victims were alone and vulnerable and took place in outdoor open spaces, during the evening or at night. The initial lunge was made to the facial area; if the jaws closed on the facial bones they were crushed, but in all cases the soft tissues were grasped and torn from the underlying bone. Reconstruction was dictated by the extent of soft tissue loss but could normally be obtained by use of local or regional flaps. Hyenas have been shown to attack humans in a predictable way and cause injuries that typically involve the soft tissues of the face.

  17. Static and Dynamic Facial Cues Differentially Affect the Consistency of Social Evaluations.

    PubMed

    Hehman, Eric; Flake, Jessica K; Freeman, Jonathan B

    2015-08-01

    Individuals are quite sensitive to others' appearance cues when forming social evaluations. Cues such as facial emotional resemblance are based on facial musculature and thus dynamic. Cues such as a face's structure are based on the underlying bone and are thus relatively static. The current research examines the distinction between these types of facial cues by investigating the consistency in social evaluations arising from dynamic versus static cues. Specifically, across four studies using real faces, digitally generated faces, and downstream behavioral decisions, we demonstrate that social evaluations based on dynamic cues, such as intentions, have greater variability across multiple presentations of the same identity than do social evaluations based on static cues, such as ability. Thus, although evaluations of intentions vary considerably across different instances of a target's face, evaluations of ability are relatively fixed. The findings highlight the role of facial cues' consistency in the stability of social evaluations.

  18. Bifocal tibial corrective osteotomy with lengthening in achondroplasia: an analysis of results and complications.

    PubMed

    Vaidya, Sandeep V; Song, Hae-Ryong; Lee, Seok-Hyun; Suh, Seung-Woo; Keny, Swapnil M; Telang, Shailendra S

    2006-01-01

    The results and complications of bifocal tibial osteotomies with gradual correction and lengthening by Ilizarov ring fixator performed in 47 tibiae in 24 achondroplastic patients were analyzed. Comparison was made between the parameters of angular and torsional deformities of the tibia preoperatively, at fixator removal, and at last follow-up. Of these parameters, statistically significant change was seen postoperatively in the values of medial proximal tibial angle, lateral distal tibial angle, mechanical axis deviation, and tibial torsion, which changed from 78.8 +/- 7.05 degrees, 103.2 +/- 11.8 degrees, 25.1 +/- 14.6 mm (medial), and 22.7 +/- 10 degrees (internal) preoperatively to 87.3 +/- 6.3 degrees, 90.9 +/- 5.4 degrees, 5.3 +/- 10 cm (medial), and 15.8 +/- 4.2 degrees (external), respectively, at the time of fixator removal; and this correction was maintained during the follow-up period. Mean total tibial lengthening was 6.84 +/- 1.3 cm. Average healing index was 26.06 days/cm. Complications observed were 15 pin tract infections, 1 residual varus, 1 overcorrection into valgus, 2 recurrence of varus, 22 equinus contractures, 2 premature consolidations, and 3 fibula malalignments. Recurrence of varus was observed in limbs with a residual abnormal medial mechanical axis deviation due to femoral deformity. A hundred percent incidence of equinus was observed in limbs with tibial lengthening of more than 40%, with distal tibial lengthening of more than 15%. To minimize the risk for occurrence of equinus, we recommend restriction of distal tibial lengthening in achondroplasia to less than 15%, although total tibial lengthening may exceed 40%. Fibula malalignment was not observed after double fibula osteotomy. This procedure is safe and efficacious if performed with strict adherence to prescribed technique.

  19. The effect on the extracellular matrix of the deep fascia in response to leg lengthening

    PubMed Central

    Wang, Hai-Qiang; Li, Xin-Kui; Wu, Zi-Xiang; Wei, Yi-Yong; Luo, Zhuo-Jing

    2008-01-01

    Background Whereas the alterations of diverse tissues in cellular and molecular levels have been investigated during leg lengthening via microscopy and biochemical studies, little is known about the response of deep fascia. This study aims to investigate the changes of the extracellular matrix in deep fascia in response to leg lengthening. Methods Animal model of leg lengthening was established in New Zealand white rabbits. Distraction was initiated at a rate of 1 mm/day and 2 mm/day in two steps, and preceded until increases of 10% and 20% in the initial length of tibia had been achieved. Alcian blue stain and picrosirius-polarization method were used for the study of the extracellular matrix of deep fascia samples. Leica DM LA image analysis system was used to investigate the quantitative changes of collagen type I and III. Results Alcian blue stain showed that glycosaminoglycans of fascia of each group were composed of chondroitin sulphate and heparin sulphate, but not of keratan sulphate. Under the polarization microscopy, the fascia consisted mainly of collagen type I. After leg lengthening, the percentage of collagen type III increased. The most similar collagen composition of the fascia to that of the normal fascia was detected at a 20% increase in tibia length achieved via a distraction rate of 1 mm/d. Conclusion The changes in collagen distribution and composition occur in deep fascia during leg lengthening. Although different lengthening schemes resulted in varied matrix changes, the most comparable collagen composition to be demonstrated under the scheme of a distraction rate of 1 mm/day and 20% increase in tibia length. Efficient fascia regeneration is initiated only in certain combinations of the leg load parameters including appropriate intensity and duration time, e.g., either low density distraction that persist a relatively short time or high distraction rates. PMID:18611283

  20. Stresses in ultrasonically assisted bone cutting

    NASA Astrophysics Data System (ADS)

    Alam, K.; Mitrofanov, A. V.; Bäker, M.; Silberschmidt, V. V.

    2009-08-01

    Bone cutting is a frequently used procedure in the orthopaedic surgery. Modern cutting techniques, such as ultrasonic assisted drilling, enable surgeons to perform precision operations in facial and spinal surgeries. Advanced understanding of the mechanics of bone cutting assisted by ultrasonic vibration is required to minimise bone fractures and to optimise the technique performance. The paper presents results of finite element simulations on ultrasonic and conventional bone cutting analysing the effects of ultrasonic vibration on cutting forces and stress distribution. The developed model is used to study the effects of cutting and vibration parameters (e.g. amplitude and frequency) on the stress distributions in the cutting region.

  1. Achondroplasia and limb lengthening: Results in a UK cohort and review of the literature

    PubMed Central

    Donaldson, James; Aftab, Syed; Bradish, Christopher

    2015-01-01

    Aims We aim to review the results, complications and outcomes of a single surgeon's series of lower limb lengthening in patients with achondroplasia. Methods Ten achondroplastic children underwent limb lengthening. The patients, medical records and radiographs were reviewed. Results The average age at the time of the index operation was 7.8 years. A single surgeon undertook all procedures. The average total length gain was 20.5 cm. The commonest complication was a fractured femur after removal of the frame. Conclusion Although complication rates were high (70%), none were left with any long-term sequelae and all were pleased with the results. PMID:25829758

  2. Secondary stem lengthening in palms: response to commentary by Tomlinson and Quinn.

    PubMed

    Renninger, Heidi J; Phillips, Nathan

    2013-03-01

    In this response, we address the criticisms put forth by Tomlinson and Quinn (American Journal of Botany 100: 461-464) about our original publication on secondary stem lengthening in Iriartea deltoidea palms (American Journal of Botany 99: 607-613) and find areas on which we may agree. We address our figure of a typical palm vascular bundle; the location, timing, and species where secondary lengthening would likely occur; and our measurement of internodes in various palms as well as our choice of individuals. Our original observations were a novel finding in the field of palm biology, and we invite more research and investigation on this subject.

  3. Bizarre paediatric facial burns.

    PubMed

    Ho, W S; Ying, S Y; Wong, T W

    2000-08-01

    Child abuse and neglect account for a significant number of paediatric burn injuries. It is of great importance because of the high mortality, high frequency of repeated abuse, as well as the physical, psychological and social sequelae that it causes. Burn abuse is often under-recognized and under-reported because it is difficult to define non-accidental injury. On the other hand, false accusation of burn abuse is extremely damaging to the family. Bizarre and unusual burn injuries can be caused by accident and should not automatically be assumed to be deliberate injury. Three boys of age 1-7 years with bizarre facial burns were admitted to the Burns Unit at the Prince of Wales Hospital between February 1995 and July 1999. One was burned by his baby-sitter with hot water steam and the other two were burned by their mothers with hot boiled eggs. The unusual causes of their burns raised the suspicion of child abuse and formal investigations were carried out by the Social Services Department. Detail assessment including a developmental history of the child and the psychosocial assessment of the family revealed that these three boys were burned because of poor medical advice and innocent cultural belief.

  4. Facial tissue depths in children with cleft lip and palate.

    PubMed

    Starbuck, John M; Ghoneima, Ahmed; Kula, Katherine

    2015-03-01

    Cleft lip and palate (CLP) is a craniofacial malformation affecting more than seven million people worldwide that results in defects of the hard palate, teeth, maxilla, nasal spine and floor, and maxillodental asymmetry. CLP facial soft-tissue depth (FSTD) values have never been published. The purpose of this research is to report CLP FSTD values and compare them to previously published FSTD values for normal children. Thirty-eight FSTDs were measured on cone beam computed tomography images of CLP children (n = 86; 7-17 years). MANOVA and ANOVA tests determined whether cleft type, age, sex, and bone graft surgical status affect tissue depths. Both cleft type (unilateral/bilateral) and age influence FSTDs. CLP FSTDs exhibit patterns of variation that differ from normal children, particularly around the oronasal regions of the face. These differences should be taken into account when facial reconstructions of children with CLP are created.

  5. A Contemporary Approach to Facial Reanimation.

    PubMed

    Jowett, Nate; Hadlock, Tessa A

    2015-01-01

    The management of acute facial nerve insult may entail medical therapy, surgical exploration, decompression, or repair depending on the etiology. When recovery is not complete, facial mimetic function lies on a spectrum ranging from flaccid paralysis to hyperkinesis resulting in facial immobility. Through systematic assessment of the face at rest and with movement, one may tailor the management to the particular pattern of dysfunction. Interventions for long-standing facial palsy include physical therapy, injectables, and surgical reanimation procedures. The goal of the management is to restore facial balance and movement. This article summarizes a contemporary approach to the management of facial nerve insults.

  6. Compensatory Vowel Lengthening for Omitted Coda Consonants: A Phonetic Investigation of Children's Early Representations of Prosodic Words

    ERIC Educational Resources Information Center

    Song, Jae Yung; Demuth, Katherine

    2008-01-01

    Children's early word productions often differ from the target form, sometimes exhibiting vowel lengthening when word-final coda consonants are omitted (e.g., "dog" /d[open o]g/ [arrow right] [d[open o]:]). It has typically been assumed that such lengthening compensates for a missing prosodic unit (a mora). However, this study raises the…

  7. [Blood Flow and Regional Blood Flow Rate in the Middle Cerebral Artery during Surgical Leg Lengthening in Patients with Congenital and Acquired Limb Shortening].

    PubMed

    Schurov, V A; Popkov, A V

    2015-01-01

    This is a comparative study of changes in blood flow rate in the popliteal artery, the arteries of bone regenerate and cerebral arteries in 45 patients with congenital and acquired diseases of the limbs at different stages of surgical lengthening of 3-15 cm shortened shin by Ilizarov method. We observed an increase in regional blood flow rate in all patients during the periods of distraction and fixation. A 25% increase in blood flow rate in the middle cerebral artery on the contralateral side was found only in patients of the first adult age with acquired limb shortening. Basing on the analysis of the reaction of cerebral arteries during a functional test with additional muscle work, we suggested that the absence of reaction in congenital diseases is caused by relative excess of somatic afferentation which results from morphological and functional immaturity of brain regulatory systems.

  8. Compound facial expressions of emotion

    PubMed Central

    Du, Shichuan; Tao, Yong; Martinez, Aleix M.

    2014-01-01

    Understanding the different categories of facial expressions of emotion regularly used by us is essential to gain insights into human cognition and affect as well as for the design of computational models and perceptual interfaces. Past research on facial expressions of emotion has focused on the study of six basic categories—happiness, surprise, anger, sadness, fear, and disgust. However, many more facial expressions of emotion exist and are used regularly by humans. This paper describes an important group of expressions, which we call compound emotion categories. Compound emotions are those that can be constructed by combining basic component categories to create new ones. For instance, happily surprised and angrily surprised are two distinct compound emotion categories. The present work defines 21 distinct emotion categories. Sample images of their facial expressions were collected from 230 human subjects. A Facial Action Coding System analysis shows the production of these 21 categories is different but consistent with the subordinate categories they represent (e.g., a happily surprised expression combines muscle movements observed in happiness and surprised). We show that these differences are sufficient to distinguish between the 21 defined categories. We then use a computational model of face perception to demonstrate that most of these categories are also visually discriminable from one another. PMID:24706770

  9. Cortical control of facial expression.

    PubMed

    Müri, René M

    2016-06-01

    The present Review deals with the motor control of facial expressions in humans. Facial expressions are a central part of human communication. Emotional face expressions have a crucial role in human nonverbal behavior, allowing a rapid transfer of information between individuals. Facial expressions can be either voluntarily or emotionally controlled. Recent studies in nonhuman primates and humans have revealed that the motor control of facial expressions has a distributed neural representation. At least five cortical regions on the medial and lateral aspects of each hemisphere are involved: the primary motor cortex, the ventral lateral premotor cortex, the supplementary motor area on the medial wall, and the rostral and caudal cingulate cortex. The results of studies in humans and nonhuman primates suggest that the innervation of the face is bilaterally controlled for the upper part and mainly contralaterally controlled for the lower part. Furthermore, the primary motor cortex, the ventral lateral premotor cortex, and the supplementary motor area are essential for the voluntary control of facial expressions. In contrast, the cingulate cortical areas are important for emotional expression, because they receive input from different structures of the limbic system.

  10. Female facial appearance and health.

    PubMed

    Gray, Alan W; Boothroyd, Lynda G

    2012-02-01

    The current study addressed whether rated femininity, attractiveness, and health in female faces are associated with numerous indices of self-reported health history (number of colds/stomach bugs/frequency of antibiotic use) in a sample of 105 females. It was predicted that all three rating variables would correlate negatively with bouts of illness (with the exception of rates of stomach infections), on the assumption that aspects of facial appearance signal mate quality. The results showed partial support for this prediction, in that there was a general trend for both facial femininity and attractiveness to correlate negatively with the reported number of colds in the preceding twelve months and with the frequency of antibiotic use in the last three years and the last twelve months. Rated facial femininity (as documented in September) was also associated with days of flu experienced in the period spanning the November-December months. However, rated health did not correlate with any of the health indices (albeit one marginal result with antibiotic use in the last twelve months). The results lend support to previous findings linking facial femininity to health and suggest that facial femininity may be linked to some aspects of disease resistance but not others.

  11. Adjustable bracing technique for the prevention of knee flexion contracture during tibial lengthening.

    PubMed

    Segev, Eitan; Hayek, Shlomo

    2003-01-01

    The authors present a simple thigh-knee brace that prevents flexion contracture during tibial lengthening. The brace is strapped to the thigh and connected to the Ilizarov frame via two simple hinges. While in the brace the knee can be mobilized for physiotherapy and locked in extension during rest.

  12. Leg Lengthening as a Means of Improving Ambulation Following an Internal Hemipelvectomy

    PubMed Central

    Okazaki, Hiroshi; Goto, Takahiro

    2016-01-01

    Reconstructive surgery following an internal hemipelvectomy for a malignant pelvic tumor is difficult due to the structural complexity of the pelvis and the massive extension of the tumor. While high complication rates have been encountered in various types of reconstructive surgery, resection without reconstruction reportedly involved fewer complications. However, this method often results in limb shortening with resultant instability during walking. We reported herein leg lengthening performed to correct lower limb shortening after an internal hemipelvectomy, which improved ambulatory stability and overall QOL. An 18-year-old male patient came to our hospital to correct a lower limb discrepancy resulting from a left internal hemipelvectomy. His left pelvis and proximal femur had been resected, and the femur remained without an acetabular roof. His left lower limb was about 8 centimeters shorter. The left tibia was lengthened 8 centimeters with an external fixator. After the lengthening, the patient was able to walk without support and his gait remarkably improved. Additionally he no longer required placing a wallet in his back pocket as a pad as a means of raising the left side of his torso while sitting. Leg lengthening was a useful method of improving ambulation after an internal hemipelvectomy. PMID:27800202

  13. Results of the Wagner and Ilizarov methods of limb-lengthening.

    PubMed

    Aaron, A D; Eilert, R E

    1996-01-01

    We compared the results of the Wagner method of limb-lengthening in twenty extremities (nineteen patients) with those of the Ilizarov method in twenty-one extremities (eighteen patients). The Wagner external fixator was used in all twenty procedures in which the Wagner lengthening method was performed and in fourteen procedures in which the Ilizarov lengthening method was performed. The Ilizarov external fixator was used in the remaining seven procedures in which the Ilizarov method was performed. The average increase in length was 5.4 centimeters (range, 2.8 to 8.0 centimeters) with the Wagner technique and 5.9 centimeters (range, 1.0 to 16.8 centimeters) with the Ilizarov technique. The rate for the lengthening phase was nine days for one centimeter of length with the Wagner technique and twelve days for one centimeter with the Ilizarov technique. The rate for the consolidation phase was forty-four days for one centimeter with the Wagner technique and twenty-six days for one centimeter with the Ilizarov technique. The group of patients who were managed with the Wagner technique had thirty major complications, and the group of patients who were managed with the Ilizarov technique had only thirteen major complications. Forth complications were associated with the use of the uniaxial Wagner external apparatus and sixteen, with the use of the multiaxial Ilizarov external fixator.

  14. Lengthening and reconstruction of congenital leg deficiencies for enhanced prosthetic wear.

    PubMed

    Tellisi, Nazzar; Fragomen, Austin T; Ilizarov, Svetlana; Rozbruch, S Robert

    2008-02-01

    Congenital limb deficiencies with severe shortening and/or deformity can be difficult to fit with a prosthesis. We report two patients in whom gradual lengthening and deformity correction with the Ilizarov/Taylor spatial frame was used to improve prosthesis fit, comfort, and gait.

  15. Musculo-tendon length and lengthening velocity of rectus femoris in stiff knee gait.

    PubMed

    Jonkers, Ilse; Stewart, Caroline; Desloovere, Kaat; Molenaers, Guy; Spaepen, Arthur

    2006-02-01

    Inappropriate activity of M. rectus femoris (RF) during swing is believed to contribute to stiff knee gait in cerebral palsy. This study used musculoskeletal modeling techniques to analyze rectus femoris musculo-tendon (MT) length and lengthening velocity during stiff knee gait in 35 children with diplegic cerebral palsy (CP). Duncan Ely test scores were used to categorize the patients into four groups with increasing levels of rectus femoris spasticity. Knee kinematics confirmed a significant reduction and delay of maximal peak knee flexion during swing in the patient groups compared to reference values. Maximal musculo-tendon length of M. rectus femoris was reduced and occurred prematurely in swing. Musculo-tendon lengthening velocity was significantly reduced and the timing of the maximal lengthening velocity was shifted into stance phase. The present study demonstrates altered dynamic behavior of the M. rectus femoris in stiff knee gait and the results indicate that maximal knee flexion in swing was not a valid reference for the MT length of the M. rectus femoris. Furthermore, in the patient group maximal musculo-tendon lengthening velocity of the muscle related to the stance phase rather than the stance-swing transition.

  16. Crossbridge and non-crossbridge contributions to force in shortening and lengthening muscle.

    PubMed

    Ranatunga, K W; Roots, H; Pinniger, G J; Offer, G W

    2010-01-01

    Analysis of tension responses to ramp length changes in muscle can provide important information about the crossbridge cycle. During a ramp length change, the force response of an active muscle shows an early change in slope (the P₁ transition) followed by a later, gradual change in slope (the P₂ transition). Modeling shows that the first transition reflects the tension change associated with the crossbridge power stroke in shortening and with its reversal in lengthening; the reduction in slope at the second transition occurs when most of the crossbridges (myosin heads) that were attached at the start of the ramp become detached; the steady tension during shortening is borne mainly by post-stroke heads whereas tension during lengthening is borne mostly by pre-stroke heads. After the P₂ transition, the tension reaches a steady level in the model whereas in the experiments the tension continues to increase during lengthening or to decrease during shortening; this tension change is seen at a wide range of sarcomere lengths and even when active force is reduced by a myosin inhibitor. It appears that some non-crossbridge components in muscle fibers stiffen upon activation and contribute to the continued tension rise during lengthening; release of such tension leads to tension decline during shortening. Thus, non-crossbridge visco-elasticity in sarcomeres may also contribute to energy storage and release during in situ muscle function.

  17. Increased spinal reflex excitability is associated with enhanced central activation during voluntary lengthening contractions in human spinal cord injury.

    PubMed

    Kim, Hyosub E; Corcos, Daniel M; Hornby, T George

    2015-07-01

    This study of chronic incomplete spinal cord injury (SCI) subjects investigated patterns of central motor drive (i.e., central activation) of the plantar flexors using interpolated twitches, and modulation of soleus H-reflexes during lengthening, isometric, and shortening muscle actions. In a recent study of the knee extensors, SCI subjects demonstrated greater central activation ratio (CAR) values during lengthening (i.e., eccentric) maximal voluntary contractions (MVCs), compared with during isometric or shortening (i.e., concentric) MVCs. In contrast, healthy controls demonstrated lower lengthening CAR values compared with their isometric and shortening CARs. For the present investigation, we hypothesized SCI subjects would again produce their highest CAR values during lengthening MVCs, and that these increases in central activation were partially attributable to greater efficacy of Ia-α motoneuron transmission during muscle lengthening following SCI. Results show SCI subjects produced higher CAR values during lengthening vs. isometric or shortening MVCs (all P < 0.001). H-reflex testing revealed normalized H-reflexes (maximal SOL H-reflex-to-maximal M-wave ratios) were greater for SCI than controls during passive (P = 0.023) and active (i.e., 75% MVC; P = 0.017) lengthening, suggesting facilitation of Ia transmission post-SCI. Additionally, measures of spinal reflex excitability (passive lengthening maximal SOL H-reflex-to-maximal M-wave ratio) in SCI were positively correlated with soleus electromyographic activity and CAR values during lengthening MVCs (both P < 0.05). The present study presents evidence that patterns of dynamic muscle activation are altered following SCI, and that greater central activation during lengthening contractions is partly due to enhanced efficacy of Ia-α motoneuron transmission.

  18. A Comparative Evaluation for Biologic Width following Surgical Crown Lengthening Using Gingivectomy and Ostectomy Procedure.

    PubMed

    Ganji, Kiran Kumar; Patil, Veena Ashok; John, Jiji

    2012-01-01

    Surgical crown lengthening has been proposed as a means of facilitating restorative procedures and preventing injuries in teeth with structurally inadequate clinical crown or exposing tooth structure in the presence of deep, subgingival pathologies which may hamper the access for proper restorative measures. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biologic width. However, very little has been done in humans. Aims. The purpose of the study was to evaluate the potential changes in the periodontal tissues, particularly the biologic width, following surgical crown lengthening by two surgical procedures before and after crown placement. Methods and Material. Twenty (20) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening) and adjacent sites: Plaque and Gingival Indices (PI) & (GI), Position of Gingival Margin from reference Stent (PGMRS), Probing depth (PD), and Biologic Width (BW). Statistical Analysis Used. Student "t" Test. Results. Initial baseline values of biologic width were 2.55 mm (Gingivectomy procedure B1 Group) and 1.95 mm (Ostectomy procedure B2 Group) and after surgical procedure the values were 1.15 mm and 1.25 mm. Conclusions. Within the limitations of the study the biologic width, at treated sites, was re-established to its original vertical dimension by 3 months. Ostectomy with apically positioned flap can be considered as a more effective procedure than Gingivectomy for Surgical Crown Lengthening.

  19. Pediatric lower limb Ilizarov lengthening with functional evaluation in adulthood: A report on underprivileged patients

    PubMed Central

    Shahcheraghi, Gholam Hossain; Javid, Mahzad; Hadavi, Fatemeh

    2015-01-01

    Purpose Ilizarov lengthening, with the principles of Ilizarov, requires a collaboration and supervision of the physiotherapist, nurse, and psychologist, preferably in a group-therapy set-up. We report the mid- and long-term functional outcome of cases that had none of the above listed supporting elements. In addition, we tried to observe the effect of the disease category on the final outcome in the patient. Method In this study, 35 children who had undergone Ilizarov lower limb lengthening were evaluated using the following methods: clinical, radiographic, and by four functional scoring systems, and parent/patient satisfaction questionnaires, after an average of 17.2 years (10–25 years). Results In this study, 19 boys and 16 girls aged 5–16 years received 18 femoral and 20 tibial lengthening. An average of 6.2 cm lengthening in the femur and 8.4 in the tibia was achieved, with a healing index of 26.5 days. The disease category did not significantly affect the healing index, but the complications, 0.5 per femoral and 0.7 per tibial segment, were more common among congenital, and least among post-traumatic discrepancies. A complete improvement in joint stiffness was observed by 6–12 months post-frame removal in 83% of the cases, following home therapy by parents alone. Conclusion The long-term results of Ilizarov lengthening for lower limb discrepancy in children, even without group-therapy or good supportive aids, can improve function and maintain patient satisfaction in two thirds of the cases, over an average period of 17 years. Levels of evidence IV. PMID:26719612

  20. The role of prominence in determining the scope of boundary-related lengthening in Greek

    PubMed Central

    Katsika, Argyro

    2016-01-01

    This study aims at examining and accounting for the scope of the temporal effect of phrase boundaries. Previous research has indicated that there is an interaction between boundary-related lengthening and prominence such that the former extends towards the nearby prominent syllable. However, it is unclear whether this interaction is due to lexical stress and/or phrasal prominence (marked by pitch accent) and how far towards the prominent syllable the effect extends. Here, we use an electromagnetic articulography (EMA) study of Greek to examine the scope of boundary-related lengthening as a function of lexical stress and pitch accent separately. Boundaries are elicited by the means of a variety of syntactic constructions.. The results show an effect of lexical stress. Phrase-final lengthening affects the articulatory gestures of the phrase-final syllable that are immediately adjacent to the boundary in words with final stress, but is initiated earlier within phrase-final words with non-final stress. Similarly, the articulatory configurations during inter-phrasal pauses reach their point of achievement later in words with final stress than in words with non-final stress. These effects of stress hold regardless of whether the phrase-final word is accented or de-accented. Phrase-initial lengthening, on the other hand, is consistently detected on the phrase-initial constriction, independently of where the stress is within the preceding, phrase-final, word. These results indicate that the lexical aspect of prominence plays a role in determining the scope of boundary-related lengthening in Greek. Based on these results, a gestural account of prosodic boundaries in Greek is proposed in which lexical and phrasal prosody interact in a systematic and coordinated fashion. The cross-linguistic dimensions of this account and its implications for prosodic structure are discussed. PMID:27773955

  1. Facial mimicry is not necessary to recognize emotion: Facial expression recognition by people with Moebius syndrome.

    PubMed

    Rives Bogart, Kathleen; Matsumoto, David

    2010-01-01

    According to the reverse simulation model of embodied simulation theory, we recognize others' emotions by subtly mimicking their expressions, which allows us to feel the corresponding emotion through facial feedback. Previous studies examining whether facial mimicry is necessary for facial expression recognition were limited by potentially distracting manipulations intended to artificially restrict facial mimicry or very small samples of people with facial paralysis. We addressed these limitations by collecting the largest sample to date of people with Moebius syndrome, a condition characterized by congenital bilateral facial paralysis. In this Internet-based study, 37 adults with Moebius syndrome and 37 matched control participants completed a facial expression recognition task. People with Moebius syndrome did not differ from the control group or normative data in emotion recognition accuracy, and accuracy was not related to extent of ability to produce facial expressions. Our results do not support the hypothesis that reverse simulation with facial mimicry is necessary for facial expression recognition.

  2. Polyurethane elastomers for facial prostheses.

    PubMed

    Gonzalez, J B

    1978-02-01

    A review of the polyurethane elastomers used for facial prostheses has been presented. A description of the casting technique was given. The materials require accuracy and care in handling to insure the successful casting of a prosthesis. They seem to simulate the characteristics of the facial tissues and are more durable and comfortable than previously used materials. Over 300 patients have been exposed to or treated with these materials without evidencing significant adverse tissue reaction. In spite of the improvements that these materials present over previous ones (PVC and silicones), much work is still required to understand their behavior and their physical and mechanical characteristics and to compensate for the metameric phenomenon.

  3. [Dynamics of induced EEG in the intervals between a target and trigger stimuli during formation of a set to emotionally negative facial expression].

    PubMed

    Kostandov, É A; Cheremushkin, E A; Ashkinazi, M L

    2012-01-01

    A visual set was used as a model to study the influence of the increased memory load on the recognition of facial expression in 70 healthy adults. In order to additionally load the working memory, we lengthened the time gap between target (faces) and trigger stimuli. Such a lengthening from 1 to 8 s resulted in an increase of set plasticity (fewer mistakes in facial expression recognition). It also led to a reduction of the reaction time and less number of contrast illusions in recognition. We analyzed theta- and alpha-band EEG changes during individual segments of the time gap and suggested that repeated trials with a certain fixed interval between stimuli formed an inner representation of the interval duration. This inner representation up-regulates the visual attention in case of anticipation of a relevant event (stimulus) and down-regulates the attention when the stimulus is not expected. In case of the plastic set, the induced EEG synchronization in the alpha band is stronger in the trials with correct recognition in the middle of the inter-stimulus time gap. We think this synchronization reflects the action of the top-down cognitive control that suppresses the influence of irrelevant information on the brain activity. Theta-band dynamics in the inter-stimulus time gap can be associated with the emotional strain caused by the fact that a person had to retain in memory (for several seconds) the result of facial expression recognition.

  4. Facial Specialty. Teacher Edition. Cosmetology Series.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This publication is one of a series of curriculum guides designed to direct and support instruction in vocational cosmetology programs in the State of Oklahoma. It contains seven units for the facial specialty: identifying enemies of the skin, using aromatherapy on the skin, giving facials without the aid of machines, giving facials with the aid…

  5. Frontal bone fractures.

    PubMed

    Marinheiro, Bruno Henrique; de Medeiros, Eduardo Henrique Pantosso; Sverzut, Cássio Edvard; Trivellato, Alexandre Elias

    2014-11-01

    The aim of this retrospective study was to evaluate the epidemiology, treatment, and complications of frontal bone fractures associated, or not, with other facial fractures. This evaluation also sought to minimize the influence of the surgeon's skills and the preference for any rigid internal fixation system. The files from 3758 patients who attended the Oral and Maxillofacial Surgery Department of the School of Dentistry of Ribeirao Preto, University of Sao Paulo, from March 2004 to November 2011 and presented with facial trauma were scanned, and 52 files were chosen for the review. Eleven (21.15%) of these patients had pure fractures of the frontal bone, and trauma incidence was more prevalent in men (92.3%), whites (61.53%), and adults (50%). Despite the use of helmets at the moment of the trauma, motorcycle crashes were the most common etiological factor (32.69%). Fracture of the anterior wall of the frontal sinus with displacement was the main injury observed (54.9%), and the most common treatment was internal fixation with a plate and screws (45.09%). Postoperative complications were observed in 35.29% of the cases. The therapy applied was effective in handling this type of fracture, and the success rate was comparable to that reported in other published studies.

  6. Tibial lengthening over humeral and tibial intramedullary nails in patients with sequelae of poliomyelitis: a comparative study.

    PubMed

    Chen, Daoyun; Chen, Jianmin; Jiang, Yao; Liu, Fanggang

    2011-06-01

    Leg discrepancy is common after poliomyelitis. Tibial lengthening is an effective way to solve this problem. It is believed lengthening over a tibial intramedullary nail can provide a more comfortable lengthening process than by the conventional technique. However, patients with sequelae of poliomyelitis typically have narrow intramedullary canals allowing limited space for inserting a tibial intramedullary nail and Kirschner wires. To overcome this problem, we tried using humeral nails instead of tibial nails in the lengthening procedure. In this study, we used humeral nails in 20 tibial lengthening procedures and compared the results with another group of patients who were treated with tibial lengthening over tibial intramedullary nails. The mean consolidation index, percentage of increase and external fixation index did not show significant differences between the two groups. However, less blood loss and shorter operating time were noted in the humeral nail group. More patients encountered difficulty with the inserted intramedullary nail in the tibial nail group procedure. The complications did not show a statistically significant difference between the two techniques on follow-up. In conclusion, we found the humeral nail lengthening technique was more suitable in leg discrepancy patients with sequelae of poliomyelitis.

  7. Morbidity Profile and Functional Outcome of Modified Facial Translocation Approaches for Skull Base Tumors

    PubMed Central

    Kekatpure, Vikram D.; Rajan, Gunesh P.; Patel, Daxesh; Trivedi, Nirav P.; Arun, P.; Iyer, Subramania; Kuriakose, Moni Abraham

    2011-01-01

    The primary objective of this study was to evaluate morbidity associated with facial translocation approaches for skull base and results of various technical modifications. Forty consecutive patients who underwent facial translocation approaches for accessing skull base tumors from July 2005 to June 2010 were included in this study. There were 25 patients who underwent standard facial translocation, 4 patients medial mini, and 11 patients underwent extended facial translocation. Thirteen patients had benign disease and 27 patients had malignant disease. Resection was R0 in 36 and R1 in 4 patients. Most patients had acceptable cosmetic results. None of the patients had problems related to occlusion or speech and swallowing. The commonest complication observed was nasal crusting in 16 patients. Grade 2 trismus and exposure of mini plate was seen in three patients. Two patients developed necrosis of translocated bone. Three patients developed palatal fistula before modification of palatal incision. Facial translocation provides a satisfactory access for adequate clearance of skull base tumors with satisfactory aesthetic and functional results. With modifications of the surgical technique and implementation of new surgical tools, the morbidity of facial translocation approaches will continue to decrease. PMID:22470269

  8. Revisiting the Anatomy of the Facial Recess: The Boundaries of the Round Window Exposure

    PubMed Central

    Öztürk, Kerem; Göde, Sercan; Çelik, Servet; Orhan, Mustafa; Bilge, Okan; Bilgen, Cem; Kirazlı, Tayfun; Saylam, Canan Y.

    2016-01-01

    Background: The exposure of the round window (RW) through the facial recess (FR) is sometimes partial. The anatomic variations that alter RW exposure during cochleostomy have not been clearly defined to date. Aims: The aim of this study was to assess the best FR position in which to achieve the widest exposure of the RW niche and to define the topographic relationship between two other important anatomical structures, the facial nerve (FN) and the chorda tympani (CT). Study Design: Cadaver study. Methods: Twenty-four temporal bones were included in the study. Anterior and posterior epitympanectomy and posterior tympanotomy were performed after mastoidectomy. Bone was removed until the FN and CT were skeletonized and the CT branching point was visible. Two pictures were taken. The first was taken when the facial recess was at its widest exposure, while the second was taken when the RW niche was maximally exposed through the facial recess. Various measurements were taken. Results: The RW niche was totally visible in 19 temporal bones (79.2%). The RW was partially visible in the remaining five bones (20.8%). The unexposed part of the RW lay posteromedial to the FN in these five bones. While the branching point of the CT could be visualized in all cases at the widest exposure of RW, the part of the FN distal to the branching point was hidden in eight subjects (33.3%) under the posterior wall of the external ear canal. Conclusions: The RW niche was totally visible in most of the temporal bones. The RW lay posteromedial to the FN in some cases and total exposure was impossible. PMID:27761285

  9. [Facial trauma and multiple trauma].

    PubMed

    Corre, Pierre; Arzul, Ludovic; Khonsari, Roman Hossein; Mercier, Jacques

    2013-09-01

    The human face contains the sense organs and is responsible for essential functions: swallowing, chewing, speech, breathing and communication. It is also and most importantly the seat of a person's identity. Multiple trauma adds a life-threatening dimension to the physical and psychological impact of a facial trauma.

  10. Psychometric profiles and facial pain.

    PubMed

    Eversole, L R; Stone, C E; Matheson, D; Kaplan, H

    1985-09-01

    The myofacial pain-dysfunction syndrome and atypical facial pain are the most prevalent chronic pain disorders of the facial region. Previously, the myofacial pain-dysfunction syndrome included all TMJ/masticatory muscle pain, jaw dysfunction, and joint clicking. We have segregated two major subgroups subsumed within this diagnostic classification and have assigned them to a myogenic facial pain (MFP) group and a TMJ internal derangement (TMJID) group. Significant age and personality differences were uncovered when these subpopulations were compared to subjects with atypical facial pain (AFP). Both MFP and TMJID groups are relatively homologous, involving younger persons than AFP subjects. Alternatively, when MFP, TMJID, and AFP subjects were compared for differences in MMPI psychometric scales, MFP and AFP subjects exhibited significantly higher scores, particularly for hypochondriasis, depression, and hysteria, than did TMJID subjects. It is concluded that subcategorization of myofascial pain-dysfunction patients into a myogenic pain group and a TMJ internal derangement group is justified on the basis of psychometric differences. Furthermore, psychopathologic factors are more significant among MFP and AFP subjects than among TMJID patients.

  11. Social facial touch in rats.

    PubMed

    Wolfe, Jason; Mende, Carolin; Brecht, Michael

    2011-12-01

    We know much about how rats use their whiskers to discriminate simple tactile properties, but little about how they are used in natural settings. Here we studied whisker motion during social interactions between rats in order to gain a better understanding of natural whisker use in this model system for sensorimotor integration. In the first set of experiments, an intruder was placed in a second rat's home cage. Anogenital sniffing immediately ensued; later in the trial, facial interactions occurred at least as frequently. Whereas much previous work has focused on the importance of anogenital sniffing during social interactions, these facial interactions were accompanied by some of the most intense whisker behaviors described to date. Whisker trimming increased biting but reduced boxing. In addition, whiskers were more protracted and whisking amplitude was larger in aggressive than in nonaggressive interactions. In a second set of experiments, rats interacted facially across a gap. As rats approached each other, whisking amplitude decreased and whiskers were more protracted. Whisker trimming disrupted facial alignment and reduced the frequency of interactions, indicating that whisker use, and possibly whisker protraction, is important for rats to orient themselves with respect to one another. We also found that females whisked with smaller amplitude when interacting with males than with females, and that they held their whiskers less protracted than males. The natural whisker use described here should further our understanding of this important somatosensory system during social interactions.

  12. Mapping and Manipulating Facial Expression

    ERIC Educational Resources Information Center

    Theobald, Barry-John; Matthews, Iain; Mangini, Michael; Spies, Jeffrey R.; Brick, Timothy R.; Cohn, Jeffrey F.; Boker, Steven M.

    2009-01-01

    Nonverbal visual cues accompany speech to supplement the meaning of spoken words, signify emotional state, indicate position in discourse, and provide back-channel feedback. This visual information includes head movements, facial expressions and body gestures. In this article we describe techniques for manipulating both verbal and nonverbal facial…

  13. Differential segmental strain during active lengthening in a large biarticular thigh muscle during running

    PubMed Central

    Carr, Jennifer A.; Ellerby, David J.; Marsh, Richard L.

    2011-01-01

    SUMMARY The iliotibialis lateralis pars postacetabularis (ILPO) is the largest muscle in the hindlimb of the guinea fowl and is thought to play an important role during the stance phase of running, both absorbing and producing work. Using sonomicrometry and electromyography, we examined whether the ILPO experiences differential strain between proximal, central and distal portions of the posterior fascicles. When the ILPO is being lengthened while active, the distal portion was found to lengthen significantly more than either the proximal or central portions of the muscle. Our data support the hypothesis that the distal segment lengthened farther and faster because it began activity at shorter sarcomere lengths on the ascending limb of the length–tension curve. Probably because of the self-stabilizing effects of operating on the ascending limb of the length–tension curve, all segments reached the end of lengthening and started shortening at the same sarcomere length. During shortening, this similarity in sarcomere length among the segments was maintained, as predicted from force–velocity effects, and shortening strain was similar in all segments. The differential active strain during active lengthening is thus ultimately determined by differences in strain during the passive portion of the cycle. The sarcomere lengths of all segments of the fascicles were similar at the end of active shortening, but after the passive portion of the cycle the distal segment was shorter. Differential strain in the segments during the passive portion of the cycle may be caused by differential joint excursions at the knee and hip acting on the ends of the muscle and being transmitted differentially by the passive visco-elastic properties of the muscle. Alternatively, the differential passive strain could be due to the action of active or passive muscles in the thigh that transmit force to the IPLO in shear. Based on basic sarcomere dynamics we predict that differential strain is

  14. [Peculiarities of ballistic wounds of maxillo-facial area inflicted by modern ballistic weapon].

    PubMed

    Prokhvatilov, G I; Vatrenitsa, V I; Logatkin, S M; Asfendiarov, D D

    2009-08-01

    The article presents data of a comparative investigation of volume of ballistic damages of maxillo-facial area, given by different ballistic weapon (from usual PM to newest GSh-18). The article says that was set up a large volume of damages of sort and bone tissues of maxillo-facial area, given by bullet of cartridge of GSh-18 in all searched parameters. All materials, received in investigation, could be used in science substantiation and in elaboration of recommendations in planning of structure of sanitarium casualty, methods of investigations, surgical treatment and rehabilitation of wounded with damages, given by modern ballistic weapon.

  15. Tibial lengthening using a humeral intramedullary nail combined with a single-plane external fixator for leg discrepancy in sequelae of poliomyelitis.

    PubMed

    Chen, Daoyun; Chen, Jianmin; Liu, Fanggang; Jiang, Yao

    2011-03-01

    The sequelae of poliomyelitis are the common causes of leg discrepancy. Tibial lengthening is an effective way to solve this problem but it is associated with a high rate of complications. In this study, we combined the use of humeral nail and external fixator in tibial lengthening with the purpose of reducing lengthening complications. Compared with the cases lengthened by a single-plane external fixator alone, this combined strategy was found to be beneficial in maintaining the tibial alignment. Therefore, it can be recommended as a good technique for tibial lengthening in patients with sequelae of poliomyelitis.

  16. New perspectives in facial contouring using external ultrasonography.

    PubMed

    Wilkinson, T S

    2001-10-01

    The use of XUAL ultrasonic energy to "fractionate" and redistribute facial fat is a valuable adjunct in facial plastic surgery. The 59 patients enrolled in the author's preliminary evaluation of XUAL under the auspices of the American Society of Aesthetic Plastic Surgery Innovative Procedures Committee had in addition to the body liposculpture external ultrasonography application to "superwet" anesthetized face and neck with or without physical removal of fat or skin. When no excisions or liposuctioning were performed, there was visible and photographic improvement in facial contouring. Interview comments ranged from "I can see my cheek bones now" to questions as to whether or not a facelift had indeed been performed. Individuals who had submental resculpturing ("submental tuck") or simple "safe zone" liposuction in the submental area, jowl, and nasolabial zones also showed a remarkable degree of skin tightening and contouring beyond the area of actual fat removal. Those individuals who have been observed closely for more than 12 months still have the improvement. Redistribution of fat and skin tightening initially noted between the second and eighth weeks have persisted unchanged, often in spite of fat accumulation elsewhere from weight gain.

  17. [Neurological disease and facial recognition].

    PubMed

    Kawamura, Mitsuru; Sugimoto, Azusa; Kobayakawa, Mutsutaka; Tsuruya, Natsuko

    2012-07-01

    To discuss the neurological basis of facial recognition, we present our case reports of impaired recognition and a review of previous literature. First, we present a case of infarction and discuss prosopagnosia, which has had a large impact on face recognition research. From a study of patient symptoms, we assume that prosopagnosia may be caused by unilateral right occipitotemporal lesion and right cerebral dominance of facial recognition. Further, circumscribed lesion and degenerative disease may also cause progressive prosopagnosia. Apperceptive prosopagnosia is observed in patients with posterior cortical atrophy (PCA), pathologically considered as Alzheimer's disease, and associative prosopagnosia in frontotemporal lobar degeneration (FTLD). Second, we discuss face recognition as part of communication. Patients with Parkinson disease show social cognitive impairments, such as difficulty in facial expression recognition and deficits in theory of mind as detected by the reading the mind in the eyes test. Pathological and functional imaging studies indicate that social cognitive impairment in Parkinson disease is possibly related to damages in the amygdalae and surrounding limbic system. The social cognitive deficits can be observed in the early stages of Parkinson disease, and even in the prodromal stage, for example, patients with rapid eye movement (REM) sleep behavior disorder (RBD) show impairment in facial expression recognition. Further, patients with myotonic dystrophy type 1 (DM 1), which is a multisystem disease that mainly affects the muscles, show social cognitive impairment similar to that of Parkinson disease. Our previous study showed that facial expression recognition impairment of DM 1 patients is associated with lesion in the amygdalae and insulae. Our study results indicate that behaviors and personality traits in DM 1 patients, which are revealed by social cognitive impairment, are attributable to dysfunction of the limbic system.

  18. Living Bones, Strong Bones

    NASA Video Gallery

    In this classroom activity, engineering, nutrition, and physical activity collide when students design and build a healthy bone model of a space explorer which is strong enough to withstand increas...

  19. Recognizing Facial Expressions Automatically from Video

    NASA Astrophysics Data System (ADS)

    Shan, Caifeng; Braspenning, Ralph

    Facial expressions, resulting from movements of the facial muscles, are the face changes in response to a person's internal emotional states, intentions, or social communications. There is a considerable history associated with the study on facial expressions. Darwin [22] was the first to describe in details the specific facial expressions associated with emotions in animals and humans, who argued that all mammals show emotions reliably in their faces. Since that, facial expression analysis has been a area of great research interest for behavioral scientists [27]. Psychological studies [48, 3] suggest that facial expressions, as the main mode for nonverbal communication, play a vital role in human face-to-face communication. For illustration, we show some examples of facial expressions in Fig. 1.

  20. Imaging the Facial Nerve: A Contemporary Review

    PubMed Central

    Gupta, Sachin; Mends, Francine; Hagiwara, Mari; Fatterpekar, Girish; Roehm, Pamela C.

    2013-01-01

    Imaging plays a critical role in the evaluation of a number of facial nerve disorders. The facial nerve has a complex anatomical course; thus, a thorough understanding of the course of the facial nerve is essential to localize the sites of pathology. Facial nerve dysfunction can occur from a variety of causes, which can often be identified on imaging. Computed tomography and magnetic resonance imaging are helpful for identifying bony facial canal and soft tissue abnormalities, respectively. Ultrasound of the facial nerve has been used to predict functional outcomes in patients with Bell's palsy. More recently, diffusion tensor tractography has appeared as a new modality which allows three-dimensional display of facial nerve fibers. PMID:23766904

  1. Parotid lymphangioma associated with facial nerve paralysis.

    PubMed

    Imaizumi, Mitsuyoshi; Tani, Akiko; Ogawa, Hiroshi; Omori, Koichi

    2014-10-01

    Parotid lymphangioma is a relatively rare disease that is usually detected in infancy or early childhood, and which has typical features. Clinical reports of facial nerve paralysis caused by lymphangioma, however, are very rare. Usually, facial nerve paralysis in a child suggests malignancy. Here we report a very rare case of parotid lymphangioma associated with facial nerve paralysis. A 7-year-old boy was admitted to hospital with a rapidly enlarging mass in the left parotid region. Left peripheral-type facial nerve paralysis was also noted. Computed tomography and magnetic resonance imaging also revealed multiple cystic lesions. Open biopsy was undertaken in order to investigate the cause of the facial nerve paralysis. The histopathological findings of the excised tumor were consistent with lymphangioma. Prednisone (40 mg/day) was given in a tapering dose schedule. Facial nerve paralysis was completely cured 1 month after treatment. There has been no recurrent facial nerve paralysis for eight years.

  2. Man-machine collaboration using facial expressions

    NASA Astrophysics Data System (ADS)

    Dai, Ying; Katahera, S.; Cai, D.

    2002-09-01

    For realizing the flexible man-machine collaboration, understanding of facial expressions and gestures is not negligible. In our method, we proposed a hierarchical recognition approach, for the understanding of human emotions. According to this method, the facial AFs (action features) were firstly extracted and recognized by using histograms of optical flow. Then, based on the facial AFs, facial expressions were classified into two calsses, one of which presents the positive emotions, and the other of which does the negative ones. Accordingly, the facial expressions belonged to the positive class, or the ones belonged to the negative class, were classified into more complex emotions, which were revealed by the corresponding facial expressions. Finally, the system architecture how to coordinate in recognizing facil action features and facial expressions for man-machine collaboration was proposed.

  3. An imaging study of the facial nerve canal in congenital aural atresia.

    PubMed

    Zhao, Shouqin; Han, Demin; Wang, Zhenchang; Li, Jie; Qian, Yanni; Ren, Yuanyuan; Dong, Jiyong

    2015-01-01

    We conducted a prospective study to investigate the abnormalities of the facial nerve canal in patients with congenital aural atresia by computed tomography (CT). Our study population was made up of 99 patients--68 males and 31 females, aged 6 to 22 years (mean: 13.5)--who had unilateral congenital aural atresia without any inner ear malformations. We compared our findings in these patients with those in 50 controls-33 males and 17 females, aged 5 to 22 years (mean: 15.0)-who had normal ears. We classified the congenital aural atresia patients into three groups (A, B, and C) according to their Jahrsdoerfer grading scale score (≥8; 6 or 7; and ≤5, respectively). The course of the facial nerve canal in both the controls and the study patients was determined by temporal bone CT with multiplanar reconstruction. The distances from different parts of the facial nerve canal to surrounding structures were also measured. The course of the facial nerve canal in the normal ears did not vary much, and there were no statistically significant differences according to head side and sex. In groups B and C, the tympanic segment, mastoid segment, and angle of the second genu of the facial nerve canal were all significantly smaller than those of the controls (p < 0.01 in all cases). Statistically, the tympanic segment of the facial nerve canal in patients with congenital aural atresia was downwardly displaced. The mastoid segment of the facial nerve canal in these patients was more anterior than that of the controls. We conclude that congenital aural atresia is often accompanied by abnormalities of the facial nerve canal, especially in the tympanic segment, the mastoid segment, and the second genu. We found that the lower the Jahrsdoerfer score was, the shorter the tympanic segment was and the more forward the mastoid segment was.

  4. Genetic factors that increase male facial masculinity decrease facial attractiveness of female relatives.

    PubMed

    Lee, Anthony J; Mitchem, Dorian G; Wright, Margaret J; Martin, Nicholas G; Keller, Matthew C; Zietsch, Brendan P

    2014-02-01

    For women, choosing a facially masculine man as a mate is thought to confer genetic benefits to offspring. Crucial assumptions of this hypothesis have not been adequately tested. It has been assumed that variation in facial masculinity is due to genetic variation and that genetic factors that increase male facial masculinity do not increase facial masculinity in female relatives. We objectively quantified the facial masculinity in photos of identical (n = 411) and nonidentical (n = 782) twins and their siblings (n = 106). Using biometrical modeling, we found that much of the variation in male and female facial masculinity is genetic. However, we also found that masculinity of male faces is unrelated to their attractiveness and that facially masculine men tend to have facially masculine, less-attractive sisters. These findings challenge the idea that facially masculine men provide net genetic benefits to offspring and call into question this popular theoretical framework.

  5. Genetic Factors That Increase Male Facial Masculinity Decrease Facial Attractiveness of Female Relatives

    PubMed Central

    Lee, Anthony J.; Mitchem, Dorian G.; Wright, Margaret J.; Martin, Nicholas G.; Keller, Matthew C.; Zietsch, Brendan P.

    2014-01-01

    For women, choosing a facially masculine man as a mate is thought to confer genetic benefits to offspring. Crucial assumptions of this hypothesis have not been adequately tested. It has been assumed that variation in facial masculinity is due to genetic variation and that genetic factors that increase male facial masculinity do not increase facial masculinity in female relatives. We objectively quantified the facial masculinity in photos of identical (n = 411) and nonidentical (n = 782) twins and their siblings (n = 106). Using biometrical modeling, we found that much of the variation in male and female facial masculinity is genetic. However, we also found that masculinity of male faces is unrelated to their attractiveness and that facially masculine men tend to have facially masculine, less-attractive sisters. These findings challenge the idea that facially masculine men provide net genetic benefits to offspring and call into question this popular theoretical framework. PMID:24379153

  6. Emotional Empathy and Facial Mimicry for Static and Dynamic Facial Expressions of Fear and Disgust.

    PubMed

    Rymarczyk, Krystyna; Żurawski, Łukasz; Jankowiak-Siuda, Kamila; Szatkowska, Iwona

    2016-01-01

    Facial mimicry is the tendency to imitate the emotional facial expressions of others. Increasing evidence suggests that the perception of dynamic displays leads to enhanced facial mimicry, especially for happiness and anger. However, little is known about the impact of dynamic stimuli on facial mimicry for fear and disgust. To investigate this issue, facial EMG responses were recorded in the corrugator supercilii, levator labii, and lateral frontalis muscles, while participants viewed static (photos) and dynamic (videos) facial emotional expressions. Moreover, we tested whether emotional empathy modulated facial mimicry for emotional facial expressions. In accordance with our predictions, the highly empathic group responded with larger activity in the corrugator supercilii and levator labii muscles. Moreover, dynamic compared to static facial expressions of fear revealed enhanced mimicry in the high-empathic group in the frontalis and corrugator supercilii muscles. In the low-empathic group the facial reactions were not differentiated between fear and disgust for both dynamic and static facial expressions. We conclude that highly empathic subjects are more sensitive in their facial reactions to the facial expressions of fear and disgust compared to low empathetic counterparts. Our data confirms that personal characteristics, i.e., empathy traits as well as modality of the presented stimuli, modulate the strength of facial mimicry. In addition, measures of EMG activity of the levator labii and frontalis muscles may be a useful index of empathic responses of fear and disgust.

  7. Emotional Empathy and Facial Mimicry for Static and Dynamic Facial Expressions of Fear and Disgust

    PubMed Central

    Rymarczyk, Krystyna; Żurawski, Łukasz; Jankowiak-Siuda, Kamila; Szatkowska, Iwona

    2016-01-01

    Facial mimicry is the tendency to imitate the emotional facial expressions of others. Increasing evidence suggests that the perception of dynamic displays leads to enhanced facial mimicry, especially for happiness and anger. However, little is known about the impact of dynamic stimuli on facial mimicry for fear and disgust. To investigate this issue, facial EMG responses were recorded in the corrugator supercilii, levator labii, and lateral frontalis muscles, while participants viewed static (photos) and dynamic (videos) facial emotional expressions. Moreover, we tested whether emotional empathy modulated facial mimicry for emotional facial expressions. In accordance with our predictions, the highly empathic group responded with larger activity in the corrugator supercilii and levator labii muscles. Moreover, dynamic compared to static facial expressions of fear revealed enhanced mimicry in the high-empathic group in the frontalis and corrugator supercilii muscles. In the low-empathic group the facial reactions were not differentiated between fear and disgust for both dynamic and static facial expressions. We conclude that highly empathic subjects are more sensitive in their facial reactions to the facial expressions of fear and disgust compared to low empathetic counterparts. Our data confirms that personal characteristics, i.e., empathy traits as well as modality of the presented stimuli, modulate the strength of facial mimicry. In addition, measures of EMG activity of the levator labii and frontalis muscles may be a useful index of empathic responses of fear and disgust. PMID:27933022

  8. Bone Cancer

    MedlinePlus

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another ... more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 and ...

  9. Bone Diseases

    MedlinePlus

    Your bones help you move, give you shape and support your body. They are living tissues that rebuild constantly ... childhood and your teens, your body adds new bone faster than it removes old bone. After about ...

  10. Bone Metastasis

    MedlinePlus

    ... metastasis, surgeons can stabilize the bone using metal plates, screws and nails (orthopedic fixation). Orthopedic fixation can ... that can't be easily reinforced with metal plates or screws, such as pelvic bones and bones ...

  11. Stump lengthening procedure with modular endoprostheses - the better alternative to disarticulations of the hip joint?

    PubMed

    Henrichs, Marcel-Philipp; Singh, Gurpal; Gosheger, Georg; Nottrott, Markus; Streitbuerger, Arne; Hardes, Jendrik

    2015-04-01

    We report outcomes of 28 patients after stump-lengthening procedures (SLPs) with modular tumor endoprostheses following high-thigh amputation and hip disarticulation over 11years. Mean follow up was 41.3months (range 7.4 to 133.6months). Mean Musculoskeletal Tumour Society Score was 56% (n=11); ten out of eleven patients alive used an exoprosthesis regularly. Complications occurred in 15 patients with infection being most common. In 2 cases, the prostheses had to be explanted. Our data suggest that SLP facilitates post-operative rehabilitation and prosthesis usage. Modular endoprostheses for stump-lengthening allow optimization of remnant soft-tissue envelope, reducing the risk of stump perforation.

  12. [Spectrum of indications for intramedullary or external fixators for axis correction and limb lengthening].

    PubMed

    Schiedel, F; Rödl, R

    2013-12-01

    Corrective osteotomy is a well established operative option for correction of predominantly congenital skeletal deformities on the growing skeleton. The indications for the use of a suitable corrective instrument result partly from the location, severity of the deformity and the presence of concomitant leg length discrepancies. External fixators are predominantly used for correction of combined deformities. For isolated leg length differences limb lengthening nails can be implanted but only after growth plates have become closed; however, only a few combined deformities can be addressed in this way. Often several surgical steps are necessary. A careful treatment plan can only be created if the analysis of the deformity is carried out with appropriate parameters and a correct prognosis of the further development. The aim of this paper is to describe the indications for the corrective instruments, the planning of corrections and the presentation of typical indications for axis correction and limb lengthening.

  13. Esthetic Rehabilitation through Crown Lengthening Surgery and Conservative CAD/CAM Veneers: A Multidisciplinary Case Report

    PubMed Central

    Soares, Fernando Peixoto; Gallo, Mauricio

    2016-01-01

    This case report describes a successful multidisciplinary approach used to improve the smile esthetics of a patient presenting with excessive gingival display, asymmetric gingival margins, and small upper anterior teeth and lower anterior teeth. The treatment combined esthetic crown lengthening, dental bleaching, and restorative dentistry using CAD/CAM veneer. The 6-month follow-up examination confirmed the stability of the modification and absence of adverse effects. PMID:27668099

  14. Achilles Tendon Rupture: Avoiding Tendon Lengthening during Surgical Repair and Rehabilitation

    PubMed Central

    Maquirriain, Javier

    2011-01-01

    Achilles tendon rupture is a serious injury for which the best treatment is still controversial. Its primary goal should be to restore normal length and tension, thus obtaining an optimal function. Tendon elongation correlates significantly with clinical outcome; lengthening is an important cause of morbidity and may produce permanent functional impairment. In this article, we review all factors that may influence the repair, including the type of surgical technique, suture material, and rehabilitation program, among many others. PMID:21966048

  15. Sport-Related Maxillo-Facial Fractures.

    PubMed

    Ruslin, Muhammad; Boffano, Paolo; ten Brincke, Y J D; Forouzanfar, Tymour; Brand, Henk S

    2016-01-01

    Sports and exercise are important causes of maxillofacial injuries. Different types of sports might differ in frequency and type of fractures. The aim of the present study was to explore the possible relation between the types of sport practiced and the frequency and nature of the facial bone fractures of patients presenting in an oral and maxillofacial surgery department of a Dutch university center. This study is based on an analysis of patient records containing maxillofacial fractures sustained between January 1, 2000 and April 1, 2014 at the Vrije Universiteit University Medical Center (VUmc) in Amsterdam, The Netherlands. The present study comprised data from 108 patients with 128 maxillofacial fractures. Seventy-nine percent of the patients were male and 21% were female. The patients ranged in age from 10 to 64 years old with a mean age of 30.6 ± 12.0. The highest incidence of sport-related maxillofacial fractures occurred in individuals between the ages of 20 and 29. The most common sport-related fractures were zygoma complex fractures, followed by mandible fractures. Soccer and hockey were the most prominent causes of sport-related maxillofacial trauma in the present study. Coronoid process fractures were only observed in soccer players and not in other sports groups. Mandible angle fractures were relatively more frequent in rugby than in other sports. The results of this study suggest a relation between type of sport and the nature and frequency of the fractures it causes.

  16. Reduced activation in isometric muscle action after lengthening contractions is not accompanied by reduced performance fatigability

    PubMed Central

    Seiberl, W.; Hahn, D.; Paternoster, F. K.

    2016-01-01

    After active lengthening contractions, a given amount of force can be maintained with less muscle activation compared to pure isometric contractions at the same muscle length and intensity. This increase in neuromuscular efficiency is associated with mechanisms of stretch-induced residual force enhancement. We hypothesized that stretch-related increase in neuromuscular efficiency reduces fatigability of a muscle during submaximal contractions. 13 subjects performed 60 s isometric knee extensions at 60% of maximum voluntary contraction (MVC) with and without prior stretch (60°/s, 20°). Each 60 s trial was preceded and followed by neuromuscular tests consisting of MVCs, voluntary activation (VA) and resting twitches (RT), and there was 4 h rest between sets. We found a significant (p = 0.036) 10% reduction of quadriceps net-EMG after lengthening compared to pure isometric trials. However, increase in neuromuscular efficiency did not influence the development of fatigue. Albeit we found severe reduction of MVC (30%), RT (30%) and VA (5%) after fatiguing trials, there were no differences between conditions with and without lengthening. As the number of subjects showing no activation reduction increased with increasing contraction time, intensity may have been too strenuous in both types of contractions, such that a distinction between different states of fatigue was not possible anymore. PMID:27966620

  17. Active finite element analysis of skeletal muscle-tendon complex during isometric, shortening and lengthening contraction.

    PubMed

    Tsui, C P; Tang, C Y; Leung, C P; Cheng, K W; Ng, Y F; Chow, D H K; Li, C K

    2004-01-01

    An active finite element model was developed to predict the mechanical behaviors of skeletal muscle-tendon complex during isometric, shortening and lengthening contraction. The active finite element was created through incorporation of a user-defined material property into ABAQUS finite element code. The active finite element is controlled by a motor element that is activated by a mathematical function. The nonlinear passive behavior of the muscle was defined by the viscoelastic elements and can be easily altered to other properties by using other elements in the material library without the need of re-defining the constitutive relation of the muscle. The isometric force-length relationship, force-strain relations of the muscle-tendon complex during both shortening and lengthening contraction and muscle relaxation response were predicted using the proposed finite element model. The predicted results were found to be in good agreement with available experimental data. In addition, the stress distribution in the muscle-tendon complex during isometric, shortening and lengthening contractions was simulated. The location of the maximum stress may provide useful information for studying muscle damage and fatigue in the future.

  18. Utilization and efficacy of computational gait analysis for hamstring lengthening surgery.

    PubMed

    MacWilliams, Bruce A; Stotts, Alan K; Carroll, Kristen L; D'Astous, Jacques L

    2016-09-01

    A retrospective analysis of computational gait studies performed in a single lab over a 12 year period was undertaken to characterize how recommendations to perform or not to perform hamstring lengthenings were utilized by physicians and the effect on outcomes. 131 Subjects were identified as either having hamstring lengthening considered by the referring surgeon, recommended by gait analysis data, or performed. A subset of this data meeting inclusion criteria for pre- and post-surgical timeframes, and bilateral diagnosis was further analyzed to assess the efficacy of the recommendations. There was initial agreement between planned procedures and recommended procedures in just 41% of the cases. Including the cases where there was agreement, gait analysis altered the initial procedure in 54%. In the cases where the initial plan was not supported by gait data, surgeons followed gait recommendations in 77%. In subjects who underwent hamstring lengthening, when surgeons followed or agreed with gait recommendations, patients were 3.6 times more likely to experience a positive outcome.

  19. Analysis of scar formation after lower limb lengthening: influence on cosmesis and patient satisfaction.

    PubMed

    Karlen, Law Ka Pui; Yinusa, Wahab; Yan, Lam Shuk; Wang, Kwan Wing; Hoi, Li Yun; John, Leong Chi Yan

    2004-01-01

    Limb lengthening aims to reduce limb length discrepancy, improve cosmesis, and permit more functional mobility. Scarring, however, is a major concern of patients. In this study 25 patients (27 lengthening sites) were assessed; 6 sites were lengthened with Orthofix and 21 sites with Ilizarov. Altogether, 452 pin tract scars were assessed. The mean scar length was 11.5 mm in the Ilizarov group (n=415) and 54.1 mm in the Orthofix group (n=37). The mean scar width was 5.6 mm in the Ilizarov group and 11.5 mm in the Orthofix group. The mean patient satisfaction was 7.3 in the Orthofix group and 5.5 in the Ilizarov group. The mean Vancouver score was 0.66 in the Ilizarov group and 3.1 in the Orthofix group. The scars were shorter and cosmetically better in the Ilizarov group, but patients were more satisfied in the Orthofix group because there were fewer scars. Patients were also more satisfied with the thigh scars than with the leg scars because clothing can easily cover the thigh scars.

  20. Facial morphology and obstructive sleep apnea

    PubMed Central

    Capistrano, Anderson; Cordeiro, Aldir; Capelozza, Leopoldino; Almeida, Veridiana Correia; Silva, Priscila Izabela de Castro e; Martinez, Sandra; de Almeida-Pedrin, Renata Rodrigues

    2015-01-01

    Objective: This study aimed at assessing the relationship between facial morphological patterns (I, II, III, Long Face and Short Face) as well as facial types (brachyfacial, mesofacial and dolichofacial) and obstructive sleep apnea (OSA) in patients attending a center specialized in sleep disorders. Methods: Frontal, lateral and smile photographs of 252 patients (157 men and 95 women), randomly selected from a polysomnography clinic, with mean age of 40.62 years, were evaluated. In order to obtain diagnosis of facial morphology, the sample was sent to three professors of Orthodontics trained to classify patients' face according to five patterns, as follows: 1) Pattern I; 2) Pattern II; 3) Pattern III; 4) Long facial pattern; 5) Short facial pattern. Intraexaminer agreement was assessed by means of Kappa index. The professors ranked patients' facial type based on a facial index that considers the proportion between facial width and height. Results: The multiple linear regression model evinced that, when compared to Pattern I, Pattern II had the apnea and hypopnea index (AHI) worsened in 6.98 episodes. However, when Pattern II was compared to Pattern III patients, the index for the latter was 11.45 episodes lower. As for the facial type, brachyfacial patients had a mean AHI of 22.34, while dolichofacial patients had a significantly statistical lower index of 10.52. Conclusion: Patients' facial morphology influences OSA. Pattern II and brachyfacial patients had greater AHI, while Pattern III patients showed a lower index. PMID:26691971

  1. Enhanced Corticospinal Excitability and Volitional Drive in Response to Shortening and Lengthening Strength Training and Changes Following Detraining

    PubMed Central

    Tallent, Jamie; Goodall, Stuart; Gibbon, Karl C.; Hortobágyi, Tibor; Howatson, Glyn

    2017-01-01

    There is a limited understanding of the neurological adaptations responsible for changes in strength following shortening and lengthening resistance training and subsequent detraining. The aim of the study was to investigate differences in corticospinal and spinal responses to resistance training of the tibialis anterior muscle between shortening or lengthening muscle contractions for 4 weeks and after 2 weeks of detraining. Thirty-one untrained individuals were assigned to either shortening or lengthening isokinetic resistance training (4 weeks, 3 days/weeks) or a non-training control group. Transcranial magnetic stimulation and peripheral nerve stimulation (PNS) were used to assess corticospinal and spinal changes, respectively, at pre-, mid-, post-resistance training and post detraining. Greater increases changes (P < 0.01) in MVC were found from the respective muscle contraction training. Motor evoked potentials (expressed relative to background EMG) significantly increased in lengthening resistance training group under contraction intensities ranging from 25 to 80% of the shortening and lengthening contraction intensity (P < 0.01). In the shortening resistance training group increases were only seen at 50 and 80% of both contraction type. Volitional drive (V-wave) showed a greater increase following lengthening resistance training (57%) during maximal lengthening contractions compared to maximal shortening contractions following shortening resistance training (23%; P < 0.001). During the detraining period MVC and V-wave did not change (P > 0.05), although MEP amplitude decreased during the detraining period (P < 0.01). No changes in H-reflex were found pre to post resistance training or post detraining. Modulation in V-wave appeared to be contraction specific, whereby greatest increases occurred following lengthening resistance training. Strength and volitional drive is maintained following 2 weeks detraining, however corticospinal excitability appears to

  2. [Biomechanical studies of forces occurring in the Ilizarov and Orthofix apparatuses during limb lengthening by distractive osteogenesis].

    PubMed

    Snela, S; Kisiel, J; Gregosiewicz, A; Dziubiński, F

    2000-01-01

    The magnitude of the distractive forces occurring in the Ilizarov and Orthofix apparatuses during limb lengthening by distractive osteogenesis has been investigated. Eighteen patients treated between 1995 and 1998 were included in the study. The data obtained were computerized and related to clinical, radiographic and sonographic findings. Typical and repeatable graphs of forces were found during the process of lengthening as well as typical relationships between the callus and the values of distractive forces.

  3. Bone and bone turnover.

    PubMed

    Crofton, Patricia M

    2009-01-01

    Children with cancer are exposed to multiple influences that may adversely affect bone health. Some treatments have direct deleterious effects on bone whilst others may have indirect effects mediated through various endocrine abnormalities. Most clinical outcome studies have concentrated on survivors of acute lymphoblastic leukaemia (ALL). There is now good evidence that earlier treatment protocols that included cranial irradiation with doses of 24 Gy or greater may result in growth hormone deficiency and low bone mineral density (BMD) in the lumbar spine and femoral neck. Under current protocols, BMD decreases during intensive chemotherapy and fracture risk increases. Although total body BMD may eventually return to normal after completion of chemotherapy, lumbar spine trabecular BMD may remain low for many years. The implications for long-term fracture risk are unknown. Risk factors for low BMD include high dose methotrexate, higher cumulative doses of glucocorticoids, male gender and low physical activity. BMD outcome in non-ALL childhood cancers has been less well studied but there is evidence that survivors of childhood brain or bone tumours, and survivors of bone marrow transplants for childhood malignancy, all have a high risk of long-term osteopenia. Long-term follow-up is required, with appropriate treatment of any endocrine abnormalities identified.

  4. Florid reactive periostitis of the forearm bones in a child.

    PubMed

    Mathew, S E; Madhuri, V; Alexander, M; Walter, N M; Gibikote, S V

    2011-03-01

    Florid reactive periostitis is a pronounced periosteal reaction, usually affecting the hands and feet, for which there is no obvious cause. It is rare in children and in long bones. We report an unusual case of florid reactive periostitis in a ten-year-old girl that involved both bones of the forearm. The lesion resolved over a period of one year, leaving a residual exostosis. She developed a physeal bar in the distal ulna in the region of the lesion at one-year follow-up. This was thought to be a complication of the biopsy procedure and was treated by resection and proximal ulnar lengthening.

  5. Aging and facial changes--documenting clinical signs, part 1: clinical changes of the aging face.

    PubMed

    Nkengne, Alex; Bertin, Christiane

    2012-01-01

    The process of aging induces the transformation of the face with changes that are usually classified as either chronological or photo induced and that affect the shape, the texture, and the color of the face. Facial shape is mainly transformed by the evolution of bones and soft tissues (muscles, fat, and skin) in addition to noticeable effects of gravity. Skin texture is mainly determined by wrinkles, which arise from atrophy of the skin layers, elastosis, and facial expressions. Skin color is related to the distribution of skin chromophores and the structure of the dermis, which affects light scattering. All facial changes are dependant on sex, ethnicity, and lifestyle. They affect self-perception and social interactions and can sometimes be slowed down or reversed using appropriate clinical procedures (e.g., dermatological, surgical, and cosmetic interventions).

  6. Aging and facial changes--documenting clinical signs, part 1: clinical changes of the aging face.

    PubMed

    Nkengne, Alex; Bertin, Christiane

    2013-01-01

    The process of aging induces the transformation of the face with changes that are usually classified as either chronological or photo-induced and that affect the shape, the texture, and the color of the face. Facial shape is mainly transformed by the evolution of bones and soft tissues (muscles, fat, and skin) in addition to noticeable effects of gravity. Skin texture is mainly determined by wrinkles, which arise from atrophy of the skin layers, elastosis, and facial expressions. Skin color is related to the distribution of skin chromophores and the structure of the dermis, which affects light scattering. All facial changes are dependant on sex, ethnicity, and lifestyle. They affect self-perception and social interactions and can sometimes be slowed down or reversed using appropriate clinical procedures (eg, dermatological, surgical, cosmetic interventions).

  7. Treatment with selectin blocking antibodies after lengthening contractions of mouse muscle blunts neutrophil accumulation but does not reduce damage.

    PubMed

    Sloboda, Darcée D; Brooks, Susan V

    2016-01-01

    P- and E-selectins are expressed on the surface of endothelial cells and may contribute to neutrophil recruitment following injurious lengthening contractions of skeletal muscle. Blunting neutrophil, but not macrophage, accumulation after lengthening contractions may provide a therapeutic benefit as neutrophils exacerbate damage to muscle fibers, while macrophages promote repair. In this study, we tested the hypothesis that P- and E-selectins contribute to neutrophil, but not macrophage, accumulation in muscles after contraction-induced injury, and that reducing neutrophil accumulation by blocking the selectins would be sufficient to reduce damage to muscle fibers. To test our hypothesis, we treated mice with antibodies to block P- and E-selectin function and assessed leukocyte accumulation and damage in muscles 2 days after lengthening contractions. Treatment with P/E-selectin blocking antibodies reduced neutrophil content by about half in muscles subjected to lengthening contractions. In spite of the reduction in neutrophil accumulation, we did not detect a decrease in damage 2 days after lengthening contractions. We conclude that P- and/or E-selectin contribute to the neutrophil accumulation associated with contraction-induced muscle damage and that only a portion of the neutrophils that typically accumulate following injurious lengthening contractions is sufficient to induce muscle fiber damage and force deficits. Thus, therapeutic interventions based on blocking the selectins or other adhesion proteins will have to reduce neutrophil numbers by more than 50% in order to provide a benefit.

  8. [Facial paralysis surgery. Current concepts].

    PubMed

    Robla-Costales, David; Robla-Costales, Javier; Socolovsky, Mariano; di Masi, Gilda; Fernández, Javier; Campero, Álvaro

    2015-01-01

    Facial palsy is a relatively common condition, from which most cases recover spontaneously. However, each year, there are 127,000 new cases of irreversible facial paralysis. This condition causes aesthetic, functional and psychologically devastating effects in the patients who suffer it. Various reconstructive techniques have been described, but there is no consensus regarding their indication. While these techniques provide results that are not perfect, many of them give a very good aesthetic and functional result, promoting the psychological, social and labour reintegration of these patients. The aim of this article is to describe the indications for which each technique is used, their results and the ideal time when each one should be applied.

  9. Treatments for unwanted facial hair.

    PubMed

    Shapiro, J; Lui, H

    Twenty-two percent of women in North America have unwanted facial hair, which can cause embarrassment and result in a significant emotional burden. Treatment options include plucking, waxing (including the sugar forms), depilatories, bleaching, shaving, electrolysis, laser, intense pulsed light (IPL), and eflornithine 13.9% cream (Vaniqa, Barrier Therapeutics in Canada and Shire Pharmaceuticals elsewhere). Eflornithine 13.9% cream is a topical treatment that does not remove the hairs, but acts to reduce the rate of growth and appears to be effective for unwanted facial hair on the mustache and chin area. Eflornithine 13.9% cream can be used in combination with other treatments such as lasers and IPL to give the patient the best chance for successful hair removal.

  10. Molecular control of facial morphology

    PubMed Central

    Liu, B.; Rooker, S.M.; Helms, J.A.

    2010-01-01

    We present a developmental perspective on the concept of phylotypic and phenotypic stages of craniofacial development. Within Orders of avians and mammals, a phylotypic period exists when the morphology of the facial prominences is minimally divergent. We postulate that species-specific facial variations arise as a result of subtle shifts in the timing and the duration of molecular pathway activity (e.g., heterochrony), and present evidence demonstrating a critical role for Wnt and FGF signaling in this process. The same molecular pathways that shape the vertebrate face are also implicated in craniofacial deformities, indicating that comparisons between and among animal species may represent a novel method for the identification of human craniofacial disease genes. PMID:19747977

  11. Computer Recognition of Facial Profiles

    DTIC Science & Technology

    1974-08-01

    effective in identifying those feature vectors which are of most importance in the recognition process . Thus the training procedure generally produces...ga Ente#lodI- i COMPUTER RECOGNITTON OF FACIAL PROFILES iU A Thesis i Presented in Partial Fulfillment of the Requirements for the Degree Master of... thesis , the suggestion that the state of the art in pattern recognition was sufficient to enable a machine capable of recognizing human faces to be built

  12. Removal of unwanted facial hair.

    PubMed

    Shenenberger, Donald W; Utecht, Lynn M

    2002-11-15

    Unwanted facial hair is a common problem that is seldom discussed in the primary care setting. Although men occasionally request removal of unwanted facial hair, women most often seek help with this condition. Physicians generally neglect to address the problem if the patient does not first request help. The condition may be caused by androgen overproduction, increased sensitivity to circulating androgens, or other metabolic and endocrine disorders, and should be properly evaluated. Options for hair removal vary in efficacy, degree of discomfort, and cost. Clinical studies on the efficacy of many therapies are lacking. Short of surgical removal of the hair follicle, the only permanent treatment is electrolysis. However, the practice of electrolysis lacks standardization, and regulation of the procedure varies from state to state. Shaving, epilation, and depilation are the most commonly attempted initial options for facial hair removal. Although these methods are less expensive, they are only temporary. Laser hair removal, although better studied than most methods and more strictly regulated, has yet to be proved permanent in all patients. Eflornithine, a topical treatment, is simple to apply and has minimal side effects. By the time most patients consult a physician, they have tried several methods of hair removal. Family physicians can properly educate patients and recommend treatment for this common condition if they are armed with basic knowledge about the treatment options.

  13. Three-Dimensional Accuracy of Facial Scan for Facial Deformities in Clinics: A New Evaluation Method for Facial Scanner Accuracy

    PubMed Central

    Zhao, Yi-jiao; Xiong, Yu-xue; Wang, Yong

    2017-01-01

    In this study, the practical accuracy (PA) of optical facial scanners for facial deformity patients in oral clinic was evaluated. Ten patients with a variety of facial deformities from oral clinical were included in the study. For each patient, a three-dimensional (3D) face model was acquired, via a high-accuracy industrial “line-laser” scanner (Faro), as the reference model and two test models were obtained, via a “stereophotography” (3dMD) and a “structured light” facial scanner (FaceScan) separately. Registration based on the iterative closest point (ICP) algorithm was executed to overlap the test models to reference models, and “3D error” as a new measurement indicator calculated by reverse engineering software (Geomagic Studio) was used to evaluate the 3D global and partial (upper, middle, and lower parts of face) PA of each facial scanner. The respective 3D accuracy of stereophotography and structured light facial scanners obtained for facial deformities was 0.58±0.11 mm and 0.57±0.07 mm. The 3D accuracy of different facial partitions was inconsistent; the middle face had the best performance. Although the PA of two facial scanners was lower than their nominal accuracy (NA), they all met the requirement for oral clinic use. PMID:28056044

  14. Three-Dimensional Accuracy of Facial Scan for Facial Deformities in Clinics: A New Evaluation Method for Facial Scanner Accuracy.

    PubMed

    Zhao, Yi-Jiao; Xiong, Yu-Xue; Wang, Yong

    2017-01-01

    In this study, the practical accuracy (PA) of optical facial scanners for facial deformity patients in oral clinic was evaluated. Ten patients with a variety of facial deformities from oral clinical were included in the study. For each patient, a three-dimensional (3D) face model was acquired, via a high-accuracy industrial "line-laser" scanner (Faro), as the reference model and two test models were obtained, via a "stereophotography" (3dMD) and a "structured light" facial scanner (FaceScan) separately. Registration based on the iterative closest point (ICP) algorithm was executed to overlap the test models to reference models, and "3D error" as a new measurement indicator calculated by reverse engineering software (Geomagic Studio) was used to evaluate the 3D global and partial (upper, middle, and lower parts of face) PA of each facial scanner. The respective 3D accuracy of stereophotography and structured light facial scanners obtained for facial deformities was 0.58±0.11 mm and 0.57±0.07 mm. The 3D accuracy of different facial partitions was inconsistent; the middle face had the best performance. Although the PA of two facial scanners was lower than their nominal accuracy (NA), they all met the requirement for oral clinic use.

  15. Retrospective case series of the imaging findings of facial nerve hemangioma.

    PubMed

    Yue, Yunlong; Jin, Yanfang; Yang, Bentao; Yuan, Hui; Li, Jiandong; Wang, Zhenchang

    2015-09-01

    The aim was to compare high-resolution computed tomography (HRCT) and thin-section magnetic resonance imaging (MRI) findings of facial nerve hemangioma. The HRCT and MRI characteristics of 17 facial nerve hemangiomas diagnosed between 2006 and 2013 were retrospectively analyzed. All patients included in the study suffered from a space-occupying lesion of soft tissues at the geniculate ganglion fossa. Affected nerve was compared for size and shape with the contralateral unaffected nerve. HRCT showed irregular expansion and broadening of the facial nerve canal, damage of the bone wall and destruction of adjacent bone, with "point"-like or "needle"-like calcifications in 14 cases. The average CT value was 320.9 ± 141.8 Hu. Fourteen patients had a widened labyrinthine segment; 6/17 had a tympanic segment widening; 2/17 had a greater superficial petrosal nerve canal involvement, and 2/17 had an affected internal auditory canal (IAC) segment. On MRI, all lesions were significantly enhanced due to high blood supply. Using 2D FSE T2WI, the lesion detection rate was 82.4 % (14/17). 3D fast imaging employing steady-state acquisition (3D FIESTA) revealed the lesions in all patients. HRCT showed that the average number of involved segments in the facial nerve canal was 2.41, while MRI revealed an average of 2.70 segments (P < 0.05). HRCT and MR findings of facial nerve hemangioma were typical, revealing irregular masses growing along the facial nerve canal, with calcifications and rich blood supply. Thin-section enhanced MRI was more accurate in lesion detection and assessment compared with HRCT.

  16. Freestyle Local Perforator Flaps for Facial Reconstruction.

    PubMed

    Lee, Jun Yong; Kim, Ji Min; Kwon, Ho; Jung, Sung-No; Shim, Hyung Sup; Kim, Sang Wha

    2015-01-01

    For the successful reconstruction of facial defects, various perforator flaps have been used in single-stage surgery, where tissues are moved to adjacent defect sites. Our group successfully performed perforator flap surgery on 17 patients with small to moderate facial defects that affected the functional and aesthetic features of their faces. Of four complicated cases, three developed venous congestion, which resolved in the subacute postoperative period, and one patient with partial necrosis underwent minor revision. We reviewed the literature on freestyle perforator flaps for facial defect reconstruction and focused on English articles published in the last five years. With the advance of knowledge regarding the vascular anatomy of pedicled perforator flaps in the face, we found that some perforator flaps can improve functional and aesthetic reconstruction for the facial defects. We suggest that freestyle facial perforator flaps can serve as alternative, safe, and versatile treatment modalities for covering small to moderate facial defects.

  17. Objective facial photograph analysis using imaging software.

    PubMed

    Pham, Annette M; Tollefson, Travis T

    2010-05-01

    Facial analysis is an integral part of the surgical planning process. Clinical photography has long been an invaluable tool in the surgeon's practice not only for accurate facial analysis but also for enhancing communication between the patient and surgeon, for evaluating postoperative results, for medicolegal documentation, and for educational and teaching opportunities. From 35-mm slide film to the digital technology of today, clinical photography has benefited greatly from technological advances. With the development of computer imaging software, objective facial analysis becomes easier to perform and less time consuming. Thus, while the original purpose of facial analysis remains the same, the process becomes much more efficient and allows for some objectivity. Although clinical judgment and artistry of technique is never compromised, the ability to perform objective facial photograph analysis using imaging software may become the standard in facial plastic surgery practices in the future.

  18. Evaluation of craniofacial surgery in the treatment of facial deformities.

    PubMed Central

    Murray, J E; Swanson, L T; Strand, R D; Hricko, G M

    1975-01-01

    Surgical access to the cranial, orbital, and facial areas, as developed by Tessier, has produced not only definitive repair of previously uncorrectable congenital deformities such as orbital hypertelorism and facial stenosis (e.g., Crouzon's, Apert's syndromes) but also has improved markedly the treatment of traumatic and neoplastic defects. The surgical approach allows complete dissection of facial soft tisses including the orbits from the underlying bones followed by corrective osteotomies and fixation. Mobilization of the frontal lobes through a frontal bone flap exposure may be required. The ramifications of this latest intrusion by surgeons into a previously inviolate anatomic area have involved neurosurgeons, ophthalmologists, anesthesiologists, and dental and psycho-social disciplines. The disciplines of genetics and embryology are being influenced by this new field of surgery, much as the study of immunology was influenced by transplantation surgery two decades ago. This report analyzes a 10 year experience with over 100 patients with emphasis on patient selection by disease, age, intellectual status, morbidity, complications, and the psycho-social reactions of patient and family. Procedures initially planned to correct dental and aesthetic defects are proving beneficial for other functions including hearing, taste and smell, articulation and tongue movement, respiratory function, vision, and possibly bone growth. The development of self image, a normal process always in operation, is also strikingly altered. These operations may last as long as 14 to 16 hours. We have had no deaths or postoperative blindness. One postoperative cerebrospinal fluid leak was successfully repaired. Three partial losses of bone grafts and four instances of late cellulitis have occurred. Prevention of infection seems related to avoidance of dead spaces and primary closure of all mucosal, dural, conjunctival and skin surfaces. Images Figs. 1 a and b. Fig. 1c., Fig. 1d. Fig. 1f

  19. Postirradiation periocular granuloma faciale associated with uveitis.

    PubMed

    Nayak, Natasha V; Frohman, Larry P; Lambert, William C; Langer, Paul D

    2014-01-01

    Granuloma faciale is a rare dermatopathologic condition that presents as brown-red plaques, nodules, or papules primarily on the face, with the potential for extrafacial and mucous membrane involvement. A case of an 83-year-old woman with periocular granuloma faciale accompanied by a marked anterior uveitis is presented; an association of periocular granuloma faciale with anterior uveitis has not been previously reported.

  20. Facial nerve palsy aboard a commercial aircraft.

    PubMed

    Grossman, Alon; Ulanovski, David; Barenboim, Erez; Azaria, Bella; Goldstein, Liav

    2004-12-01

    Facial baroparesis is facial nerve palsy secondary to barotrauma. This phenomenon is frequently seen in divers, but is under-reported there and has rarely been described in aviators or passengers aboard commercial aircraft. We describe a 24-yr-old healthy aviator who experienced an episode of facial nerve palsy during ascent while traveling as a passenger aboard a commercial flight. The probable pathogenesis of this phenomenon in this case is described.

  1. Facial Feedback Mechanisms in Autistic Spectrum Disorders

    PubMed Central

    van den Heuvel, Claudia; Smeets, Raymond C.

    2008-01-01

    Facial feedback mechanisms of adolescents with Autistic Spectrum Disorders (ASD) were investigated utilizing three studies. Facial expressions, which became activated via automatic (Studies 1 and 2) or intentional (Study 2) mimicry, or via holding a pen between the teeth (Study 3), influenced corresponding emotions for controls, while individuals with ASD remained emotionally unaffected. Thus, individuals with ASD do not experience feedback from activated facial expressions as controls do. This facial feedback-impairment enhances our understanding of the social and emotional lives of individuals with ASD. PMID:18293075

  2. Neuroticism Delays Detection of Facial Expressions.

    PubMed

    Sawada, Reiko; Sato, Wataru; Uono, Shota; Kochiyama, Takanori; Kubota, Yasutaka; Yoshimura, Sayaka; Toichi, Motomi

    2016-01-01

    The rapid detection of emotional signals from facial expressions is fundamental for human social interaction. The personality factor of neuroticism modulates the processing of various types of emotional facial expressions; however, its effect on the detection of emotional facial expressions remains unclear. In this study, participants with high- and low-neuroticism scores performed a visual search task to detect normal expressions of anger and happiness, and their anti-expressions within a crowd of neutral expressions. Anti-expressions contained an amount of visual changes equivalent to those found in normal expressions compared to neutral expressions, but they were usually recognized as neutral expressions. Subjective emotional ratings in response to each facial expression stimulus were also obtained. Participants with high-neuroticism showed an overall delay in the detection of target facial expressions compared to participants with low-neuroticism. Additionally, the high-neuroticism group showed higher levels of arousal to facial expressions compared to the low-neuroticism group. These data suggest that neuroticism modulates the detection of emotional facial expressions in healthy participants; high levels of neuroticism delay overall detection of facial expressions and enhance emotional arousal in response to facial expressions.

  3. Neuroticism Delays Detection of Facial Expressions

    PubMed Central

    Sawada, Reiko; Sato, Wataru; Uono, Shota; Kochiyama, Takanori; Kubota, Yasutaka; Yoshimura, Sayaka; Toichi, Motomi

    2016-01-01

    The rapid detection of emotional signals from facial expressions is fundamental for human social interaction. The personality factor of neuroticism modulates the processing of various types of emotional facial expressions; however, its effect on the detection of emotional facial expressions remains unclear. In this study, participants with high- and low-neuroticism scores performed a visual search task to detect normal expressions of anger and happiness, and their anti-expressions within a crowd of neutral expressions. Anti-expressions contained an amount of visual changes equivalent to those found in normal expressions compared to neutral expressions, but they were usually recognized as neutral expressions. Subjective emotional ratings in response to each facial expression stimulus were also obtained. Participants with high-neuroticism showed an overall delay in the detection of target facial expressions compared to participants with low-neuroticism. Additionally, the high-neuroticism group showed higher levels of arousal to facial expressions compared to the low-neuroticism group. These data suggest that neuroticism modulates the detection of emotional facial expressions in healthy participants; high levels of neuroticism delay overall detection of facial expressions and enhance emotional arousal in response to facial expressions. PMID:27073904

  4. Periocular Reconstruction in Patients with Facial Paralysis.

    PubMed

    Joseph, Shannon S; Joseph, Andrew W; Douglas, Raymond S; Massry, Guy G

    2016-04-01

    Facial paralysis can result in serious ocular consequences. All patients with orbicularis oculi weakness in the setting of facial nerve injury should undergo a thorough ophthalmologic evaluation. The main goal of management in these patients is to protect the ocular surface and preserve visual function. Patients with expected recovery of facial nerve function may only require temporary and conservative measures to protect the ocular surface. Patients with prolonged or unlikely recovery of facial nerve function benefit from surgical rehabilitation of the periorbital complex. Current reconstructive procedures are most commonly intended to improve coverage of the eye but cannot restore blink.

  5. Social Use of Facial Expressions in Hylobatids

    PubMed Central

    Scheider, Linda; Waller, Bridget M.; Oña, Leonardo; Burrows, Anne M.; Liebal, Katja

    2016-01-01

    Non-human primates use various communicative means in interactions with others. While primate gestures are commonly considered to be intentionally and flexibly used signals, facial expressions are often referred to as inflexible, automatic expressions of affective internal states. To explore whether and how non-human primates use facial expressions in specific communicative interactions, we studied five species of small apes (gibbons) by employing a newly established Facial Action Coding System for hylobatid species (GibbonFACS). We found that, despite individuals often being in close proximity to each other, in social (as opposed to non-social contexts) the duration of facial expressions was significantly longer when gibbons were facing another individual compared to non-facing situations. Social contexts included grooming, agonistic interactions and play, whereas non-social contexts included resting and self-grooming. Additionally, gibbons used facial expressions while facing another individual more often in social contexts than non-social contexts where facial expressions were produced regardless of the attentional state of the partner. Also, facial expressions were more likely ‘responded to’ by the partner’s facial expressions when facing another individual than non-facing. Taken together, our results indicate that gibbons use their facial expressions differentially depending on the social context and are able to use them in a directed way in communicative interactions with other conspecifics. PMID:26978660

  6. Functional Endoscopic Surgery After Facial Trauma.

    PubMed

    Petrocelli, Marzia; Sbordone, Carolina; Salzano, Giovanni; Cassandro, Francesco Maria; Chiarella, Giuseppe; Scarpa, Alfonso; Romano, Antonio; Iaconetta, Giorgio; Califano, Luigi; Cassandro, Ettore

    2017-02-16

    The present study describes 3 patients of previous facial trauma who have subsequently been treated with functional endoscopic sinus surgery. The authors want pay attention on the possible correlation between facial trauma and sinusitis. Such fractures can be the cause of onset of paranasal sinusitis or of worsening of a previous sinusitis. The correlation between these 2 pathologies could be due to the fact that facial fractures concern the anatomic structures of paranasal sinuses. The damage to these structures during the facial trauma and tissue regeneration after injury or surgical treatment subverts the anatomy and function of the sinuses in a basically compromised situation.

  7. Facial Nerve Schwannoma of the Cerebellopontine Angle

    PubMed Central

    Lassaletta, Luis; Roda, José María; Frutos, Remedios; Patrón, Mercedes; Gavilán, Javier

    2002-01-01

    Facial nerve schwannomas are rare lesions that may involve any segment of the facial nerve. Because of their rarity and the lack of a consistent clinical and radiological pattern, facial nerve schwannomas located at the cerebellopontine angle (CPA) and internal auditory canal (IAC) represent a diagnostic and therapeutic challenge for clinicians. In this report, a case of a CPA/IAC facial nerve schwannoma is presented. Contemporary diagnosis and management of this rare lesion are analyzed. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5 PMID:17167683

  8. Reflectance confocal microscopy features of facial angiofibromas

    PubMed Central

    Millán-Cayetano, José-Francisco; Yélamos, Oriol; Rossi, Anthony M.; Marchetti, Michael A.; Jain, Manu

    2017-01-01

    Facial angiofibromas are benign tumors presenting as firm, dome-shaped, flesh-colored to pink papules, typically on the nose and adjoining central face. Clinically and dermoscopically they can mimic melanocytic nevi or basal cell carcinomas (BCC). Reflectance confocal microscopy (RCM) is a noninvasive imaging tool that is useful in diagnosing melanocytic and non-melanocytic facial lesions. To date no studies have described the RCM features of facial angiofibromas. Herein, we present two cases of facial angiofibromas that were imaged with RCM and revealed tumor island-like structures that mimicked BCC, leading to skin biopsy. PMID:28243496

  9. The Relationships between Processing Facial Identity, Emotional Expression, Facial Speech, and Gaze Direction during Development

    ERIC Educational Resources Information Center

    Spangler, Sibylle M.; Schwarzer, Gudrun; Korell, Monika; Maier-Karius, Johanna

    2010-01-01

    Four experiments were conducted with 5- to 11-year-olds and adults to investigate whether facial identity, facial speech, emotional expression, and gaze direction are processed independently of or in interaction with one another. In a computer-based, speeded sorting task, participants sorted faces according to facial identity while disregarding…

  10. Brain responses to facial attractiveness induced by facial proportions: evidence from an fMRI study.

    PubMed

    Shen, Hui; Chau, Desmond K P; Su, Jianpo; Zeng, Ling-Li; Jiang, Weixiong; He, Jufang; Fan, Jintu; Hu, Dewen

    2016-10-25

    Brain responses to facial attractiveness induced by facial proportions are investigated by using functional magnetic resonance imaging (fMRI), in 41 young adults (22 males and 19 females). The subjects underwent fMRI while they were presented with computer-generated, yet realistic face images, which had varying facial proportions, but the same neutral facial expression, baldhead and skin tone, as stimuli. Statistical parametric mapping with parametric modulation was used to explore the brain regions with the response modulated by facial attractiveness ratings (ARs). The results showed significant linear effects of the ARs in the caudate nucleus and the orbitofrontal cortex for all of the subjects, and a non-linear response profile in the right amygdala for only the male subjects. Furthermore, canonical correlation analysis was used to learn the most relevant facial ratios that were best correlated with facial attractiveness. A regression model on the fMRI-derived facial ratio components demonstrated a strong linear relationship between the visually assessed mean ARs and the predictive ARs. Overall, this study provided, for the first time, direct neurophysiologic evidence of the effects of facial ratios on facial attractiveness and suggested that there are notable gender differences in perceiving facial attractiveness as induced by facial proportions.

  11. Brain responses to facial attractiveness induced by facial proportions: evidence from an fMRI study

    PubMed Central

    Shen, Hui; Chau, Desmond K. P.; Su, Jianpo; Zeng, Ling-Li; Jiang, Weixiong; He, Jufang; Fan, Jintu; Hu, Dewen

    2016-01-01

    Brain responses to facial attractiveness induced by facial proportions are investigated by using functional magnetic resonance imaging (fMRI), in 41 young adults (22 males and 19 females). The subjects underwent fMRI while they were presented with computer-generated, yet realistic face images, which had varying facial proportions, but the same neutral facial expression, baldhead and skin tone, as stimuli. Statistical parametric mapping with parametric modulation was used to explore the brain regions with the response modulated by facial attractiveness ratings (ARs). The results showed significant linear effects of the ARs in the caudate nucleus and the orbitofrontal cortex for all of the subjects, and a non-linear response profile in the right amygdala for only the male subjects. Furthermore, canonical correlation analysis was used to learn the most relevant facial ratios that were best correlated with facial attractiveness. A regression model on the fMRI-derived facial ratio components demonstrated a strong linear relationship between the visually assessed mean ARs and the predictive ARs. Overall, this study provided, for the first time, direct neurophysiologic evidence of the effects of facial ratios on facial attractiveness and suggested that there are notable gender differences in perceiving facial attractiveness as induced by facial proportions. PMID:27779211

  12. Wire internal fixation: an obsolete, yet valuable method for surgical management of facial fractures

    PubMed Central

    Bouletreau, Pierre; Konsem, Tarcissus; Traoré, Ibraïma; Coulibaly, Antoine Toua; Ouédraogo, Dieudonné

    2014-01-01

    In some developing countries wire is still widely used in facial fractures internal fixation. This study presents the effectiveness and complications of wire osteosynthesis in a university teaching hospital in Burkina Faso and discusses some of its other benefits and disadvantages. Notes of 227 patients with facial fractures treated by wire internal fixation at department of stomatology and maxillofacial surgery of CHU Souro Sanou, Burkina Faso between 2006 and 2010 are reviewed retrospectively. A satisfactory treatment outcome was recorded in 91.2% of the 227 patients. Complications occurred in 8.8% of the patients who had operative site infection (3.1%), malocclusion (1.8%), sensory disturbance (1.8), facial asymmetry (1.3%), delayed bone union (0.9%) or enophtalmos (0.4%). The overall complications rate was 7.4% after mandibular osteosynthesis, 6.9% after Le Fort osteosynthesis and 6.5% after zygoma osteosynthesis. Post operative infections occurred irrespective to the surgical site. The other complications were more specific to the surgical site. Wire internal fixation may be a reasonable alternative for the surgical treatment of non-comminuted facial fractures and those without bone substance loss, in the setting of limited resources. PMID:25237416

  13. A Multivariate Analysis of Unilateral Cleft Lip and Palate Facial Skeletal Morphology.

    PubMed

    Starbuck, John M; Ghoneima, Ahmed; Kula, Katherine

    2015-07-01

    Unilateral cleft lip and palate (UCLP) occurs when the maxillary and nasal facial prominences fail to fuse correctly during development, resulting in a palatal cleft and clefted soft and hard tissues of the dentoalveolus. The UCLP deformity may compromise an individual's ability to eat, chew, and speak. In this retrospective cross-sectional study, cone beam computed tomography (CBCT) images of 7-17-year-old individuals born with UCLP (n = 24) and age- and sex-matched controls (n = 24) were assessed. Coordinate values of three-dimensional anatomical landmarks (n = 32) were recorded from each CBCT image. Data were evaluated using principal coordinates analysis (PCOORD) and Euclidean distance matrix analysis (EDMA). Approximately 40% of morphometric variation is captured by PCOORD axes 1-3, and the negative and positive ends of each axis are associated with specific patterns of morphological differences. Approximately 36% of facial skeletal measures significantly differ by confidence interval testing (α = 0.10) between samples. Although significant form differences occur across the facial skeleton, strong patterns of morphological differences were localized to the lateral and superioinferior aspects of the nasal aperture, particularly on the clefted side of the face. The UCLP deformity strongly influences facial skeletal morphology of the midface and oronasal facial regions, and to a lesser extent the upper and lower facial skeletons. The pattern of strong morphological differences in the oronasal region combined with differences across the facial complex suggests that craniofacial bones are integrated and covary, despite influences from the congenital cleft.

  14. American Academy of Facial Plastic and Reconstructive Surgery

    MedlinePlus

    ... is the world's largest specialty association for facial plastic surgery. It represents more than 2,700 facial plastic ... the American Board of Otolaryngology , which includes facial plastic surgery. Others are certified in plastic surgery, ophthalmology, and ...

  15. A facial reconstruction and identification technique for seriously devastating head wounds.

    PubMed

    Joukal, Marek; Frišhons, Jan

    2015-07-01

    Many authors have focused on facial identification techniques, and facial reconstructions for cases when skulls have been found are especially well known. However, a standardized facial identification technique for an unknown body with seriously devastating head injuries has not yet been developed. A reconstruction and identification technique was used in 7 cases of accidents involving trains striking pedestrians. This identification technique is based on the removal of skull bone fragments, subsequent fixation of soft tissue onto a universal commercial polystyrene head model, precise suture of dermatomuscular flaps, and definitive adjustment using cosmetic treatments. After reconstruction, identifying marks such as scars, eyebrows, facial lines, facial hair and partly hairstyle become evident. It is then possible to present a modified picture of the reconstructed face to relatives. After comparing the results with photos of the person before death, this technique has proven to be very useful for identifying unknown bodies when other identification techniques are not available. This technique is useful for its being rather quick and especially for its results.

  16. Caring for HIV-positive and aging patients with associated facial lipoatrophy.

    PubMed

    Esch, Pamela

    2006-01-01

    Facial lipoatrophy is characterized by fat loss and redistribution. It is a natural, biological phenomenon that occurs over time, presenting as mild-to-moderate volume depletion that gives the skin the appearance of sagging. More recently, highly active antiretroviral therapy, introduced for the management of human immunodeficiency virus, has been associated with moderate-to-severe facial lipoatrophy, and is characterized by sunken cheeks, accentuated nasolabial folds, and protruding musculature and bones. Furthermore, the consequences of facial lipoatrophy have been found to substantially impact patient quality of life. Nurses play an integral role in the treatment of facial lipoatrophy by educating the patients on available therapies and assisting them in making informed treatment decisions. It is important that treating nurses conduct a well-organized interview to understand patient treatment goals. This article will discuss several treatment options available to correct facial lipoatrophy-associated volume deficits, including collagen, hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, and permanent implants and injectables.

  17. Reconstruction of bony facial contour deficiencies with polymethylmethacrylate implants: case report

    PubMed Central

    ABDO FILHO, Ruy C. C.; OLIVEIRA, Thais M.; LOURENÇO, Natalino; GURGEL, Carla; ABDO, Ruy C.C.

    2011-01-01

    Facial trauma can be considered one of the most serious aggressions found in the medical centers due to the emotional consequences and the possibility of deformity. In craniofacial surgery, the use of autologous bone is still the first choice for reconstructing bony defects or irregularities. When there is a shortage of donor bone or a patient refuses an intracranial operation, alloplastic materials such as polymethylmethacrylate (PMMA) can be used. The PMMA prosthesis can be pre-fabricated, bringing advantages such as reduction of surgical time, easy technical handling and good esthetic results. This paper describes the procedures for rehabilitating a patient with PMMA implants in the region of the face, recovering the facial contours and esthetics of the patient. PMID:21952926

  18. Bone marrow aspiration

    MedlinePlus

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  19. Anatomical relationship between the position of the sigmoid sinus, tympanic membrane and digastric ridge with the mastoid segment of the facial nerve.

    PubMed

    Boemo, R L; Navarrete, M L; Lareo, S; Pumarola, F; Chamizo, J; Perelló, E

    2008-04-01

    Our study was carried out to examine the relationships of the sigmoid sinus, tympanic membrane and digastric ridge with the mastoid segment of the facial nerve. We studied 33 adult temporal bones. The distances among these structures were evaluated according specific landmarks that can be repeated in a simple manner. We found a good relation, in a proportional and lineal order, between these three structures and the facial nerve. This study indicated a correlation between the position of these three structures and the mastoid segment of the facial nerve through a simple morphometric method.

  20. Modulation of corticospinal excitability during lengthening and shortening contractions in the first dorsal interosseus muscle of humans.

    PubMed

    Sekiguchi, Hirofumi; Kohno, Yutaka; Hirano, Tatsuya; Akai, Masami; Nakajima, Yasoichi; Nakazawa, Kimitaka

    2007-04-01

    Lengthening and shortening contractions are the fundamental patterns of muscle activation underlying various movements. It is still unknown whether or not there is a muscle-specific difference in such a fundamental pattern of muscle activation. The purpose of this study was, therefore, to investigate whether or not the relationship between lengthening and shortening contractions in the modulation of corticospinal excitability in the first dorsal interosseus (FDI) muscle is the same as that of previously tested muscles because the hand muscles are anatomically and functionally different from the other muscles. To this end, we investigated the relationship between the input-output curves of the corticospinal pathway (i.e., the relationship between the stimulus intensities vs. the area of motor-evoked potentials) during lengthening and shortening contractions in 17 healthy subjects. The shape of this relationship was sigmoidal and characterized by a plateau value, maximum slope, and threshold. The plateau value was at the same level between lengthening and shortening contractions. However, the maximum slope (P < 0.01) and threshold (P < 0.01) were significantly higher during lengthening contractions than during shortening contractions. These findings were different from the results of other muscles tested in previous studies (i.e., the soleus muscle and the elbow flexors). That is to say, the plateau value and the maximum slope during lengthening contractions were significantly lower than those during shortening contractions in previous studies. This study provides tentative evidence that the relationship between lengthening and shortening contractions in the modulation of corticospinal excitability differs between muscles, indicating that the underlying neural control is not necessarily the same even though the fundamental patterns of muscle activation are carried out.

  1. Specific modulation of spinal and cortical excitabilities during lengthening and shortening submaximal and maximal contractions in plantar flexor muscles.

    PubMed

    Duclay, Julien; Pasquet, Benjamin; Martin, Alain; Duchateau, Jacques

    2014-12-15

    This study investigated the influence of the torque produced by plantar flexor muscles on cortical and spinal excitability during lengthening and shortening voluntary contractions. To that purpose, modulations of motor-evoked potential (MEP) and Hoffmann (H) reflex were compared in the soleus (SOL) and medial gastrocnemius (MG) during anisometric submaximal and maximal voluntary contraction (MVC) of the plantar flexor muscles. For the submaximal shortening and lengthening contractions, the target torque was set at 50% of their respective MVC force. The results indicate that the amplitudes of both MEP and H-reflex responses, normalized to the maximal M wave, were significantly (P < 0.05) lower during lengthening compared with shortening submaximal contraction. For these two parameters, the reduction reached, respectively, 22.1 and 31.9% for the SOL and 34.5 and 29.3% for the MG. During MVC, normalized MEP and H reflex of the SOL were both reduced significantly by 19.9% (P < 0.05) and 29.9% (P < 0.001) during lengthening and shortening contraction, respectively, whereas no significant change (P > 0.05) was observed for MG. In addition, the silent period in the ongoing electromyogram (EMG) activity following the MEP was significantly (P < 0.01) briefer during lengthening than shortening contractions but did not differ (P > 0.05) between contraction intensities and muscles. Together, these results indicate that cortical and spinal mechanisms involved in the modulation of muscle activation during shortening and lengthening contractions differ between synergistic muscles according to the torque produced. Data further document previous studies reporting that the specific modulation of muscle activation during lengthening contraction is not torque dependent.

  2. Slowing down Presentation of Facial Movements and Vocal Sounds Enhances Facial Expression Recognition and Induces Facial-Vocal Imitation in Children with Autism

    ERIC Educational Resources Information Center

    Tardif, Carole; Laine, France; Rodriguez, Melissa; Gepner, Bruno

    2007-01-01

    This study examined the effects of slowing down presentation of facial expressions and their corresponding vocal sounds on facial expression recognition and facial and/or vocal imitation in children with autism. Twelve autistic children and twenty-four normal control children were presented with emotional and non-emotional facial expressions on…

  3. Lateral facial cleft associated with accessory mandible having teeth, absent parotid gland and peripheral facial weakness.

    PubMed

    Ozçelik, D; Toplu, G; Türkseven, A; Senses, D A; Yiğit, B

    2014-07-01

    Transverse facial cleft is a very rare malformation. The Tessier no. 7 cleft is a lateral facial cleft which emanates from oral cavity and extends towards the tragus, involving both soft tissue and skeletal components. Here, we present a case having transverse facial cleft, accessory mandible having teeth, absent parotid gland and ipsilateral peripheral facial nerve weakness. After surgical repair of the cleft in 2-month of age, improvement of the facial nerve function was detected in 3-year of age. Resection of the accessory mandible was planned in 5-6 years of age.

  4. Mechanical Characteristics of a Polymer Spring Device used to Lengthen Small Intestine

    NASA Astrophysics Data System (ADS)

    Steinberger, Douglas J.

    Short Bowel Syndrome (SBS) is a condition that occurs due to an insufficient amount of small intestine needed for nutrient absorption and water regulation of the body. A compression spring device is being developed in order to provide a mechanical stimulus to the tissue, as this type of force has been shown to promote lengthening of the tissue. The research completed in this thesis investigated the mechanical characteristics of the spring device and attempted to relate it to the functionality in rat and porcine intestinal tissue. Results from the evaluation of the springs show that Poly(epsilon-caprolactone), or PCL, is a sufficient polymer to use for creating a biodegradable device as the spring dimensions can be adjusted through variations in the diameter, thickness, and band size in order to provide an adequate spring constant for multiple animal types. Design of the springs, however, need to take into account the size of the gelatin capsule used, the amount of plastic deformation and creep behavior of the spring under compression for an extended time period, and the variation in the mechanical properties of the animal soft tissue that requires lengthening. Integration of the spring in-continuity requires a feature that will provide a mechanical resistance to force that is greater than the force of the spring in the compressed state. The spring still requires further development and any design should also take into account the possibility of intestinal perforations or obstructions. The polymer spring device provides a good means towards developing a treatment option for SBS, and other potential soft tissue lengthening needs of the body.

  5. The MAGEC system for spinal lengthening in children with scoliosis: A NICE Medical Technology Guidance.

    PubMed

    Jenks, Michelle; Craig, Joyce; Higgins, Joanne; Willits, Iain; Barata, Teresa; Wood, Hannah; Kimpton, Christine; Sims, Andrew

    2014-12-01

    Scoliosis-structural lateral curvature of the spine-affects around four children per 1,000. The MAGEC system comprises a magnetically distractible spinal rod implant and an external remote controller, which lengthens the rod; this system avoids repeated surgical lengthening. Rod implants brace the spine internally and are lengthened as the child grows, preventing worsening of scoliosis and delaying the need for spinal fusion. The Medical Technologies Advisory Committee at the National Institute for Health and Care Excellence (NICE) selected the MAGEC system for evaluation in a NICE medical technologies guidance. Six studies were identified by the sponsor (Ellipse Technologies Inc.) as being relevant to the decision problem. Meta-analysis was used to compare the clinical evidence results with those of one conventional growth rod study, and equal efficacy of the two devices was concluded. The key weakness was selection of a single comparator study. The External Assessment Centre (EAC) identified 16 conventional growth rod studies and undertook meta-analyses of relevant outcomes. Its critique highlighted limitations around study heterogeneity and variations in baseline characteristics and follow-up duration, precluding the ability to draw firm conclusions. The sponsor constructed a de novo costing model showing that MAGEC rods generated cost savings of £9,946 per patient after 6 years, compared with conventional rods. The EAC critiqued and updated the model structure and inputs, calculating robust cost savings of £12,077 per patient with MAGEC rods compared with conventional rods over 6 years. The year of valuation was 2012. NICE issued a positive recommendation as supported by the evidence (Medical Technologies Guidance 18).

  6. Rf stability, control and bunch lengthening in electron synchrotron storage rings

    SciTech Connect

    Wachtel, J.M.

    1989-09-01

    A self-consistent theory for nonlinear longitudinal particle motion and rf cavity excitation in a high energy electron storage ring is developed. Coupled first order equations for the motion of an arbitrary number of particles and for the field in several rf cavities are given in the form used in control system theory. Stochastic quantum excitation of synchrotron motion is included, as are the effects of rf control system corrections. Results of computations for double cavity bunch lengthening are given. 11 refs., 4 figs., 1 tab.

  7. Human Facial Expressions as Adaptations:Evolutionary Questions in Facial Expression Research

    PubMed Central

    SCHMIDT, KAREN L.; COHN, JEFFREY F.

    2007-01-01

    The importance of the face in social interaction and social intelligence is widely recognized in anthropology. Yet the adaptive functions of human facial expression remain largely unknown. An evolutionary model of human facial expression as behavioral adaptation can be constructed, given the current knowledge of the phenotypic variation, ecological contexts, and fitness consequences of facial behavior. Studies of facial expression are available, but results are not typically framed in an evolutionary perspective. This review identifies the relevant physical phenomena of facial expression and integrates the study of this behavior with the anthropological study of communication and sociality in general. Anthropological issues with relevance to the evolutionary study of facial expression include: facial expressions as coordinated, stereotyped behavioral phenotypes, the unique contexts and functions of different facial expressions, the relationship of facial expression to speech, the value of facial expressions as signals, and the relationship of facial expression to social intelligence in humans and in nonhuman primates. Human smiling is used as an example of adaptation, and testable hypotheses concerning the human smile, as well as other expressions, are proposed. PMID:11786989

  8. The relationships between processing facial identity, emotional expression, facial speech, and gaze direction during development.

    PubMed

    Spangler, Sibylle M; Schwarzer, Gudrun; Korell, Monika; Maier-Karius, Johanna

    2010-01-01

    Four experiments were conducted with 5- to 11-year-olds and adults to investigate whether facial identity, facial speech, emotional expression, and gaze direction are processed independently of or in interaction with one another. In a computer-based, speeded sorting task, participants sorted faces according to facial identity while disregarding facial speech, emotional expression, and gaze direction or, alternatively, according to facial speech, emotional expression, and gaze direction while disregarding facial identity. Reaction times showed that children and adults were able to direct their attention selectively to facial identity despite variations of other kinds of face information, but when sorting according to facial speech and emotional expression, they were unable to ignore facial identity. In contrast, gaze direction could be processed independently of facial identity in all age groups. Apart from shorter reaction times and fewer classification errors, no substantial change in processing facial information was found to be correlated with age. We conclude that adult-like face processing routes are employed from 5 years of age onward.

  9. Crown lengthening procedure following intentional endodontic therapy for correction of supra-erupted posterior teeth: Case series with long-term follow-up

    PubMed Central

    Patil, Shruti Arun; Kulkarni, Sudhindra; Thakur, Srinath; Naik, Balaram

    2016-01-01

    Context: The crown lengthening procedure (CLP) is routinely carried out to correct gingival levels and achieve esthetic contours and adequate crown lengths for restorative purposes. Though the short-term outcomes have been found to be stable, long-term results are not much reported. Aims: To evaluate the long-term stability of the marginal bone levels, gingival levels, and the status of the teeth, which underwent endodontic therapy, followed by CLP and final restorations. Settings and Design: Institutional setting, long-term case series. Materials and Methods: Case records of the patients who underwent CLP and endodontic therapy for corrections of the supra-erupted teeth to regain the lost interocclusal spaces were retrieved, and the cases with complete set of the clinical and radiographs were taken. All the cases were recalled and bone levels on the radiographs, bleeding on probing, probing pocket depths, and changes in the soft tissue margins were evaluated. Statistical Analysis Used: Descriptive analysis. Results: A total of 25 teeth had undergone CLP and endodontic therapy and final restorations for a minimum of 24 months. The mean post-restorative duration was 50.8 ± 22.48 months (range 24–96 months). All the teeth were functional and asymptomatic with 100% survival. Interdental bone loss of 1 mm, probing pockets of 5 mm, and 1 mm buccal recession were observed in 16% of the sites. The amount of interocclusal space regained was adequate to restore the missing teeth in the opposing arch. Conclusions: The CLP is a predictive procedure for correction of supra-erupted teeth. The survival of the teeth that underwent the procedure in the present study was 100% over 24–96 months. PMID:27041850

  10. Predicting facial nerve invasion by parotid gland carcinoma and outcome of facial reanimation.

    PubMed

    Preis, M; Soudry, E; Bachar, G; Shufel, H; Feinmesser, R; Shpitzer, T

    2010-01-01

    We sought to define risk factors for facial nerve involvement in parotid gland carcinoma and assess the outcome of facial nerve reanimation. Medical records were reviewed of 66 patients who underwent surgery for parotid carcinoma in 2000–2007 at a tertiary hospital. Patient and tumor characteristics were compared between patients with and without facial nerve involvement and were analyzed on their influence on functional outcome following reanimation. Facial nerve involvement was verified intraoperatively in 24 patients, of whom 16 underwent reanimation during ablative surgery. Deep lobe invasion was significantly associated with intraoperative finding of facial nerve involvement. Tumors larger than 4 cm and salivary duct carcinoma had an obvious trend for facial nerve involvement. House-Brackmann score at 12 months was 3-4 in most patients. Deep lobe involvement and large tumor size may identify patients at risk of facial nerve involvement. Reanimation is associated with good functional outcome regardless of patient's age.

  11. Facial nerve palsy and hemifacial spasm.

    PubMed

    Valls-Solé, Josep

    2013-01-01

    Facial nerve lesions are usually benign conditions even though patients may present with emotional distress. Facial palsy usually resolves in 3-6 weeks, but if axonal degeneration takes place, it is likely that the patient will end up with a postparalytic facial syndrome featuring synkinesis, myokymic discharges, and hemifacial mass contractions after abnormal reinnervation. Essential hemifacial spasm is one form of facial hyperactivity that must be distinguished from synkinesis after facial palsy and also from other forms of facial dyskinesias. In this condition, there can be ectopic discharges, ephaptic transmission, and lateral spread of excitation among nerve fibers, giving rise to involuntary muscle twitching and spasms. Electrodiagnostic assessment is of relevance for the diagnosis and prognosis of peripheral facial palsy and hemifacial spasm. In this chapter the most relevant clinical and electrodiagnostic aspects of the two disorders are reviewed, with emphasis on the various stages of facial palsy after axonal degeneration, the pathophysiological mechanisms underlying the various features of hemifacial spasm, and the cues for differential diagnosis between the two entities.

  12. Facial mimicry in its social setting.

    PubMed

    Seibt, Beate; Mühlberger, Andreas; Likowski, Katja U; Weyers, Peter

    2015-01-01

    In interpersonal encounters, individuals often exhibit changes in their own facial expressions in response to emotional expressions of another person. Such changes are often called facial mimicry. While this tendency first appeared to be an automatic tendency of the perceiver to show the same emotional expression as the sender, evidence is now accumulating that situation, person, and relationship jointly determine whether and for which emotions such congruent facial behavior is shown. We review the evidence regarding the moderating influence of such factors on facial mimicry with a focus on understanding the meaning of facial responses to emotional expressions in a particular constellation. From this, we derive recommendations for a research agenda with a stronger focus on the most common forms of encounters, actual interactions with known others, and on assessing potential mediators of facial mimicry. We conclude that facial mimicry is modulated by many factors: attention deployment and sensitivity, detection of valence, emotional feelings, and social motivations. We posit that these are the more proximal causes of changes in facial mimicry due to changes in its social setting.

  13. Pneumomediastinum, an unusual complication of facial trauma.

    PubMed

    Monksfield, Peter; Whiteside, Olivia; Jaffé, Susan; Steventon, Nick; Milford, Chris

    2005-05-01

    Pneumomediastinum is often an incidental finding following a blunt or penetrating trauma to the neck or chest. We report a rare case of pneumomediastinum following an isolated facial trauma that was diagnosed on imaging. We also review the clinical signs of this condition, its radiologic characteristics, and the 18 previously reported cases of pneumomediastinum following facial trauma.

  14. Botulinum toxin to minimize facial scarring.

    PubMed

    Jablonka, Eric M; Sherris, David A; Gassner, Holger G

    2012-10-01

    Chemoimmobilization with botulinum toxin A is an ideal biochemical agent that allows near-total elimination of muscle pull on the healing facial wound. The goal of chemoimmobilization of facial cutaneous wounds is to eliminate dynamic tension on the healing tissues to improve wound healing and minimize scarring for optimal aesthetic results.

  15. Facial Feedback Mechanisms in Autistic Spectrum Disorders

    ERIC Educational Resources Information Center

    Stel, Marielle; van den Heuvel, Claudia; Smeets, Raymond C.

    2008-01-01

    Facial feedback mechanisms of adolescents with Autistic Spectrum Disorders (ASD) were investigated utilizing three studies. Facial expressions, which became activated via automatic (Studies 1 and 2) or intentional (Study 2) mimicry, or via holding a pen between the teeth (Study 3), influenced corresponding emotions for controls, while individuals…

  16. Facial mimicry in its social setting

    PubMed Central

    Seibt, Beate; Mühlberger, Andreas; Likowski, Katja U.; Weyers, Peter

    2015-01-01

    In interpersonal encounters, individuals often exhibit changes in their own facial expressions in response to emotional expressions of another person. Such changes are often called facial mimicry. While this tendency first appeared to be an automatic tendency of the perceiver to show the same emotional expression as the sender, evidence is now accumulating that situation, person, and relationship jointly determine whether and for which emotions such congruent facial behavior is shown. We review the evidence regarding the moderating influence of such factors on facial mimicry with a focus on understanding the meaning of facial responses to emotional expressions in a particular constellation. From this, we derive recommendations for a research agenda with a stronger focus on the most common forms of encounters, actual interactions with known others, and on assessing potential mediators of facial mimicry. We conclude that facial mimicry is modulated by many factors: attention deployment and sensitivity, detection of valence, emotional feelings, and social motivations. We posit that these are the more proximal causes of changes in facial mimicry due to changes in its social setting. PMID:26321970

  17. Brain Systems for Assessing Facial Attractiveness

    ERIC Educational Resources Information Center

    Winston, Joel S.; O'Doherty, John; Kilner, James M.; Perrett, David I.; Dolan, Raymond J.

    2007-01-01

    Attractiveness is a facial attribute that shapes human affiliative behaviours. In a previous study we reported a linear response to facial attractiveness in orbitofrontal cortex (OFC), a region involved in reward processing. There are strong theoretical grounds for the hypothesis that coding stimulus reward value also involves the amygdala. The…

  18. Can fast-twitch muscle fibres be selectively recruited during lengthening contractions? Review and applications to sport movements.

    PubMed

    Chalmers, Gordon R

    2008-01-01

    Literature examining the recruitment order of motor units during lengthening (eccentric) contractions was reviewed to determine if fast-twitch motor units can be active while lower threshold slow-twitch motor units are not active. Studies utilizing surface electromyogram (EMG) amplitude, single motor unit activity, spike amplitude-frequency analyses, EMG power spectrum, mechanomyographic, and phosphocreatine-to-creatine ratio (PCr/Cr) techniques were reviewed. Only single motor unit and PCr/Cr data were found to be suitable to address the goals of this review. Nine of ten single motor unit studies, examining joint movement velocities up to 225 degrees/s and forces up to 53% of a maximum voluntary contraction, found that the size principle of motor unit recruitment applied during lengthening contractions. Deviation from the size principle was demonstrated by one study examining movements within a small range of low velocities and modest forces, although other studies examining similar low forces and lengthening velocities reported size-ordered recruitment. The PCr/Cr data demonstrated the activation of all fibre types in lengthening maximal contractions. Most evidence indicates that for lengthening contractions of a wide range of efforts and speeds, fast-twitch muscle fibres cannot be selectively recruited without activity of the slow-twitch fibres of the same muscle.

  19. Modulation of soleus H-reflex during shortening and lengthening muscle actions in young and older adults.

    PubMed

    Chen, Yung-Sheng; Zhou, Shi; Cartwright, Colleen

    2015-02-28

    The H-reflex is dependently modulated during isometric and anisometric muscle actions. However, the manner of the H-reflex modulation during dynamic muscle movements in relation to ageing is less stated in the literature. This study was designed to investigate the effects of ageing on soleus (SOL) H-reflex modulation during dynamic muscle actions. Twenty young (24 ± 4 years of age) and 20 older adults (73 ± 5 years of age) voluntarily participated in the study. The SOL H-reflex was measured during passive and active shortening and lengthening muscle actions in a sitting position. The older group showed a lower ratio of the maximal amplitude of H-reflex to M-wave (SOL Hmax/Mmax) during the passive lengthening than that during the passive shortening (shortening: 0.40 ± 0.22 vs. lengthening: 0.15 ± 0.10, P < 0.05), whereas the SOL Hmax/Mmax ratio of the young group was significantly higher during the shortening than that during the lengthening contractions at maximal effort (shortening: 0.51 ± 0.26 vs. lengthening: 0.37 ± 0.18, P < 0.05). These results suggested different modulations of group Ia afferent inputs to the SOL motoneurons during passive and active dynamic muscle actions between young and older adults.

  20. Mutual information-based facial expression recognition

    NASA Astrophysics Data System (ADS)

    Hazar, Mliki; Hammami, Mohamed; Hanêne, Ben-Abdallah

    2013-12-01

    This paper introduces a novel low-computation discriminative regions representation for expression analysis task. The proposed approach relies on interesting studies in psychology which show that most of the descriptive and responsible regions for facial expression are located around some face parts. The contributions of this work lie in the proposition of new approach which supports automatic facial expression recognition based on automatic regions selection. The regions selection step aims to select the descriptive regions responsible or facial expression and was performed using Mutual Information (MI) technique. For facial feature extraction, we have applied Local Binary Patterns Pattern (LBP) on Gradient image to encode salient micro-patterns of facial expressions. Experimental studies have shown that using discriminative regions provide better results than using the whole face regions whilst reducing features vector dimension.

  1. Enhanced Facial Symmetry Assessment in Orthodontists.

    PubMed

    Jackson, Tate H; Clark, Kait; Mitroff, Stephen R

    2013-01-01

    Assessing facial symmetry is an evolutionarily important process, which suggests that individual differences in this ability should exist. As existing data are inconclusive, the current study explored whether a group trained in facial symmetry assessment, orthodontists, possessed enhanced abilities. Symmetry assessment was measured using face and non-face stimuli among orthodontic residents and two control groups: university participants with no symmetry training and airport security luggage screeners, a group previously shown to possess expert visual search skills unrelated to facial symmetry. Orthodontic residents were more accurate at assessing symmetry in both upright and inverted faces compared to both control groups, but not for non-face stimuli. These differences are not likely due to motivational biases or a speed-accuracy tradeoff-orthodontic residents were slower than the university participants but not the security screeners. Understanding such individual differences in facial symmetry assessment may inform the perception of facial attractiveness.

  2. Hepatitis Diagnosis Using Facial Color Image

    NASA Astrophysics Data System (ADS)

    Liu, Mingjia; Guo, Zhenhua

    Facial color diagnosis is an important diagnostic method in traditional Chinese medicine (TCM). However, due to its qualitative, subjective and experi-ence-based nature, traditional facial color diagnosis has a very limited application in clinical medicine. To circumvent the subjective and qualitative problems of facial color diagnosis of Traditional Chinese Medicine, in this paper, we present a novel computer aided facial color diagnosis method (CAFCDM). The method has three parts: face Image Database, Image Preprocessing Module and Diagnosis Engine. Face Image Database is carried out on a group of 116 patients affected by 2 kinds of liver diseases and 29 healthy volunteers. The quantitative color feature is extracted from facial images by using popular digital image processing techni-ques. Then, KNN classifier is employed to model the relationship between the quantitative color feature and diseases. The results show that the method can properly identify three groups: healthy, severe hepatitis with jaundice and severe hepatitis without jaundice with accuracy higher than 73%.

  3. Warfare facial trauma: who will treat?

    PubMed

    Holmes, D K

    1996-09-01

    Most of the facial trauma in the United States is treated in trauma centers in large urban or university medical centers, with limited trauma care taking place in our military medical treatment facilities. In many cases, active duty facial trauma surgeons may lack the current experience necessary for the optimal care of facial wounds of our inquired military personnel in the early stages of the conflict. Consequently, the skills of the reservist trauma surgeons who staff our civilian trauma centers and who care for facial trauma victims daily will be critical in caring for our wounded. These "trauma-current" reservists may act as a cadre of practiced surgeons to aid those with less experience. A plan for refresher training of active duty facial trauma surgeons is presented.

  4. How Does Facial Feedback Modulate Emotional Experience?

    PubMed Central

    Davis, Joshua Ian; Senghas, Ann; Ochsner, Kevin N.

    2009-01-01

    Contracting muscles involved in facial expressions (e.g. smiling or frowning) can make emotions more intense, even when unaware one is modifying expression (e.g. Strack, Martin, & Stepper, 1988). However, it is unresolved whether and how inhibiting facial expressions might weaken emotional experience. In the present study, 142 participants watched positive and negative video clips while either inhibiting their facial expressions or not. When hypothesis awareness and effects of distraction were experimentally controlled, inhibiting facial expressions weakened some emotional experiences. These findings provide new insight into ways that inhibition of facial expression can affect emotional experience: the link is not dependent on experimental demand, lay theories about connections between expression and experience, or the distraction involved in inhibiting one’s expressions. PMID:20160935

  5. Enhanced Facial Symmetry Assessment in Orthodontists

    PubMed Central

    Jackson, Tate H.; Clark, Kait; Mitroff, Stephen R.

    2013-01-01

    Assessing facial symmetry is an evolutionarily important process, which suggests that individual differences in this ability should exist. As existing data are inconclusive, the current study explored whether a group trained in facial symmetry assessment, orthodontists, possessed enhanced abilities. Symmetry assessment was measured using face and non-face stimuli among orthodontic residents and two control groups: university participants with no symmetry training and airport security luggage screeners, a group previously shown to possess expert visual search skills unrelated to facial symmetry. Orthodontic residents were more accurate at assessing symmetry in both upright and inverted faces compared to both control groups, but not for non-face stimuli. These differences are not likely due to motivational biases or a speed-accuracy tradeoff—orthodontic residents were slower than the university participants but not the security screeners. Understanding such individual differences in facial symmetry assessment may inform the perception of facial attractiveness. PMID:24319342

  6. Comparison of planar images and SPECT with bayesean preprocessing for the demonstration of facial anatomy and craniomandibular disorders

    SciTech Connect

    Kircos, L.T.; Ortendahl, D.A.; Hattner, R.S.; Faulkner, D.; Taylor, R.L.

    1984-01-01

    Craniomandiublar disorders involving the facial anatomy may be difficult to demonstrate in planar images. Although bone scanning is generally more sensitive than radiography, facial bone anatomy is complex and focal areas of increased or decreased radiotracer may become obscured by overlapping structures in planar images. Thus SPECT appears ideally suited to examination of the facial skeleton. A series of patients with craniomandibular disorders of unknown origin were imaged using 20 mCi Tc-99m MDP. Planar and SPECT (Siemens 7500 ZLC Orbiter) images were obtained four hours after injection. The SPECT images were reconstructed with a filtered back-projection algorithm. In order to improve image contrast and resolution in SPECT images, the rotation views were pre-processed with a Bayesean deblurring algorithm which has previously been show to offer improved contrast and resolution in planar images. SPECT images using the pre-processed rotation views were obtained and compared to the SPECT images without pre-processing and the planar images. TMJ arthropathy involving either the glenoid fossa or the mandibular condyle, orthopedic changes involving the mandible or maxilla, localized dental pathosis, as well as changes in structures peripheral to the facial skeleton were identified. Bayesean pre-processed SPECT depicted the facial skeleton more clearly as well as providing a more obvious demonstration of the bony changes associated with craniomandibular disorders than either planar images or SPECT without pre-processing.

  7. Bone Scan

    MedlinePlus

    ... Mayo Clinic Staff A bone scan is a nuclear imaging test that helps diagnose and track several ... you're nursing. A bone scan is a nuclear imaging procedure. In nuclear imaging, tiny amounts of ...

  8. Bone grafts.

    PubMed

    Hubble, Matthew J W

    2002-09-01

    Bone grafts are used in musculoskeletal surgery to restore structural integrity and enhance osteogenic potential. The demand for bone graft for skeletal reconstruction in bone tumor, revision arthroplasty, and trauma surgery, couple with recent advances in understanding and application of the biology of bone transplantation, has resulted in an exponential increase in the number of bone-grafting procedures performed over the last decade. It is estimated that 1.5 million bone-grafting procedures are currently performed worldwide each year, compared to a fraction of that number 20 years ago. Major developments also have resulted in the harvesting, storage, and use of bone grafts and production of graft derivatives, substitutes, and bone-inducing agents.

  9. Bone cement

    PubMed Central

    Vaishya, Raju; Chauhan, Mayank; Vaish, Abhishek

    2013-01-01

    The knowledge about the bone cement is of paramount importance to all Orthopaedic surgeons. Although the bone cement had been the gold standard in the field of joint replacement surgery, its use has somewhat decreased because of the advent of press-fit implants which encourages bone in growth. The shortcomings, side effects and toxicity of the bone cement are being addressed recently. More research is needed and continues in the field of nanoparticle additives, enhanced bone–cement interface etc. PMID:26403875

  10. Bone Analyzer

    NASA Technical Reports Server (NTRS)

    1985-01-01

    The danger of disuse osteoporosis under weightless condition in space led to extensive research into measurements of bone stiffness and mass by the Biomedical Research Division of Ames and Stanford University. Through its Technology Utilization Program, NASA funded an advanced SOBSA, a microprocessor-controlled bone probe system. SOBSA determines bone stiffness by measuring responses to an electromagnetic shaker. With this information, a physician can identify bone disease, measure deterioration and prescribe necessary therapy. The system is now undergoing further testing.

  11. Guided bone regeneration to repair an osseous defect.

    PubMed

    Carvalho, Roberto S; Nelson, Donald; Kelderman, Hans; Wise, Roger

    2003-04-01

    The ultimate goal of orthodontic therapy is to establish functional and esthetic dental relationships in a balanced facial pattern. In patients with compromised periodontal support, the use of multidisciplinary treatment plans is essential in attaining these goals. This case report includes a thorough documentation of the orthodontic and periodontal treatments to demonstrate the effectiveness of guided bone regenerative procedures combined with a bone allograft to aid in correcting a dental malocclusion.

  12. The management of leg-length discrepancy in Ollier's disease with a fully implantable lengthening nail.

    PubMed

    Baumgart, R; Bürklein, D; Hinterwimmer, S; Thaller, P; Mutschler, W

    2005-07-01

    Ollier's disease is characterised by severe deformity of the extremities and retarded growth because of multiple enchondromas. For correction of deformity, the Ilizarov method has been used although it has many complications. A 17-year-old boy with Ollier's disease had a limb-length discrepancy of 17.4 cm, with a valgus deformity of the right knee and recurvatum of the femur of 23 degrees . He had undergone three unsuccessful attempts to correct the deformities by using external fixators. We used a fully implantable, motorised, lengthening and correction nail (Fitbone) to achieve full correction of all the deformities without complications. We decided to carry out the procedure in three stages. First, we lengthened the femur by 3.6 cm and the tibia by 4 cm. We then exchanged the femoral nail for a longer implant and achieved a further 6 cm of length. This reduced the shortening to 3.8 cm. When the boy has finished secondary school we will adjust the remaining discrepancy.

  13. A Magnetic Resonance-Compatible Loading Device for Dynamically Imaging Shortening and Lengthening Muscle Contraction Mechanics

    PubMed Central

    Silder, Amy; Westphal, Christopher J.; Thelen, Darryl G.

    2013-01-01

    The purpose of this study was to design and test a magnetic resonance (MR)-compatible device to induce either shortening or lengthening muscle contractions for use during dynamic MR imaging. The proposed device guides the knee through cyclic flexion-extension, while either elastic or inertial loads are imposed on the hamstrings. Ten subjects were tested in a motion capture laboratory to evaluate the repeatability of limb motion and imposed loads. Image data were subsequently obtained for all ten subjects using cine phase contrast imaging. Subjects achieved ~30 deg of knee joint motion, with individual subjects remaining within ~1 deg of their average motion across 56 repeated cycles. The maximum hamstring activity and loading occurred when the knee was flexed for the elastic loading condition (shortening contraction), and extended for the inertial loading condition (lengthening contraction). Repeat MR image acquisitions of the same loading condition resulted in similar tissue velocities, while spatial variations in velocity data were clearly different between loading conditions. The proposed device can enable dynamic imaging of the muscle under different types of loads, which has the potential to improve our understanding of basic muscle mechanics, identify potential causes of muscle injury, and provide a basis for quantitatively assessing injury effects at the tissue level. Slight modifications to the device design and/or subject positioning could allow for imaging of the quadriceps or the knee. PMID:24353749

  14. Distal fascia lata lengthening: an alternative surgical technique for recalcitrant trochanteric bursitis.

    PubMed

    Pretell, Juan; Ortega, Javier; García-Rayo, Ramón; Resines, Carlos

    2009-10-01

    This article presents a simple technique for fascia lata lengthening that is less aggressive, can be performed under local anaesthetic with little morbidity and disability, and has excellent results. Eleven patients (13 hips) were enrolled in this study. Mean age was 54.6 years, there was one man and ten women. Outcomes were assessed by using a visual analog pain scale, Harris hip score and Lickert scale (satisfaction). There was a mean follow-up time of 43 months (range 15-84). All patients were scored by the Harris hip scale with a mean improvement from 61 (range 48-77) to 91 (range 76-95) after surgery. The mean visual analogue scale (VAS) score improved from 83 (range 60-99) to 13 (range 0-70). We had 12 of 13 patients reporting a good result. Mean surgical time was 15 min, and only one seroma was reported as a complication. No inpatient management was needed. In conclusion, distal "Z" lengthening of the fascia lata appears to be a good alternative for treatment of this condition.

  15. Bone Infections

    MedlinePlus

    ... bloodstream. People who are at risk for bone infections include those with diabetes, poor circulation, or recent injury to the bone. You may also be at risk if you are having hemodialysis. Symptoms of bone infections include Pain in the infected area Chills and ...

  16. A Study Of Facial Asymmetries By The Stereometric Method

    NASA Astrophysics Data System (ADS)

    Crete, N.; Deloison, Y.; Mollard, R.

    1980-07-01

    In order to determine the part played in facial dissymmetry observed on a living person by the various constitutive elements of the cephalic tip (the soft parts - skin, muscles and the underlying bone structure) we undertook, using a biostereometric method, to evaluate asymmetries between homologous right and left dimensions on a living person's face and on a skeleton. While in an individual, a marked degree of facial dissymmetry can sometimes be observed; average differences between the right and left sides of the face may nethertheless balance out, and remain slight. Conventional anthropometrics techniques do not show up such slight values. With a view to securing a higher degree of accuracy, study of the stereometric technique of measurements. Using this technique, quasi imperceptible differences between the right and the left sides of the face on a living person as well as on a skeleton, together with variations in the orientation or angulation of anatomical segments in a three-dimensional space can be measured. We were thus able to detect, in a number of dry skulls, average differences of approxi-mately a millimetre between the two sides of the face which cannot be attributed to back of accuracy in measurements. Although statistically the difference are not always significant, the para-metric values of facial dimensions are invariably greater for the left side. On the other hand, for the sample of living subjects as a whole, the differences between homologous distances are not statistically significant. But it may be that, on a living subject, the experimenter is inclined to take measurements that are susceptible of symmetrization (for instance, the nasion in the median sagittal plane) whereas on a dry skull anatomical reference marks can be determined with the utmost accuracy. It may be inferred from there results that the softer parts tend, as a rule, to correct the dissymmetry of the underlying skeleton.

  17. Facial Orientation and Facial Shape in Extant Great Apes: A Geometric Morphometric Analysis of Covariation

    PubMed Central

    Neaux, Dimitri; Guy, Franck; Gilissen, Emmanuel; Coudyzer, Walter; Vignaud, Patrick; Ducrocq, Stéphane

    2013-01-01

    The organization of the bony face is complex, its morphology being influenced in part by the rest of the cranium. Characterizing the facial morphological variation and craniofacial covariation patterns in extant hominids is fundamental to the understanding of their evolutionary history. Numerous studies on hominid facial shape have proposed hypotheses concerning the relationship between the anterior facial shape, facial block orientation and basicranial flexion. In this study we test these hypotheses in a sample of adult specimens belonging to three extant hominid genera (Homo, Pan and Gorilla). Intraspecific variation and covariation patterns are analyzed using geometric morphometric methods and multivariate statistics, such as partial least squared on three-dimensional landmarks coordinates. Our results indicate significant intraspecific covariation between facial shape, facial block orientation and basicranial flexion. Hominids share similar characteristics in the relationship between anterior facial shape and facial block orientation. Modern humans exhibit a specific pattern in the covariation between anterior facial shape and basicranial flexion. This peculiar feature underscores the role of modern humans' highly-flexed basicranium in the overall integration of the cranium. Furthermore, our results are consistent with the hypothesis of a relationship between the reduction of the value of the cranial base angle and a downward rotation of the facial block in modern humans, and to a lesser extent in chimpanzees. PMID:23441232

  18. The spectrum of facial fractures in motor vehicle accidents: an MDCT study of 374 patients.

    PubMed

    Peltola, Elina M; Koivikko, Mika P; Koskinen, Seppo K

    2014-04-01

    Road traffic accidents are a major health problem worldwide resulting frequently in maxillofacial injuries. The purpose of the study was to assess the incidence and spectrum of facial fractures in patients involved in a motor vehicle accident (MVA). Using picture archiving and communication system, all requests for suspected facial trauma were retrieved during a 62-month period; 374 met the inclusion criteria. Two researchers interpreted the multidetector computed tomography images by consensus. The motor vehicles involved were divided into two groups: those involving a passenger car or a larger vehicle and those involving a motorized two-wheeler. Furthermore, the motor vehicle accidents were divided into collisions and run-off-road accidents. Of the 374 patients (aged 15-80, mean 34), 271 (72 %) were male and 103 (28 %) female. Of all patients, 262 (70 %) had a facial or skull base fracture; of these, multiple separate fractures were present in 56 %. Nasal fractures were the most common fractures followed by orbital, skull base, and maxillary fractures. Frontal bone, LeFort, and zygomatic arch fractures were always accompanied by other fractures. Fractures were more frequent in the group of collisions compared with run-off-road accidents. In the two-wheeled group, only 15 % did not have facial or skull base fractures. Fractures often occur in multitudes as 39 % of all patients have multiple facial or skull bone fractures, and thus, emergency radiologists should be familiar with the complexity of the injuries. Negative clear sinus sign and low-energy sentinel injuries should be trusted as indications of undetected injuries in MVA victims.

  19. Facial soft tissue thickness among various vertical facial patterns in adult Pakistani subjects.

    PubMed

    Jeelani, Waqar; Fida, Mubassar; Shaikh, Attiya

    2015-12-01

    Facial reconstruction techniques are used to obtain an approximation of an individual's appearance thus helping identification of unidentified decedents from their dried skeletal remains. Many of these techniques rely on the sets of average facial soft tissue thickness (FST) values at different anatomical landmarks provided by the previous studies. FST is influenced by the age, sex, ethnicity and the body mass index of the individual. Recent literature has shown that the anthropological variations of the skull may also affect FST at certain points. This study was designed to evaluate the effect of such variations in vertical skull morphology on FST as around one third of different population groups have either a long or short facial pattern as compared to the average facial pattern. Moreover, this study also provides a FST database for the adult Pakistani subjects that may have potential implications in the facial reconstruction of the local subjects. A retrospective analysis of 276 lateral cephalograms of adult subjects having normal sagittal facial pattern was performed. Subjects were categorized into three vertical facial patterns (long face=95, average face=102, short face=79) according to the vertical dimensions of the skull and the FST was measured at 11 midline points. To compare the FST between males and females Mann-Whitney U test was used. Kruskal-Wallis test was applied to compare FST among three vertical facial patterns. The results of our study revealed significant differences in FST at nine landmarks between males and females. These sex-based differences were more pronounced in the long and short facial patterns as compared to the average facial pattern. FST at stomion, pogonion, gnathion and menton was significantly greater in the short facial pattern as compared to the long facial pattern in both the sexes. The results of the present study highlight the importance of anthropological analysis of the skull and taking the vertical skeletal dimension

  20. Specific modulation of corticospinal and spinal excitabilities during maximal voluntary isometric, shortening and lengthening contractions in synergist muscles.

    PubMed

    Duclay, Julien; Pasquet, Benjamin; Martin, Alain; Duchateau, Jacques

    2011-06-01

    This study was designed to investigate the cortical and spinal mechanisms involved in the modulations of neural activation during lengthening compared with isometric and shortening maximal voluntary contractions (MVCs). Two muscles susceptible to different neural adjustments at the spinal level, the soleus (SOL) and medial gastrocnemius (MG), were compared. Twelve healthy males participated in at least two experimental sessions designed to assess corticospinal and spinal excitabilities. We compared the modulation of motor evoked potentials (MEPs) in response to transcranial magnetic stimulation and Hoffmann reflexes (H-reflexes) during isometric and anisometric MVCs. The H-reflex and MEP responses, recorded during lengthening and shortening MVCs, were compared with those obtained during isometric MVCs. The results indicate that the maximal amplitude of both MEP and H-reflex in the SOL were smaller (P < 0.01) during lengthening MVCs compared with isometric and shortening MVCs but similar (P > 0.05) in MG for all three muscle contraction types. The silent period that follows maximal MEPs was reduced (P < 0.01) during lengthening MVCs in the SOL but not the MG. Similar observations were obtained regardless of the initial length of the MG muscle. Collectively, the current results indicate that the relative contribution of both cortical and spinal mechanisms to the modulation of neural activation differs during lengthening MVCs and between two synergist muscles. The comparison of SOL and MG responses further suggests that the specific modulation of the corticospinal excitability during lengthening MVCs depends mainly on pre- and postsynaptic inhibitory mechanisms acting at the spinal level.

  1. Calf muscle-tendon lengths before and after Tendo-Achilles lengthenings and gastrocnemius lengthenings for equinus in cerebral palsy and idiopathic toe walking.

    PubMed

    Jahn, Jessica; Vasavada, Anita N; McMulkin, Mark L

    2009-06-01

    The calf muscle-tendon lengths in children exhibiting equinus gait in two clinical populations, cerebral palsy (CP) and idiopathic toe walking (ITW), were examined to compare the effects of diagnosis and two different surgical procedures, Tendo-Achilles lengthening (TAL) versus Vulpius procedure (VP) gastrocnemius recession. Pre- and post-surgical gait data were obtained from 38 subjects (58 limbs) and 38 age-matched controls. Peak muscle-tendon lengths increased following surgery in 84% of limbs. For medial gastrocnemius (MGAS) and lateral gastrocnemius (LGAS) in stance, muscle-tendon lengths increased significantly following TAL surgeries but were not significantly different pre- and post-VP surgeries. For soleus (SOL) (swing and stance) and MGAS and LGAS (swing), muscle-tendon lengths increased significantly following both TAL and VP surgeries. Pre-operatively, muscle-tendon lengths were significantly shorter for the TAL group compared to the VP group; however, post-operatively the lengths were not significantly different between the surgeries. There were no significant differences between CP and ITW patients or indications that the surgery affected the groups differently. The change in length following surgery was well correlated to the subjects' initial muscle-tendon length.

  2. Genetics Home Reference: SOST-related sclerosing bone dysplasia

    MedlinePlus

    ... hearing loss, vision loss, and a sense of smell that is diminished (hyposmia) or completely absent (anosmia). ... Bone Dysplasias MedlinePlus Encyclopedia: Facial Paralysis MedlinePlus Encyclopedia: Smell--Impaired General Information from MedlinePlus (5 links) Diagnostic ...

  3. Idiopathic facial swelling secondary to sickle cell anaemia.

    PubMed

    Moghe, Swapnil; Pillai, Ajay; Guru, Kanishka Navin; Nair, Preeti P

    2012-10-10

    Sickle cell disease is a common inherited autosomal disease that is characterised by abnormally shaped (sickle-shaped) red blood cells (RBCs). It can involve virtually any organ system. The clinical manifestations of sickle cell disease vary and are classified as vaso-occlusion, chronic anaemia and infection. The imaging appearances of central nervous system and musculoskeletal involvement by sickle cell disease have been well documented; however, involvement of the head and neck region is often unreported, although it is not uncommon. In the head and neck, sickle cell disease can involve the inner ears, orbits, paranasal sinuses, bones, lymph nodes and vessels. This paper describes a case of idiopathic facial swelling associated with sickle cell disease in a young patient.

  4. Headache and Facial Pain in Sickle Cell Disease.

    PubMed

    Vgontzas, Angeliki; Charleston, Larry; Robbins, Matthew S

    2016-03-01

    Children and adolescents with sickle cell disease (SCD) have a high prevalence of recurrent headaches (24.0-43.9 %). Acute presentation with headache can be diagnostically challenging, as the clinician must consider evaluation of several potentially devastating conditions including vascular diseases (stroke, hemorrhage, venous sinus thrombosis, moyamoya, posterior reversible encephalopathy syndrome), facial and orbital bone infarcts, dental pain, and osteomyelitis. Patients with SCD and primary headache disorders may benefit from comprehensive headache treatment plans that include abortive therapy, prophylactic therapy, and non-pharmacological modalities. Although there is limited data in adults, those with SCD are at risk for medication overuse headache secondary to frequent opioid use. Addressing headache in patients with SCD may help to reduce their use of opioids and disability and improve pain and quality of life.

  5. Bone poroelasticity.

    PubMed

    Cowin, S C

    1999-03-01

    Poroelasticity is a well-developed theory for the interaction of fluid and solid phases of a fluid-saturated porous medium. It is widely used in geomechanics and has been applied to bone by many authors in the last 30 years. The purpose of this work is, first, to review the literature related to the application of poroelasticity to the interstitial bone fluid and, second, to describe the specific physical and modeling considerations that establish poroelasticity as an effective and useful model for deformation-driven bone fluid movement in bone tissue. The application of poroelasticity to bone differs from its application to soft tissues in two important ways. First, the deformations of bone are small while those of soft tissues are generally large. Second, the bulk modulus of the mineralized bone matrix is about six times stiffer than that of the fluid in the pores while the bulk moduli of the soft tissue matrix and the pore water are almost the same. Poroelasticity and electrokinetics can be used to explain strain-generated potentials in wet bone. It is noted that strain-generated potentials can be used as an effective tool in the experimental study of local bone fluid flow, and that the knowledge of this technique will contribute to the answers of a number of questions concerning bone mineralization, osteocyte nutrition and the bone mechanosensory system.

  6. Modeling 3D facial shape from DNA.

    PubMed

    Claes, Peter; Liberton, Denise K; Daniels, Katleen; Rosana, Kerri Matthes; Quillen, Ellen E; Pearson, Laurel N; McEvoy, Brian; Bauchet, Marc; Zaidi, Arslan A; Yao, Wei; Tang, Hua; Barsh, Gregory S; Absher, Devin M; Puts, David A; Rocha, Jorge; Beleza, Sandra; Pereira, Rinaldo W; Baynam, Gareth; Suetens, Paul; Vandermeulen, Dirk; Wagner, Jennifer K; Boster, James S; Shriver, Mark D

    2014-03-01

    Human facial diversity is substantial, complex, and largely scientifically unexplained. We used spatially dense quasi-landmarks to measure face shape in population samples with mixed West African and European ancestry from three locations (United States, Brazil, and Cape Verde). Using bootstrapped response-based imputation modeling (BRIM), we uncover the relationships between facial variation and the effects of sex, genomic ancestry, and a subset of craniofacial candidate genes. The facial effects of these variables are summarized as response-based imputed predictor (RIP) variables, which are validated using self-reported sex, genomic ancestry, and observer-based facial ratings (femininity and proportional ancestry) and judgments (sex and population group). By jointly modeling sex, genomic ancestry, and genotype, the independent effects of particular alleles on facial features can be uncovered. Results on a set of 20 genes showing significant effects on facial features provide support for this approach as a novel means to identify genes affecting normal-range facial features and for approximating the appearance of a face from genetic markers.

  7. The identification of unfolding facial expressions.

    PubMed

    Fiorentini, Chiara; Schmidt, Susanna; Viviani, Paolo

    2012-01-01

    We asked whether the identification of emotional facial expressions (FEs) involves the simultaneous perception of the facial configuration or the detection of emotion-specific diagnostic cues. We recorded at high speed (500 frames s-1) the unfolding of the FE in five actors, each expressing six emotions (anger, surprise, happiness, disgust, fear, sadness). Recordings were coded every 10 frames (20 ms of real time) with the Facial Action Coding System (FACS, Ekman et al 2002, Salt Lake City, UT: Research Nexus eBook) to identify the facial actions contributing to each expression, and their intensity changes over time. Recordings were shown in slow motion (1/20 of recording speed) to one hundred observers in a forced-choice identification task. Participants were asked to identify the emotion during the presentation as soon as they felt confident to do so. Responses were recorded along with the associated response times (RTs). The RT probability density functions for both correct and incorrect responses were correlated with the facial activity during the presentation. There were systematic correlations between facial activities, response probabilities, and RT peaks, and significant differences in RT distributions for correct and incorrect answers. The results show that a reliable response is possible long before the full FE configuration is reached. This suggests that identification is reached by integrating in time individual diagnostic facial actions, and does not require perceiving the full apex configuration.

  8. Amblyopia Associated with Congenital Facial Nerve Paralysis.

    PubMed

    Iwamura, Hitoshi; Kondo, Kenji; Sawamura, Hiromasa; Baba, Shintaro; Yasuhara, Kazuo; Yamasoba, Tatsuya

    2016-01-01

    The association between congenital facial paralysis and visual development has not been thoroughly studied. Of 27 pediatric cases of congenital facial paralysis, we identified 3 patients who developed amblyopia, a visual acuity decrease caused by abnormal visual development, as comorbidity. These 3 patients had facial paralysis in the periocular region and developed amblyopia on the paralyzed side. They started treatment by wearing an eye patch immediately after diagnosis and before the critical visual developmental period; all patients responded to the treatment. Our findings suggest that the incidence of amblyopia in the cases of congenital facial paralysis, particularly the paralysis in the periocular region, is higher than that in the general pediatric population. Interestingly, 2 of the 3 patients developed anisometropic amblyopia due to the hyperopia of the affected eye, implying that the periocular facial paralysis may have affected the refraction of the eye through yet unspecified mechanisms. Therefore, the physicians who manage facial paralysis should keep this pathology in mind, and when they see pediatric patients with congenital facial paralysis involving the periocular region, they should consult an ophthalmologist as soon as possible.

  9. Modeling 3D Facial Shape from DNA

    PubMed Central

    Claes, Peter; Liberton, Denise K.; Daniels, Katleen; Rosana, Kerri Matthes; Quillen, Ellen E.; Pearson, Laurel N.; McEvoy, Brian; Bauchet, Marc; Zaidi, Arslan A.; Yao, Wei; Tang, Hua; Barsh, Gregory S.; Absher, Devin M.; Puts, David A.; Rocha, Jorge; Beleza, Sandra; Pereira, Rinaldo W.; Baynam, Gareth; Suetens, Paul; Vandermeulen, Dirk; Wagner, Jennifer K.; Boster, James S.; Shriver, Mark D.

    2014-01-01

    Human facial diversity is substantial, complex, and largely scientifically unexplained. We used spatially dense quasi-landmarks to measure face shape in population samples with mixed West African and European ancestry from three locations (United States, Brazil, and Cape Verde). Using bootstrapped response-based imputation modeling (BRIM), we uncover the relationships between facial variation and the effects of sex, genomic ancestry, and a subset of craniofacial candidate genes. The facial effects of these variables are summarized as response-based imputed predictor (RIP) variables, which are validated using self-reported sex, genomic ancestry, and observer-based facial ratings (femininity and proportional ancestry) and judgments (sex and population group). By jointly modeling sex, genomic ancestry, and genotype, the independent effects of particular alleles on facial features can be uncovered. Results on a set of 20 genes showing significant effects on facial features provide support for this approach as a novel means to identify genes affecting normal-range facial features and for approximating the appearance of a face from genetic markers. PMID:24651127

  10. Evaluation of Facial Beauty Using Anthropometric Proportions

    PubMed Central

    Milutinovic, Jovana

    2014-01-01

    The improvement of a patient's facial appearance is one of the main goals of contemporary orthodontic treatment. The aim of this investigation was to evaluate the difference in facial proportions between attractive and anonymous females in order to establish objective facial features which are widely considered as beautiful. The study included two groups: first group consisted of 83 Caucasian female subjects between 22 and 28 years of age who were selected from the population of students at the University of Belgrade, and the second group included 24 attractive celebrity Caucasian females. The en face facial photographs were taken in natural head position (NHP). Numerous parameters were recorded on these photographs, in order to establish facial symmetry and correlation with the ideal set of proportions. This study showed significant difference between anonymous and attractive females. Attractive females showed smaller face in general and uniformity of the facial thirds and fifths, and most of the facial parameters meet the criteria of the ideal proportions. PMID:24701166

  11. Mucosal perforators from the facial artery.

    PubMed

    Coronel-Banda, Mauricio E; Serra-Renom, Jose M; Lorente, Marian; Larrea-Terán, Wendy P

    2014-07-01

    The cutaneous perforators of the facial artery have been well described, but to our knowledge the oral mucosal perforators have not. We studied 10 facial arteries from 10 hemifaces in 5 cadavers. The arteries were injected with latex, and we studied all perforators that extended from the facial artery and headed directly to the oral mucosa. The diameter and length of the facial artery and its mucosal perforators were measured and compared. We found 52 oral mucosal perforators in the 10 facial arteries injected with latex. Their mean (SD) diameter was 0.5 (0.2) mm and the mean (SD) number/facial artery was 5.2 (1.1). Their mean (SD) length was 16.4 (5.3) mm. Most of those to the cheek were localised between the branching-off points of the inferior and superior labial arteries. The facial artery has perforators to the oral mucosa of the cheek, most of them between the points at which the labial arteries emerge.

  12. [Management of peripheral facial nerve palsy in children].

    PubMed

    Tabarki, B

    2014-10-01

    Peripheral facial nerve palsy may (secondary) or may not have a detectable cause (idiopathic facial palsy or Bell's palsy). Idiopathic facial palsy is the common form of facial palsy. It remains diagnosis by exclusion. The prognosis is more favourable in children than in adults. We present current diagnostic procedures and recommendations regarding treatment in children.

  13. Cranio-facial remodeling in domestic dogs is associated with changes in larynx position.

    PubMed

    Plotsky, Kyle; Rendall, Drew; Chase, Kevin; Riede, Tobias

    2016-06-01

    The hyo-laryngeal complex is a multi-segmented structure integrating the oral and pharyngeal cavities and thus a variety of critical functions related to airway control, feeding, and vocal communication. Currently, we lack a complete understanding of how the hyoid complex, and the functions it mediates, can also be affected by changes in surrounding cranio-facial dimensions. Here, we explore these relationships in a breed of domestic dog, the Portuguese Water Dog, which is characterized by strong cranio-facial variation. We used radiographic images of the upper body and head of 55 adult males and 51 adult females to obtain detailed measures of cranio-facial variation and hyoid anatomy. Principal components analysis revealed multiple orthogonal dimensions of cranio-facial variation, some of which were associated with significant differences in larynx position: the larynx occupied a more descended position in individuals with shorter, broader faces than in those with longer, narrower faces. We then tested the possibility that caudal displacement of the larynx in brachycephalic individuals might reflect a degree of tongue crowding resulting from facial shortening and reduction of oral and pharyngeal spaces. A cadaver sample was used to obtain detailed measurements of constituent bones of the hyoid skeleton and of the tongue body, and their relationships to cranio-facial size and shape and overall body size supported the tongue-crowding hypothesis. Considering the presence of descended larynges in numerous mammalian taxa, our findings establish an important precedent for the possibility that laryngeal descent can be initiated, and even sustained, in part in response to remodeling of the face and cranium for selective pressures unrelated to vocal production. These integrated changes could also have been involved in hominin evolution, where the different laryngeal positions in modern humans compared with nonhuman primates have been traditionally linked to the evolution

  14. Distraction osteogenesis for tibial nonunion with bone loss using combined Ilizarov and Taylor spatial frames versus a conventional circular frame.

    PubMed

    Abuomira, Ibrahim Elsayed Abdellatif; Sala, Francesco; Elbatrawy, Yasser; Lovisetti, Giovanni; Alati, Salvatore; Capitani, Dario

    2016-11-01

    This retrospective review assesses 55 tibial nonunions with bone loss to compare union achieved with combined Ilizarov and Taylor spatial frames (I-TSF) versus a conventional circular frame with the standard Ilizarov procedure. Seventeen (31 %) of the 55 nonunions were infected. Thirty patients treated with I-TSF were compared with 25 patients treated with a conventional circular frame. In the I-TSF group, an average of 7.6 cm of bone was resected and the lengthening index (treatment time in months divided by lengthening amount in centimeters) was 1.97. In the conventional circular frame group, a mean of 6.5 cm was resected and the lengthening index was 2.1. Consolidation at the docking site and at the regenerate bone occurred in 49 (89 %) of 55 cases after the first procedure. No statistically significant difference was shown between the two groups. Superiority of one modality of treatment over the other cannot be concluded from our data. Application of combined Ilizarov and Taylor spatial frames for bone transport is useful for treatment of tibial nonunion with bone loss. Level of evidence Case series, Level III.

  15. Facial Dysmorphism Across the Fetal Alcohol Spectrum

    PubMed Central

    Suttie, Michael; Foroud, Tatiana; Wetherill, Leah; Jacobson, Joseph L.; Molteno, Christopher D.; Meintjes, Ernesta M.; Hoyme, H. Eugene; Khaole, Nathaniel; Robinson, Luther K.; Riley, Edward P.; Jacobson, Sandra W.

    2013-01-01

    OBJECTIVE: Classic facial characteristics of fetal alcohol syndrome (FAS) are shortened palpebral fissures, smooth philtrum, and thin upper vermillion. We aim to help pediatricians detect facial dysmorphism across the fetal alcohol spectrum, especially among nonsyndromal heavily exposed (HE) individuals without classic facial characteristics. METHODS: Of 192 Cape Coloured children recruited, 69 were born to women who reported abstaining from alcohol during pregnancy. According to multifaceted criteria, the remainder were allocated clinically to the FAS (n = 22), partial FAS (n = 26) or nonsyndromal HE (n = 75) categories. We used dense surface modeling and signature analyses of 3-dimensional facial photographs to determine agreement between clinical categorization and classifications induced from face shape alone, to visualize facial differences, and to consider predictive links between face shape and neurobehavior. RESULTS: Face classification achieved significant agreement with clinical categories for discrimination of nonexposed from FAS alone (face: 0.97–1.00; profile: 0.92) or with the addition of partial FAS (face: 0.90; profile: 0.92). Visualizations of face signatures delineated dysmorphism across the fetal alcohol spectrum and in half of the nonsyndromal HE category face signature graphs detected facial characteristics consistent with prenatal alcohol exposure. This subgroup performed less well on IQ and learning tests than did nonsyndromal subjects without classic facial characteristics. CONCLUSIONS: Heat maps and morphing visualizations of face signatures may help clinicians detect facial dysmorphism across the fetal alcohol spectrum. Face signature graphs show potential for identifying nonsyndromal heavily exposed children who lack the classic facial phenotype but have cognitive impairment. PMID:23439907

  16. Facial Soft Tissue Measurement in Microgravity-induces Fluid Shifts

    NASA Technical Reports Server (NTRS)

    Marshburn, Thomas; Cole, Richard; Pavela, James; Garcia, Kathleen; Sargsyan, Ashot

    2014-01-01

    Fluid shifts are a well-known phenomenon in microgravity, and one result is facial edema. Objective measurement of tissue thickness in a standardized location could provide a correlate with the severity of the fluid shift. Previous studies of forehead tissue thickness (TTf) suggest that when exposed to environments that cause fluid shifts, including hypergravity, head-down tilt, and high-altitude/lowpressure, TTf changes in a consistent and measurable fashion. However, the technique in past studies is not well described or standardized. The International Space Station (ISS) houses an ultrasound (US) system capable of accurate sub-millimeter measurements of TTf. We undertook to measure TTf during long-duration space flight using a new accurate, repeatable and transferable technique. Methods: In-flight and post-flight B-mode ultrasound images of a single astronaut's facial soft tissues were obtained using a Vivid-q US system with a 12L-RS high-frequency linear array probe (General Electric, USA). Strictly mid-sagittal images were obtained involving the lower frontal bone, the nasofrontal angle, and the osseo-cartilaginous junction below. Single images were chosen for comparison that contained identical views of the bony landmarks and identical acoustical interface between the probe and skin. Using Gingko CADx DICOM viewing software, soft tissue thickness was measured at a right angle to the most prominent point of the inferior frontal bone to the epidermis. Four independent thickness measurements were made. Conclusions: Forehead tissue thickness measurement by ultrasound in microgravity is feasible, and our data suggest a decrease in tissue thickness upon return from microgravity environment, which is likely related to the cessation of fluid shifts. Further study is warranted to standardize the technique with regard to the individual variability of the local anatomy in this area.

  17. Topological optimization for designing patient-specific large craniofacial segmental bone replacements

    PubMed Central

    Sutradhar, Alok; Paulino, Glaucio H.; Miller, Michael J.; Nguyen, Tam H.

    2010-01-01

    Restoring normal function and appearance after massive facial injuries with bone loss is an important unsolved problem in surgery. An important limitation of the current methods is heuristic ad hoc design of bone replacements by the operating surgeon at the time of surgery. This problem might be addressed by incorporating a computational method known as topological optimization into routine surgical planning. We tested the feasibility of using a multiresolution three-dimensional topological optimization to design replacements for massive midface injuries with bone loss. The final solution to meet functional requirements may be shaped differently than the natural human bone but be optimized for functional needs sufficient to support full restoration using a combination of soft tissue repair and synthetic prosthetics. Topological optimization for designing facial bone tissue replacements might improve current clinical methods and provide essential enabling technology to translate generic bone tissue engineering methods into specific solutions for individual patients. PMID:20628014

  18. Facial and axillary apocrine chromhidrosis.

    PubMed

    Pérez Tato, Berta; Zamora Martínez, Elena; Sánchez Albisua, Begoña; Pérez González, Yosmar C; Polimón Olabarrieta, Isabel; Marinero Escobedo, Silvia; Fernández López, Paloma

    2012-03-15

    Apocrine chromhidrosis is a rare, chronic, idiopathic disorder, characterized by the excretion of pigmented sweat. A 26-year-old woman presented with a 3-year history of dark blue secretions on bilateral malar cheeks. On examination, upon pressure on the cheeks, a dark blue fluid was expressed, which appeared to arise primarily from the follicle. The patient had not appreciated it, but on examination of her axillae, a very subtle blue coloring was observed. Histopathologic examination revealed apocrine glands in the deep reticular dermis. Bluish cytoplasmic granules were observed in the apocrine epithelium lining, which correspond to lipofuscin granules. The diagnosis of apocrine cromhidrosis was made. We began treatment with 20 percent aluminum chloride hexahydrate solution and capsaicin cream with poor tolerance. Finally, we treated with botulinum toxin type A with a successful response. We report a case of facial and axillary apocrine cromhidrosis with good response to botulinum toxin type A.

  19. Facial attractiveness: evolutionary based research

    PubMed Central

    Little, Anthony C.; Jones, Benedict C.; DeBruine, Lisa M.

    2011-01-01

    Face preferences affect a diverse range of critical social outcomes, from mate choices and decisions about platonic relationships to hiring decisions and decisions about social exchange. Firstly, we review the facial characteristics that influence attractiveness judgements of faces (e.g. symmetry, sexually dimorphic shape cues, averageness, skin colour/texture and cues to personality) and then review several important sources of individual differences in face preferences (e.g. hormone levels and fertility, own attractiveness and personality, visual experience, familiarity and imprinting, social learning). The research relating to these issues highlights flexible, sophisticated systems that support and promote adaptive responses to faces that appear to function to maximize the benefits of both our mate choices and more general decisions about other types of social partners. PMID:21536551

  20. [Tissue adhesives in facial-nerve surgery].

    PubMed

    Murata, K; Fisch, U

    1976-01-01

    Large amounts of the tissue glue Histoacryl applied over the circumference of the epi- and perineurium of the facial nerve produced a rapid decrease of the summation potentials of the face in acute and chronic experiments performed in cats and guinea pigs. No toxic action on the motor neurons of the facial nerve was seen after application of 1 or 2 drops of the tissue glue over the epi- or perineurium of the facial nerve in association with or without a collagen tube splint.

  1. Facial reanimation procedures depicted on radiologic imaging.

    PubMed

    Ginat, D T; Bhama, P; Cunnane, M E; Hadlock, T A

    2014-09-01

    Various facial reanimation procedures can be performed for treating patients with chronic facial nerve paralysis. The radiologic imaging features of static and dynamic techniques are reviewed in this article with clinical correlation, including brow lift, eyelid weights and springs, gracilis free flaps, fascia lata grafts, temporalis flaps, and Gore-Tex suspension slings. Although the anatomic alterations resulting from facial reanimation surgery may not necessarily be the focus of the imaging examination, it is important to recognize such changes and be familiar with MR imaging compatibility of the associated implanted materials. Furthermore, imaging is sometimes used to specifically evaluate the postoperative results, such as vessel patency following free gracilis transfer.

  2. Bullous leukemia cutis mimicking facial cellulitis*

    PubMed Central

    Caldato, Luciana de Sales; Britto, Juliana de Sousa; Niero-Melo, Ligia; Miot, Hélio Amante

    2016-01-01

    Bullous leukemia cutis is an uncommon clinical manifestation of cutaneous infiltration by leukemic cells, from B-cell chronic lymphocytic leukemia. We present the case of a 67-year-old, female, chronic lymphocytic leukemia patient. She was taking chlorambucil and developed facial edema with erythema and warmth, misjudged as facial cellulitis. Two days later, she developed bullous lesions in the arms, legs, neck and face. The histopathology of facial and bullous lesions confirmed leukemia cutis. All lesions disappeared following the administration of rituximab combined with cycles of fludarabine and cyclophosphamide. Although soft tissue infections are common complications in patients undergoing chemotherapy, leukemia cutis can also resemble cellulitis. PMID:27192532

  3. Facial attractiveness: beauty and the machine.

    PubMed

    Eisenthal, Yael; Dror, Gideon; Ruppin, Eytan

    2006-01-01

    This work presents a novel study of the notion of facial attractiveness in a machine learning context. To this end, we collected human beauty ratings for data sets of facial images and used various techniques for learning the attractiveness of a face. The trained predictor achieves a significant correlation of 0.65 with the average human ratings. The results clearly show that facial beauty is a universal concept that a machine can learn. Analysis of the accuracy of the beauty prediction machine as a function of the size of the training data indicates that a machine producing human-like attractiveness rating could be obtained given a moderately larger data set.

  4. Eye movement during facial affect recognition by patients with schizophrenia, using Japanese pictures of facial affect.

    PubMed

    Shiraishi, Yuko; Ando, Kazuhiro; Toyama, Sayaka; Norikane, Kazuya; Kurayama, Shigeki; Abe, Hiroshi; Ishida, Yasushi

    2011-10-01

    A possible relationship between recognition of facial affect and aberrant eye movement was examined in patients with schizophrenia. A Japanese version of standard pictures of facial affect was prepared. These pictures of basic emotions (surprise, anger, happiness, disgust, fear, sadness) were shown to 19 schizophrenic patients and 20 healthy controls who identified emotions while their eye movements were measured. The proportion of correct identifications of 'disgust' was significantly lower for schizophrenic patients, their eye fixation time was significantly longer for all pictures of facial affect, and their eye movement speed was slower for some facial affects (surprise, fear, and sadness). One index, eye fixation time for "happiness," showed a significant difference between the high- and low-dosage antipsychotic drug groups. Some expected facial affect recognition disorder was seen in schizophrenic patients responding to the Japanese version of affect pictures, but there was no correlation between facial affect recognition disorder and aberrant eye movement.

  5. Sphenoid Sinus and Sphenoid Bone Fractures in Patients with Craniomaxillofacial Trauma

    PubMed Central

    Cantini Ardila, Jorge Ernesto; Mendoza, Miguel Ángel Rivera; Ortega, Viviana Gómez

    2013-01-01

    Background and Purpose Sphenoid bone fractures and sphenoid sinus fractures have a high morbidity due to its association with high-energy trauma. The purpose of this study is to describe individuals with traumatic injuries from different mechanisms and attempt to determine if there is any relationship between various isolated or combined fractures of facial skeleton and sphenoid bone and sphenoid sinus fractures. Methods We retrospectively studied hospital charts of all patients who reported to the trauma center at Hospital de San José with facial fractures from December 2009 to August 2011. All patients were evaluated by computed tomography scan and classified into low-, medium-, and high-energy trauma fractures, according to the classification described by Manson. Design This is a retrospective descriptive study. Results The study data were collected as part of retrospective analysis. A total of 250 patients reported to the trauma center of the study hospital with facial trauma. Thirty-eight patients were excluded. A total of 212 patients had facial fractures; 33 had a combination of sphenoid sinus and sphenoid bone fractures, and facial fractures were identified within this group (15.5%). Gender predilection was seen to favor males (77.3%) more than females (22.7%). The mean age of the patients was 37 years. Orbital fractures (78.8%) and maxillary fractures (57.5%) were found more commonly associated with sphenoid sinus and sphenoid bone fractures. Conclusions High-energy trauma is more frequently associated with sphenoid fractures when compared with medium- and low-energy trauma. There is a correlation between facial fractures and sphenoid sinus and sphenoid bone fractures. A more exhaustive multicentric case-control study with a larger sample and additional parameters will be essential to reach definite conclusions regarding the spectrum of fractures of the sphenoid bone associated with facial fractures. PMID:24436756

  6. Impaired Overt Facial Mimicry in Response to Dynamic Facial Expressions in High-Functioning Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Yoshimura, Sayaka; Sato, Wataru; Uono, Shota; Toichi, Motomi

    2015-01-01

    Previous electromyographic studies have reported that individuals with autism spectrum disorders (ASD) exhibited atypical patterns of facial muscle activity in response to facial expression stimuli. However, whether such activity is expressed in visible facial mimicry remains unknown. To investigate this issue, we videotaped facial responses in…

  7. Recombinant human bone morphogenetic protein-2 suspended in fibrin glue enhances bone formation during distraction osteogenesis in rabbits

    PubMed Central

    Li, Yunfeng; Li, Rui; Hu, Jing; Song, Donghui; Jiang, Xiaowen

    2016-01-01

    Introduction Bone morphogenetic protein-2 (BMP-2) has high potential for bone formation, but its in vivo effects are unpredictable due to the short life time. This study was designed to evaluate the effects of recombinant human (rh) BMP-2 suspended in fibrin on bone formation during distraction osteogenesis (DO) in rabbits. Material and methods The in vitro release kinetics of rhBMP-2 suspended in fibrin was tested using an enzyme-linked immunosorbent assay. Unilateral tibial lengthening for 10 mm was achieved in 48 rabbits. At the completion of osteodistraction, vehicle, fibrin, rhBMP-2 or rhBMP-2 suspended in fibrin (rhBMP-2 + fibrin) was injected into the center of the lengthened gap, with 12 animals in each group. Eight weeks later, the distracted callus was examined by histology, micro-CT and biomechanical testing. Radiographs of the distracted tibiae were taken at both 4 and 8 weeks after drug treatment. Results It was found that fibrin prolonged the life span of rhBMP-2 in vitro with sustained release during 17 days. The rhBMP-2 + fibrin treated animals showed the best results in bone mineral density, bone volume fraction, cortical bone thickness by micro-CT evaluation and mechanical properties by the three-point bending test when compared to the other groups (p < 0.05). In histological images, rhBMP-2 + fibrin treatment showed increased callus formation and better gap bridging compared to the other groups. Conclusions The results of this study suggest that fibrin holds promise to be a good carrier of rhBMP-2, and rhBMP-2 suspended in fibrin showed a stronger promoting effect on bone formation during DO in rabbits. PMID:27279839

  8. Attenuated sarcomere lengthening of the aged murine left ventricle observed using two-photon fluorescence microscopy.

    PubMed

    Nance, Michael E; Whitfield, Justin T; Zhu, Yi; Gibson, Anne K; Hanft, Laurin M; Campbell, Kenneth S; Meininger, Gerald A; McDonald, Kerry S; Segal, Steven S; Domeier, Timothy L

    2015-09-01

    The Frank-Starling mechanism, whereby increased diastolic filling leads to increased cardiac output, depends on increasing the sarcomere length (Ls) of cardiomyocytes. Ventricular stiffness increases with advancing age, yet it remains unclear how such changes in compliance impact sarcomere dynamics in the intact heart. We developed an isolated murine heart preparation to monitor Ls as a function of left ventricular pressure and tested the hypothesis that sarcomere lengthening in response to ventricular filling is impaired with advanced age. Mouse hearts isolated from young (3-6 mo) and aged (24-28 mo) C57BL/6 mice were perfused via the aorta under Ca(2+)-free conditions with the left ventricle cannulated to control filling pressure. Two-photon imaging of 4-{2-[6-(dioctylamino)-2-naphthalenyl]ethenyl}1-(3-sulfopropyl)-pyridinium fluorescence was used to monitor t-tubule striations and obtain passive Ls between pressures of 0 and 40 mmHg. Ls values (in μm, aged vs. young, respectively) were 2.02 ± 0.04 versus 2.01 ± 0.02 at 0 mmHg, 2.13 ± 0.04 versus 2.23 ± 0.02 at 5 mmHg, 2.21 ± 0.03 versus 2.27 ± 0.03 at 10 mmHg, and 2.28 ± 0.02 versus 2.36 ± 0.01 at 40 mmHg, indicative of impaired sarcomere lengthening in aged hearts. Atomic force microscopy nanoindentation revealed that intact cardiomyocytes enzymatically isolated from aged hearts had increased stiffness compared with those of young hearts (elastic modulus: aged, 41.9 ± 5.8 kPa vs. young, 18.6 ± 3.3 kPa; P = 0.006). Impaired sarcomere lengthening during left ventricular filling may contribute to cardiac dysfunction with advancing age by attenuating the Frank-Starling mechanism and reducing stroke volume.

  9. [Summery and recommendations for acupuncture for peripheral facial paralysis].

    PubMed

    Wang, Sheng-Qiang; Yu, Su; Wang, Jian-Ping

    2011-12-01

    Articles on acupuncture for peripheral facial paralysis were picked up from CNKI database. The retrieved original studies were evaluated and summarized. The problems of acupuncture for peripheral facial paralysis were analyzed, and concrete solutions were proposed. Problems that differential diagnosis, prognosis, treatment of severe facial paralysis, and identification of sequelae and compliation were not embasized in clinical treatment of facial paralysis. Consequently, the effectiveness of acupuncture for peripheral facial paralysis will be improved by sloving above problems.

  10. Developmental and Evolutionary Significance of the Zygomatic Bone

    PubMed Central

    Heuzé, Yann; Kawasaki, Kazuhiko; Schwarz, Tobias; Schoenebeck, Jeffrey J.

    2016-01-01

    ABSTRACT The zygomatic bone is derived evolutionarily from the orbital series. In most modern mammals the zygomatic bone forms a large part of the face and usually serves as a bridge that connects the facial skeleton to the neurocranium. Our aim is to provide information on the contribution of the zygomatic bone to variation in midfacial protrusion using three samples; humans, domesticated dogs, and monkeys. In each case, variation in midface protrusion is a heritable trait produced by one of three classes of transmission: localized dysmorphology associated with single gene dysfunction, selective breeding, or long‐term evolution from a common ancestor. We hypothesize that the shape of the zygomatic bone reflects its role in stabilizing the connection between facial skeleton and neurocranium and consequently, changes in facial protrusion are more strongly reflected by the maxilla and premaxilla. Our geometric morphometric analyses support our hypothesis suggesting that the shape of the zygomatic bone has less to do with facial protrusion. By morphometrically dissecting the zygomatic bone we have determined a degree of modularity among parts of the midfacial skeleton suggesting that these components have the ability to vary independently and thus can evolve differentially. From these purely morphometric data, we propose that the neural crest cells that are fated to contribute to the zygomatic bone experience developmental cues that distinguish them from the maxilla and premaxilla. The spatiotemporal and molecular identity of the cues that impart zygoma progenitors with their identity remains an open question that will require alternative data sets. Anat Rec, 299:1616–1630, 2016. © 2016 The Authors The Anatomical Record Published by Wiley Periodicals, Inc. PMID:27870340

  11. [Treatment of congenital facial paralysis with crossed innervation of facial nerve and electric field stimulation].

    PubMed

    Ysunza-Rivera, A; Iñigo-Muñoz, F; Drucker-Colín, R; Ortiz-Monasterio, F; Pesqueira, T

    1992-04-01

    Congenital facial palsy is a devastating deformity. At present time there are no reports of the early treatment of this disorder. The treatment may be to supply contralateral auto reinnervation to the affected muscles through a sural-facial nerve graft enhanced by electric field stimulation. The purpose of this paper is to report 5 cases of congenital facial palsy treated by a crossed sural-facial nerve graft, enhanced by electric field stimulation. One year after surgery, clinical and electrodiagnostic examinations indicate appropriate reinnervation activity in all the patients.

  12. Evaluation of the facial dimensions of young adult women with a preferred facial appearance

    PubMed Central

    Kim, Sae Yong; Bayome, Mohamed; Park, Jae Hyun; Kang, Ju Hee; Kim, Kang Hyuk; Moon, Hong-Beom

    2015-01-01

    Objective The aim of this study was to evaluate the facial dimensions of young adult women with a preferred facial appearance and compare the results with those from the general population. Methods Twenty-five linear, nine angular, and three area measurements were made and four ratios were calculated using a sample of standardized frontal and lateral photographs of 46 young adult women with a preferred facial appearance (Miss Korea group) and 44 young adult women from the general population (control group). Differences between the two groups were analyzed using multivariate analysis of variance (MANOVA). Results Compared with the control group, the Miss Korea group exhibited a significantly greater facial height, total facial height (TFH; trichion-menton), facial width (tragus right-tragus left), facial depth (tragus-true vertical line), and trichion-nasion/TFH ratio and smaller subnasale-menton/TFH and facial width/TFH ratios. Furthermore, the control group had smaller intercanthal and interpupillary widths. Conclusions The Miss Korea group exhibited longer, wider, and deeper faces compared with those from the general population. Furthermore, the Miss Korea group had larger eyes, longer but less protruded noses, longer and more retruded lower lips and chins, larger lip vermilion areas, and smaller labiomental angles. These results suggest that the latest trends in facial esthetics should be considered during diagnosis and treatment planning for young women with dentofacial abnormalities. PMID:26445720

  13. Facial rehabilitation: a neuromuscular reeducation, patient-centered approach.

    PubMed

    Vanswearingen, Jessie

    2008-05-01

    Individuals with facial paralysis and distorted facial expressions and movements secondary to a facial neuromotor disorder experience substantial physical, psychological, and social disability. Previously, facial rehabilitation has not been widely available or considered to be of much benefit. An emerging rehabilitation science of neuromuscular reeducation and evidence for the efficacy of facial neuromuscular reeducation, a process of facilitating the return of intended facial movement patterns and eliminating unwanted patterns of facial movement and expression, may provide patients with disorders of facial paralysis or facial movement control opportunity for the recovery of facial movement and function. We provide a brief overview of the scientific rationale for facial neuromuscular reeducation in the structure and function of the facial neuromotor system, the neuropsychology of facial expression, and relations among expressions, movement, and emotion. The primary purpose is to describe principles of neuromuscular reeducation, assessment and outcome measures, approach to treatment, the process, including surface-electromyographic biofeedback as an adjunct to reeducation, and the goal of enhancing the recovery of facial expression and function in a patient-centered approach to facial rehabilitation.

  14. Evaluation of the influence of pedicle-lengthening osteotomy on lumbar stability

    PubMed Central

    Gao, Maofeng; Zou, Jun; Zhang, Zhigang; Luo, Zongping; Yang, Huilin

    2016-01-01

    Pedicle-lengthening osteotomy (PLO) is a minimally invasive and effective surgical procedure for lumbar spinal stenosis syndrome. Compared with traditional surgery, PLO can effectively enlarge the spinal canal while minimizing the disruption of posterior anatomical structures of the lumbar vertebra, leading to reduced postoperative perineural scarring adhesion and good clinical outcomes using minimally invasive procedures. However, PLO is still in its early stages, and only a few relevant experimental and clinical studies have been reported. The present study was performed to investigate the influence of PLO on the stability of lumbar vertebrae. The results indicated that PLO can effectively enlarge the spinal canal, and no lumbar spondylolisthesis or other complications occurred in this study. Moreover, this procedure does not significantly affect the stability of the lumbar spine, suggesting a possible clinical application. PMID:27347315

  15. Group velocity and pulse lengthening of mismatched laser pulses in plasma channels

    SciTech Connect

    Schroeder, Carl; Benedetti, Carlo; Esarey, Eric; van Tilborg, Jeroen; Leemans, Wim

    2011-07-07

    Analytic solutions are presented to the non-paraxial wave equation describing an ultra-short, low-power, laser pulse propagating in aplasma channel. Expressions for the laser pulse centroid motion and laser group velocity are derived, valid for matched and mismatchedpropagation in a parabolic plasma channel, as well as in vacuum, for an arbitrary Laguerre-Gaussian laser mode. The group velocity of amismatched laser pulse, for which the laser spot size is strongly oscillating, is found to be independent of propagation distance andsignificantly less than that of a matched pulse. Laser pulse lengthening of a mismatched pulse owing to laser mode slippage isexamined and found to dominate over that due to dispersive pulse spreading for sufficiently long pulses. Analytic results are shown tobe in excellent agreement with numerical solutions of the full Maxwell equations coupled to the plasma response. Implications for plasmachannel diagnostics are discussed.

  16. Gastrocnemius recession or tendo-achilles lengthening for equinus deformity in the diabetic foot?

    PubMed

    Greenhagen, Robert M; Johnson, Adam R; Bevilacqua, Nicholas J

    2012-07-01

    Contracture of the Achilles-gastrocnemius-soleus complex leading to ankle equinus has been linked to the development of various foot disorders. Decrease in ankle dorsiflexion results in an increase in plantar pressures and in diabetes and neuropathy, increased pressures can lead to ulceration and possibly the formation of Charcot foot. Surgical management of the equinus deformity corrects this abnormality and has the potential to avert the development of Charcot foot or ankle. Gastrocnemius recession, tendo-Achilles lengthening, and Achilles tenotomy have all been offered as surgical solutions to this condition. This article reviews ankle equinus and compares the treatment options available. A video of Hoke's triple hemisection has been included with this article and can be viewed at www.podiatric.theclinics.com.

  17. Outcome of gastrocnemius recession and tendo-achilles lengthening in ambulatory children with cerebral palsy.

    PubMed

    Kay, Robert M; Rethlefsen, Susan A; Ryan, James A; Wren, Tishya A L

    2004-03-01

    Preoperative and postoperative gait analysis data were retrospectively studied for 54 children with cerebral palsy who had undergone either gastrocnemius recession (GR) or tendo-achilles lengthening (TAL) as part of multi-level surgery. Decision-making between GR and TAL was based on the Silfverskiöld test. The TAL group had greater equinus preoperatively than the GR group. Both groups showed significant improvement in static and dynamic dorsiflexion and in outcome measured by a modified Physician Rating Scale (PRS) postoperatively. Calf spasticity decreased and push-off power increased after GR. Both GR and TAL are effective in appropriately selected patients. However, a potential for over- and under-correction with both GR and TAL was demonstrated.

  18. Cluster reduction and compensatory lengthening in the acquisition of possessive -s.

    PubMed

    Mealings, Kiri Trengove; Demuth, Katherine

    2014-05-01

    Previous research shows that two-year-olds' third person singular -s and plural -s are produced more accurately in utterance-final compared to utterance-medial position. However, only the third person singular is affected by coda complexity. This study explores these effects with possessive -s. Acoustic analysis of twelve two-year-olds' elicited imitations examined the use of simple versus complex codas (e.g. Sue's vs. Doug's ) both utterance-medially and utterance-finally. Morpheme production was surprisingly robust across contexts, though coda clusters were often simplified to a lengthened -s morpheme utterance-medially (e.g., Dou's [dɐz]). The findings raise many questions about the development of speech planning processes across populations.

  19. The Role of ATRX in the Alternative Lengthening of Telomeres (ALT) Phenotype

    PubMed Central

    Amorim, João P.; Santos, Gustavo; Vinagre, João; Soares, Paula

    2016-01-01

    Telomeres are responsible for protecting chromosome ends in order to prevent the loss of coding DNA. Their maintenance is required for achieving immortality by neoplastic cells and can occur by upregulation of the telomerase enzyme or through a homologous recombination-associated process, the alternative lengthening of telomeres (ALT). The precise mechanisms that govern the activation of ALT or telomerase in tumor cells are not fully understood, although cellular origin may favor one of the other mechanisms that have been found thus far in mutual exclusivity. Specific mutational events influence ALT activation and maintenance: a unifying frequent feature of tumors that acquire this phenotype are the recurrent mutations of the Alpha Thalassemia/Mental Retardation Syndrome X-Linked (ATRX) or Death-Domain Associated Protein (DAXX) genes. This review summarizes the established criteria about this phenotype: its prevalence, theoretical molecular mechanisms and relation with ATRX, DAXX and other proteins (directly or indirectly interacting and resulting in the ALT phenotype). PMID:27657132

  20. Newborn Infants Imitate Adult Facial Gestures.

    ERIC Educational Resources Information Center

    Meltzoff, Andrew N.; Moore, M. Keith

    1983-01-01

    Results indicated that infants only 0.7 to 71 hours old can imitate adults' facial gestures (mouth opening and tongue protrusions). Three possible mechanisms underlying this early imitative behavior are suggested. (Author/MP)

  1. Men's facial masculinity: when (body) size matters.

    PubMed

    Holzleitner, Iris J; Hunter, David W; Tiddeman, Bernard P; Seck, Alassane; Re, Daniel E; Perrett, David I

    2014-01-01

    Recent studies suggest that judgments of facial masculinity reflect more than sexually dimorphic shape. Here, we investigated whether the perception of masculinity is influenced by facial cues to body height and weight. We used the average differences in three-dimensional face shape of forty men and forty women to compute a morphological masculinity score, and derived analogous measures for facial correlates of height and weight based on the average face shape of short and tall, and light and heavy men. We found that facial cues to body height and weight had substantial and independent effects on the perception of masculinity. Our findings suggest that men are perceived as more masculine if they appear taller and heavier, independent of how much their face shape differs from women's. We describe a simple method to quantify how body traits are reflected in the face and to define the physical basis of psychological attributions.

  2. Computed tomography of orbital-facial neurofibromatosis

    SciTech Connect

    Zimmerman, R.A.; Bilaniuk, L.T.; Metzger, R.A.; Grossman, R.I.; Schut, L.; Bruce, D.A.

    1983-01-01

    Twenty-four patients with orbital-facial manifestations of neurofibromations were examined by computed tomography. Delineation of the extent of the disease, and differentiation of the disease processes (orbital tumor, osseous orbital dysplasia, plexiform neurofibromatosis, and buphthalmos) was possible.

  3. Ethics and the facial plastic surgeon.

    PubMed

    Sethi, Neeraj

    2016-09-01

    The facial plastic surgeon potentially has a conflict of interest when confronted with the patients requesting surgery, due to the personal gain attainable by agreeing to perform surgery. The aim of this review is to discuss the potential harm the surgeon can inflict by carrying out facial plastic surgery, beyond the standard surgical complications of infection or bleeding. It will discuss the desire for self-improvement and perfection and increase in the prevalence facial plastic surgery. We address the principles of informed consent, beneficence and non-maleficence, as well as justice and equality and how the clinician who undertakes facial plastic surgery is at risk of breaching these principles without due care and diligence.

  4. Recurrent facial urticaria following herpes simplex labialis.

    PubMed

    Zawar, Vijay; Godse, Kiran

    2012-03-01

    We describe recurrent acute right-sided facial urticaria associated with herpes labialis infection in a middle-aged female patient. Antiviral medications and antihistamines not only successfully cleared the herpes infection and urticaria but also prevented further recurrences.

  5. Developing psychological services following facial trauma

    PubMed Central

    Choudhury-Peters, Deba; Dain, Vicky

    2016-01-01

    Adults presenting to oral and maxillofacial surgery services are at high risk of psychological morbidity. Research by the Institute of Psychotrauma and the centre for oral and maxillofacial surgery trauma clinic at the Royal London hospital (2015) demonstrated nearly 40% of patients met diagnostic criteria for either depression, post traumatic stress disorder (PTSD), anxiety, alcohol misuse, or substance misuse, or were presenting with facial appearance distress. Most facial injury patients were not receiving mental health assessment or treatment, and the maxillofacial team did not have direct access to psychological services. Based on these research findings, an innovative one-year pilot psychology service was designed and implemented within the facial trauma clinic. The project addressed this need by offering collaborative medical and psychological care for all facial injury patients. The project provided brief screening, assessment, and early psychological intervention. The medical team were trained to better recognise and respond to psychological distress. PMID:27493750

  6. Camouflaging Facial Emphysema: a new syndrome.

    PubMed

    Martínez-Carpio, Pedro A; del Campillo, Ángel F Bedoya; Leal, María Jesús; Lleopart, Núria; Marrón, María T; Trelles, Mario A

    2012-10-10

    Camouflaging Facial Emphysema, as is defined in this paper, is the result of a simple technique used by the patient to deform his face in order to prevent recognition at a police identity parade. The patient performs two punctures in the mucosa at the rear of the upper lip and, after several Valsalva manoeuvres, manages to deform his face in less than 15 min by inducing subcutaneous facial emphysema. The examination shows an accumulation of air in the face, with no laterocervical, mediastinal or thoracic affectations. The swelling is primarily observed in the eyelids and the orbital and zygomatic regions, whereas it is less prominent in other areas of the face. Patients therefore manage to avoid recognition in properly conducted police identity parades. Only isolated cases of self-induced facial emphysema have been reported to date among psychiatric patients and prison inmates. However, the facial emphysema herein described exhibits specific characteristics of significant medical, deontological, social, police-related, and legal implications.

  7. Ranking of facial profiles among Asians.

    PubMed

    Lew, K K; Soh, G; Loh, E

    1992-01-01

    The purpose of this study was to determine the facial profile preferences in a sample of 1,189 Asian teenagers (aged 15.3 +/- 3.2 years). Five facial profile types were computer-generated by trained personnel (orthodontists and oral maxillofacial surgeons) to represent distinct facial types. Subjects were asked to rank the profiles in descending order of attractiveness. The ranking was as follows: orthognathic profile, bimaxillary retrusive profile, bimaxillary protrusive profile, mandibular retrognathic profile, and mandibular prognathic profile. The differences in rank scores between all the profile types were statistically significant (p < 0.05). Assessment of profile types among lay personnel could provide clinicians an indication into the relative attractiveness among profile types and health care workers in treatment prioritization among dysmorphic facial types.

  8. Analysis of neural crest–derived clones reveals novel aspects of facial development

    PubMed Central

    Kaucka, Marketa; Ivashkin, Evgeny; Gyllborg, Daniel; Zikmund, Tomas; Tesarova, Marketa; Kaiser, Jozef; Xie, Meng; Petersen, Julian; Pachnis, Vassilis; Nicolis, Silvia K.; Yu, Tian; Sharpe, Paul; Arenas, Ernest; Brismar, Hjalmar; Blom, Hans; Clevers, Hans; Suter, Ueli; Chagin, Andrei S.; Fried, Kaj; Hellander, Andreas; Adameyko, Igor

    2016-01-01

    Cranial neural crest cells populate the future facial region and produce ectomesenchyme-derived tissues, such as cartilage, bone, dermis, smooth muscle, adipocytes, and many others. However, the contribution of individual neural crest cells to certain facial locations and the general spatial clonal organization of the ectomesenchyme have not been determined. We investigated how neural crest cells give rise to clonally organized ectomesenchyme and how this early ectomesenchyme behaves during the developmental processes that shape the face. Using a combination of mouse and zebrafish models, we analyzed individual migration, cell crowd movement, oriented cell division, clonal spatial overlapping, and multilineage differentiation. The early face appears to be built from multiple spatially defined overlapping ectomesenchymal clones. During early face development, these clones remain oligopotent and generate various tissues in a given location. By combining clonal analysis, computer simulations, mouse mutants, and live imaging, we show that facial shaping results from an array of local cellular activities in the ectomesenchyme. These activities mostly involve oriented divisions and crowd movements of cells during morphogenetic events. Cellular behavior that can be recognized as individual cell migration is very limited and short-ranged and likely results from cellular mixing due to the proliferation activity of the tissue. These cellular mechanisms resemble the strategy behind limb bud morphogenesis, suggesting the possibility of common principles and deep homology between facial and limb outgrowth. PMID:27493992

  9. Lengthening of the duration of xylogenesis engenders disproportionate increases in xylem production.

    PubMed

    Rossi, Sergio; Girard, Marie-Josée; Morin, Hubert

    2014-07-01

    In cold climates, the expected global warming will lead to earlier cambial resumptions in spring, with a resultant lengthening of the growing season but unknown consequences on forest productivity. The phenological traits of cambium activity and xylem formation were analyzed at a short time scale along a thermal gradient represented by an alti-latitudinal range from the 48th to 53rd parallels and covering the whole closed black-spruce [Picea mariana (Mill.) BSP] forest in Quebec, Canada. A hypothesis was tested that warmer temperatures influence cambium phenology, allowing longer duration and higher intensity of growth, and resulting in proportionally increased xylem production. From April to October 2012, cell division in cambium and post-cambial differentiation of xylem were observed on anatomical sections obtained from microcores collected weekly from the stem of fifty trees. The southern and warmer site was characterized by the highest radial growth, which corresponded to both the highest rates and longest durations of cell production. The differences in terms of xylem phenology and growth were marginal between the other sites. Xylem growth was positively correlated with rate and duration of cell production, with the latter explaining most variability in growth. Within the range analyzed, the relationship between temperature and most phenological phases of xylogenesis was linear. On the contrary, temperature was related with cell production according to an exponential pattern. Periods of xylogenesis of 14 days longer (+13.1%) corresponded to a massive increase in cell production (33 cells, +109%). This disproportionate change occurred at a May-September average temperature of ca. 14 °C and a snow-free period of 210-235 days. At the lower boundary of the distribution of black spruce, small environmental changes allowing marginal lengthening of the period of cell division could potentially lead to disproportionate increases in xylem cell production, with

  10. Reconstructive procedures for segmental resection of bone in giant cell tumors around the knee

    PubMed Central

    Aggarwal, Aditya N; Jain, Anil K; Kumar, Sudhir; Dhammi, Ish K; Prashad, Bhagwat

    2007-01-01

    Background: Segmental resection of bone in Giant Cell Tumor (GCT) around the knee, in indicated cases, leaves a gap which requires a complex reconstructive procedure. The present study analyzes various reconstructive procedures in terms of morbidity and various complications encountered. Materials and Methods: Thirteen cases (M-six and F-seven; lower end femur-six and upper end tibia -seven) of GCT around the knee, radiologically either Campanacci Grade II, Grade II with pathological fracture or Grade III were included. Mean age was 25.6 years (range 19-30 years). Resection arthrodesis with telescoping (shortening) over intramedullary nail (n=5), resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail (n=3) and resection arthrodesis with intercalary fibular autograft and simultaneous limb lengthening (n=5) were the procedure performed. Results: Shortening was the major problem following resection arthrodesis with telescoping (shortening) over intramedullary nail. Only two patients agreed for subsequent limb lengthening. The rest continued to walk with shortening. Infection was the major problem in all cases of resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail and required multiple drainage procedures. Fusion was achieved after two years in two patients. In the third patient the allograft sequestrated. The patient underwent sequestrectomy, telescoping of fragments and ilizarov fixator application with subsequent limb lengthening. The patient was finally given an ischial weight relieving orthosis, 54 months after the index procedure. After resection arthrodesis with intercalary autograft and simultaneous lengthening the resultant gap (∼15cm) was partially bridged by intercalary nonvascularized dual fibular strut graft (6-7cm) and additional corticocancellous bone graft from ipsilateral patella. Simultaneous limb lengthening with a distal tibial corticotomy was performed on an ilizarov

  11. Temporomandibular disorders, facial pain, and headaches.

    PubMed

    Bender, Steven D

    2012-05-01

    Headaches and facial pain are common in the general population. In many cases, facial pain can be resultant from temporomandibular joint disorders. Studies have identified an association between headaches and temporomandibular joint disorders suggesting the possibility of shared pathophysiologic mechanisms of these 2 maladies. The aim of this paper is to elucidate potential commonalities of these disorders and to provide a brief overview of an examination protocol that may benefit the headache clinician in daily practice.

  12. Botulinum toxin to minimize facial scarring.

    PubMed

    Sherris, David A; Gassner, Holger G

    2002-02-01

    Botulinum toxin injection has been used for a variety of indications in humans, including blepharospasm and hyperfunctional facial lines. This article describes a novel formulation of botulinum toxin, which supplies immediate feedback to the injecting physician. Additionally, recent findings are described that indicate the immediate injection of botulinum toxin into the muscles underlying a wound can improve the cosmetic outcome of the facial cutaneous scar. Future applications of these findings are discussed.

  13. Chronic Facial Pain: A Clinical Approach

    PubMed Central

    Marotta, Joseph T.

    1983-01-01

    Facial pain is a common presenting complaint requiring patience and diagnostic acumen. The proliferation of eponyms attached to various syndromes complicates the subject. The most frequent cause of pain is likely to be muscle spasm in masticatory or temporalis muscles. This article presents a rank order for the common causes of facial pain that present diagnostic difficulty, such as temporomandibular joint pain, trigeminal neuralgia, giant cell arteritis, and post-herpetic neuralgia. PMID:21286580

  14. Laptop Computer - Based Facial Recognition System Assessment

    SciTech Connect

    R. A. Cain; G. B. Singleton

    2001-03-01

    The objective of this project was to assess the performance of the leading commercial-off-the-shelf (COTS) facial recognition software package when used as a laptop application. We performed the assessment to determine the system's usefulness for enrolling facial images in a database from remote locations and conducting real-time searches against a database of previously enrolled images. The assessment involved creating a database of 40 images and conducting 2 series of tests to determine the product's ability to recognize and match subject faces under varying conditions. This report describes the test results and includes a description of the factors affecting the results. After an extensive market survey, we selected Visionics' FaceIt{reg_sign} software package for evaluation and a review of the Facial Recognition Vendor Test 2000 (FRVT 2000). This test was co-sponsored by the US Department of Defense (DOD) Counterdrug Technology Development Program Office, the National Institute of Justice, and the Defense Advanced Research Projects Agency (DARPA). Administered in May-June 2000, the FRVT 2000 assessed the capabilities of facial recognition systems that were currently available for purchase on the US market. Our selection of this Visionics product does not indicate that it is the ''best'' facial recognition software package for all uses. It was the most appropriate package based on the specific applications and requirements for this specific application. In this assessment, the system configuration was evaluated for effectiveness in identifying individuals by searching for facial images captured from video displays against those stored in a facial image database. An additional criterion was that the system be capable of operating discretely. For this application, an operational facial recognition system would consist of one central computer hosting the master image database with multiple standalone systems configured with duplicates of the master operating in

  15. Dynamic reanimation for facial palsy: an overview.

    PubMed

    Coyle, Margaret; Godden, Andrew; Brennan, Peter A; Cascarini, Luke; Coombes, Darryl; Kerawala, Cyrus; McCaul, James; Godden, Daryl

    2013-12-01

    Facial paralysis can have a profound effect on the patient from both an aesthetic and functional point of view. The symptoms depend on which branch of the nerve has been damaged and the severity of the injury. The purpose of this paper is to review currently available treatments for dynamic reanimation of a damaged facial nerve, and the goals are a symmetrical and coordinated smile. Careful selection of patients and use of the appropriate surgical technique can have excellent results.

  16. [Bone diseases].

    PubMed

    Uebelhart, Brigitte; Rizzoli, René

    2016-01-13

    Calcium intake shows a small impact on bone mineral density and fracture risk. Denosumab is a more potent inhibitor of bone resorption than zoledronate. Abaloparatide, PTHrP analog, increases bone mineral density and decreases fracture incidence. Teriparatide could be delivered via a transdermic device. Romosozumab and odanacatib improve calculated bone strength. Sequential or combined treatments with denosumab and teriparatide could be of interest, but not denosumab followed by teriparatide. Fibrous dysplasia, Paget disease and hypophosphatasia are updated, as well as atypical femoral fracture and osteonecrosis of the jaw.

  17. Bone cutting.

    PubMed

    Giraud, J Y; Villemin, S; Darmana, R; Cahuzac, J P; Autefage, A; Morucci, J P

    1991-02-01

    Bone cutting has always been a problem for surgeons because bone is a hard living material, and many osteotomes are still very crude tools. Technical improvement of these surgical tools has first been their motorization. Studies of the bone cutting process have indicated better features for conventional tools. Several non-conventional osteotomes, particularly ultrasonic osteotomes are described. Some studies on the possible use of lasers for bone cutting are also reported. Use of a pressurised water jet is also briefly examined. Despite their advantages, non-conventional tools still require improvement if they are to be used by surgeons.

  18. Growth disturbance after lengthening of the lower limb and quantitative assessment of physeal closure in skeletally immature patients with achondroplasia.

    PubMed

    Song, S H; Kim, S E; Agashe, M V; Lee, H; Refai, M A; Park, Y E; Choi, H J; Park, J H; Song, H R

    2012-04-01

    This study evaluated the effect of limb lengthening on longitudinal growth in patients with achondroplasia. Growth of the lower extremity was assessed retrospectively by serial radiographs in 35 skeletally immature patients with achondroplasia who underwent bilateral limb lengthening (Group 1), and in 12 skeletally immature patients with achondroplasia who did not (Group 2). In Group 1, 23 patients underwent only tibial lengthening (Group 1a) and 12 patients underwent tibial and femoral lengthening sequentially (Group 1b). The mean lengthening in the tibia was 9.2 cm (59.5%) in Group 1a, and 9.0 cm (58.2%) in the tibia and 10.2 cm (54.3%) in the femur in Group 1b. The mean follow-up was 9.3 years (8.6 to 10.3). The final mean total length of lower extremity in Group 1a was 526.6 mm (501.3 to 552.9) at the time of skeletal maturity and 610.1 mm (577.6 to 638.6) in Group 1b, compared with 457.0 mm (411.7 to 502.3) in Group 2. However, the mean actual length, representing the length solely grown from the physis without the length of distraction, showed that there was a significant disturbance of growth after limb lengthening. In Group 1a, a mean decrease of 22.4 mm (21.3 to 23.1) (4.9%) was observed in the actual limb length when compared with Group 2, and a greater mean decrease of 38.9 mm (37.2 to 40.8) (8.5%) was observed in Group 1b when compared with Group 2 at skeletal maturity. In Group 1, the mean actual limb length was 16.5 mm (15.8 to 17.2) (3.6%) shorter in Group 1b when compared with Group 1a at the time of skeletal maturity. Premature physeal closure was seen mostly in the proximal tibia and the distal femur with relative preservation of proximal femur and distal tibia. We suggest that significant disturbance of growth can occur after extensive limb lengthening in patients with achondroplasia, and therefore, this should be included in pre-operative counselling of these patients and their parents.

  19. Medium Term Follow-up of Achilles Tendon Lengthening in the Treatment of Ankle Equinus in Cerebral Palsy

    PubMed Central

    Dietz, Frederick R; Albright, Jay C; Dolan, Lori

    2006-01-01

    Introduction: The optimal treatment for equinus of the ankle in ambulatory patients with cerebral palsy is not known. This study assessed the medium term follow-up results of treatment of spastic ankle equinus deformity in cerebral palsy using Hoke or coronal Z-lengthening of the Achilles tendon. It was hypothesized that the use of Achilles tendon lengthening (TAL) as a treatment for spastic ankle equinus during gait results in a high rate of over-weakening of the triceps surae resulting in crouch gait. We also investigated patient characteristics that could identify which patients are at risk for crouch gait due to triceps surae weakening from Achilles tendon lengthening. Materials and Methods: Seventy-nine patients (114 procedures) who had undergone Achilles lengthening were retrospectively reviewed to determine how many patients developed crouch gait with dorsiflexion of the ankle throughout stance phase requiring anterior-floor-reaction bracing. The following patient characteristics were evaluated: age at surgery, geographic type of cerebral palsy, length of follow-up, need for anterior-floor-reaction bracing, length of time after surgery when brace was prescribed, age at time of need for bracing, side of surgery, technique used, additional procedures performed at time of TAL, previous or later procedures performed, and walking ability. Results: The average age at the time of TAL was 7 years and 3 months, and the average follow-up was seven years. The geographic type of cerebral palsy greatly affected the outcome. None of the twenty-three hemiplegic patients required bracing. Fourteen of 34 (41%) patients with spastic diplegia and seven of fourteen (50%) patients with spastic quadriplegia required bracing. There was no significant difference in outcome between the Hoke and the Z-lengthening procedures. Patients who underwent more procedures and bilateral procedures were more likely to require anterior-floor-reaction bracing. Conclusions: Achilles tendon

  20. Horses discriminate between facial expressions of conspecifics

    PubMed Central

    Wathan, J.; Proops, L.; Grounds, K.; McComb, K.

    2016-01-01

    In humans, facial expressions are rich sources of social information and have an important role in regulating social interactions. However, the extent to which this is true in non-human animals, and particularly in non-primates, remains largely unknown. Therefore we tested whether domestic horses (Equus caballus) could discriminate between facial expressions of their conspecifics captured in different contexts, and whether viewing these expressions elicited functionally relevant reactions. Horses were more likely to approach photographic stimuli displaying facial expressions associated with positive attention and relaxation, and to avoid stimuli displaying an expression associated with aggression. Moreover, differing patterns of heart rate changes were observed in response to viewing the positive anticipation and agonistic facial expressions. These results indicate that horses spontaneously discriminate between photographs of unknown conspecifics portraying different facial expressions, showing appropriate behavioural and physiological responses. Thus horses, an animal far-removed from the primate lineage, also have the ability to use facial expressions as a means of gaining social information and potentially regulating social interactions. PMID:27995958

  1. Delayed facial nerve decompression for Bell's palsy.

    PubMed

    Kim, Sang Hoon; Jung, Junyang; Lee, Jong Ha; Byun, Jae Yong; Park, Moon Suh; Yeo, Seung Geun

    2016-07-01

    Incomplete recovery of facial motor function continues to be long-term sequelae in some patients with Bell's palsy. The purpose of this study was to investigate the efficacy of transmastoid facial nerve decompression after steroid and antiviral treatment in patients with late stage Bell's palsy. Twelve patients underwent surgical decompression for Bell's palsy 21-70 days after onset, whereas 22 patients were followed up after steroid and antiviral therapy without decompression. Surgical criteria included greater than 90 % degeneration on electroneuronography and no voluntary electromyography potentials. This study was a retrospective study of electrodiagnostic data and medical chart review between 2006 and 2013. Recovery from facial palsy was assessed using the House-Brackmann grading system. Final recovery rate did not differ significantly in the two groups; however, all patients in the decompression group recovered to at least House-Brackmann grade III at final follow-up. Although postoperative hearing threshold was increased in both groups, there was no significant between group difference in hearing threshold. Transmastoid decompression of the facial nerve in patients with severe late stage Bell's palsy at risk for a poor facial nerve outcome reduced severe complications of facial palsy with minimal morbidity.

  2. Facial nerve paralysis after cervical traction.

    PubMed

    So, Edmund Cheung

    2010-10-01

    Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination revealed a peripheral-type facial nerve paralysis. Symptoms of facial nerve paralysis subsided after prednisolone treatment and suspension of traction therapy. It is suspected that a misplaced or an overstrained harness may have been the cause of facial nerve paralysis in this patient. Possible causes were (1) direct compression by the harness on the right facial nerve near its exit through the stylomastoid foramen; (2) compression of the right external carotid artery by the harness, causing transient ischemic injury at the geniculate ganglion; or (3) coincidental herpes zoster virus infection or idiopathic Bell's palsy involving the facial nerve.

  3. Facial expression recognition in perceptual color space.

    PubMed

    Lajevardi, Seyed Mehdi; Wu, Hong Ren

    2012-08-01

    This paper introduces a tensor perceptual color framework (TPCF) for facial expression recognition (FER), which is based on information contained in color facial images. The TPCF enables multi-linear image analysis in different color spaces and demonstrates that color components provide additional information for robust FER. Using this framework, the components (in either RGB, YCbCr, CIELab or CIELuv space) of color images are unfolded to two-dimensional (2- D) tensors based on multi-linear algebra and tensor concepts, from which the features are extracted by Log-Gabor filters. The mutual information quotient (MIQ) method is employed for feature selection. These features are classified using a multi-class linear discriminant analysis (LDA) classifier. The effectiveness of color information on FER using low-resolution and facial expression images with illumination variations is assessed for performance evaluation. Experimental results demonstrate that color information has significant potential to improve emotion recognition performance due to the complementary characteristics of image textures. Furthermore, the perceptual color spaces (CIELab and CIELuv) are better overall for facial expression recognition than other color spaces by providing more efficient and robust performance for facial expression recognition using facial images with illumination variation.

  4. Similarities in Aegyptopithecus and Afropithecus facial morphology.

    PubMed

    Leakey, M G; Leakey, R E; Richtsmeier, J T; Simons, E L; Walker, A C

    1991-01-01

    Recently discovered cranial fossils from the Oligocene deposits of the Fayum depression in Egypt provide many details of the facial morphology of Aegyptopithecus zeuxis. Similar features are found in the Miocene hominoid Afropithecus turkanensis. Their presence is the first good evidence of a strong phenetic link between the Oligocene and Miocene hominoids of Africa. A comparison of trait lists emphasizes the similarities of the two fossil species, and leads us to conclude that the two fossil genera share many primitive facial features. In addition, we studied facial morphology using finite-element scaling analysis and found that the two genera show similarities in morphological integration, or the way in which biological landmarks relate to one another in three dimensions to define the form of the organism. Size differences between the two genera are much greater than the relatively minor shape differences. Analysis of variability in landmark location among the four Aegyptopithecus specimens indicates that variability within the sample is not different from that found within two samples of modern macaques. We propose that the shape differences found among the four Aegyptopithecus specimens simply reflect individual variation in facial characteristics, and that the similarities in facial morphology between Aegyptopithecus and Afropithecus probably represent a complex of primitive facial features retained over millions of years.

  5. Searching for proprioceptors in human facial muscles.

    PubMed

    Cobo, Juan L; Abbate, Francesco; de Vicente, Juan C; Cobo, Juan; Vega, José A

    2017-02-15

    The human craniofacial muscles innervated by the facial nerve typically lack muscle spindles. However these muscles have proprioception that participates in the coordination of facial movements. A functional substitution of facial proprioceptors by cutaneous mechanoreceptors has been proposed but at present this alternative has not been demonstrated. Here we have investigated whether other kinds of sensory structures are present in two human facial muscles (zygomatic major and buccal). Human checks were removed from Spanish cadavers, and processed for immunohistochemical detection of nerve fibers (neurofilament proteins and S100 protein) and two putative mechanoproteins (acid-sensing ion channel 2 and transient receptor potential vanilloid 4) associated with mechanosensing. Nerves of different calibers were found in the connective septa and within the muscle itself. In all the muscles analysed, capsular corpuscle-like structures resembling elongated or round Ruffini-like corpuscles were observed. Moreover the axon profiles within these structures displayed immunoreactivity for both putative mechanoproteins. The present results demonstrate the presence of sensory structures in facial muscles that can substitute for typical muscle spindles as the source of facial proprioception.

  6. Forensic Facial Reconstruction: The Final Frontier

    PubMed Central

    Gupta, Vineeta; Vij, Hitesh; Vij, Ruchieka; Tyagi, Nutan

    2015-01-01

    Forensic facial reconstruction can be used to identify unknown human remains when other techniques fail. Through this article, we attempt to review the different methods of facial reconstruction reported in literature. There are several techniques of doing facial reconstruction, which vary from two dimensional drawings to three dimensional clay models. With the advancement in 3D technology, a rapid, efficient and cost effective computerized 3D forensic facial reconstruction method has been developed which has brought down the degree of error previously encountered. There are several methods of manual facial reconstruction but the combination Manchester method has been reported to be the best and most accurate method for the positive recognition of an individual. Recognition allows the involved government agencies to make a list of suspected victims’. This list can then be narrowed down and a positive identification may be given by the more conventional method of forensic medicine. Facial reconstruction allows visual identification by the individual’s family and associates to become easy and more definite. PMID:26501035

  7. Beyond the functional matrix hypothesis: a network null model of human skull growth for the formation of bone articulations

    PubMed Central

    Esteve-Altava, Borja; Rasskin-Gutman, Diego

    2014-01-01

    Craniofacial sutures and synchondroses form the boundaries among bones in the human skull, providing functional, developmental and evolutionary information. Bone articulations in the skull arise due to interactions between genetic regulatory mechanisms and epigenetic factors such as functional matrices (soft tissues and cranial cavities), which mediate bone growth. These matrices are largely acknowledged for their influence on shaping the bones of the skull; however, it is not fully understood to what extent functional matrices mediate the formation of bone articulations. Aiming to identify whether or not functional matrices are key developmental factors guiding the formation of bone articulations, we have built a network null model of the skull that simulates unconstrained bone growth. This null model predicts bone articulations that arise due to a process of bone growth that is uniform in rate, direction and timing. By comparing predicted articulations with the actual bone articulations of the human skull, we have identified which boundaries specifically need the presence of functional matrices for their formation. We show that functional matrices are necessary to connect facial bones, whereas an unconstrained bone growth is sufficient to connect non-facial bones. This finding challenges the role of the brain in the formation of boundaries between bones in the braincase without neglecting its effect on skull shape. Ultimately, our null model suggests where to look for modified developmental mechanisms promoting changes in bone growth patterns that could affect the development and evolution of the head skeleton. PMID:24975579

  8. Beyond the functional matrix hypothesis: a network null model of human skull growth for the formation of bone articulations.

    PubMed

    Esteve-Altava, Borja; Rasskin-Gutman, Diego

    2014-09-01

    Craniofacial sutures and synchondroses form the boundaries among bones in the human skull, providing functional, developmental and evolutionary information. Bone articulations in the skull arise due to interactions between genetic regulatory mechanisms and epigenetic factors such as functional matrices (soft tissues and cranial cavities), which mediate bone growth. These matrices are largely acknowledged for their influence on shaping the bones of the skull; however, it is not fully understood to what extent functional matrices mediate the formation of bone articulations. Aiming to identify whether or not functional matrices are key developmental factors guiding the formation of bone articulations, we have built a network null model of the skull that simulates unconstrained bone growth. This null model predicts bone articulations that arise due to a process of bone growth that is uniform in rate, direction and timing. By comparing predicted articulations with the actual bone articulations of the human skull, we have identified which boundaries specifically need the presence of functional matrices for their formation. We show that functional matrices are necessary to connect facial bones, whereas an unconstrained bone growth is sufficient to connect non-facial bones. This finding challenges the role of the brain in the formation of boundaries between bones in the braincase without neglecting its effect on skull shape. Ultimately, our null model suggests where to look for modified developmental mechanisms promoting changes in bone growth patterns that could affect the development and evolution of the head skeleton.

  9. Facial reanimation with masseteric to facial nerve transfer: a three-dimensional longitudinal quantitative evaluation.

    PubMed

    Sforza, Chiarella; Tarabbia, Filippo; Mapelli, Andrea; Colombo, Valeria; Sidequersky, Fernanda V; Rabbiosi, Dimitri; Annoni, Isabella; Biglioli, Federico

    2014-10-01

    Facial paralysis is a severe pathological condition, negatively affecting patients' quality of life. The altered tone and mobility of the mimetic musculature provoke both functional and morphological deficits. In the present study, we longitudinally measured facial movements in 14 patients (21-69 years) affected by unilateral facial paralysis not lasting longer than 23 months. The patients were analyzed before and after surgical masseteric to facial nerve neurorrhaphy. Examinations were performed at least 3 months after they had clinically started to regain facial mimicry. The displacement of selected facial landmarks was measured using an optoelectronic three-dimensional motion analyzer during: maximum smile without clenching (pre- and postsurgery), maximum smile by clenching on their posterior teeth (only postsurgery), and spontaneous smile (recorded during the vision of a funny video in both examinations). Before facial surgery, in all smiles facial landmarks moved more in the healthy than in the paretic side; after surgery, the differences decreased for both reduction of the healthy-side motion, and increment of the paretic-side motion (motion ratio before 52%, after 87%, p < 0.05, Students' t-test). The ratio between the paretic and healthy-side total motion (asymmetry) did not modify for maximum and spontaneous smiles, but significantly increased for the maximum smiles made with teeth clenching (asymmetry before 32%, after 11%, p < 0.001). Spontaneous smiles were recorded only in a subset of patients, but their execution was modified by surgery, with more symmetrical movements of the rehabilitated-side landmarks (asymmetry before 33%, after 10%), and reduced motion of the healthy-side ones (motion ratio before 51%, after 83%). In conclusion, the significant asymmetry in the magnitude of facial movements that characterized the analyzed patients before surgery reduced after surgery, at least in those facial areas interested by the masseteric to facial nerve

  10. Newer Understanding of Specific Anatomic Targets in the Aging Face as Applied to Injectables: Aging Changes in the Craniofacial Skeleton and Facial Ligaments.

    PubMed

    Wong, Chin-Ho; Mendelson, Bryan

    2015-11-01

    Logical correction of aging contour changes of the face is based on understanding its structure and the processes involved in the aging appearance. Aging changes are seen at all tissue levels between the skin and bone although the relative contribution of each component to the overall change of facial appearance has yet to be satisfactorily determined. Significantly, the facial skeleton changes profoundly with aging as a consequence of significant resorption of the bones of dental origin in particular. The resultant loss of skeletal projection gives the visual impression of descent while the reduced ligamentous support leads to laxity of the overlying soft tissues. Understanding the specific changes of the face with aging is fundamental to achieving optimum correction and safe use of injectables for facial rejuvenation.

  11. Outcome of a graduated minimally invasive facial reanimation in patients with facial paralysis.

    PubMed

    Holtmann, Laura C; Eckstein, Anja; Stähr, Kerstin; Xing, Minzhi; Lang, Stephan; Mattheis, Stefan

    2017-04-08

    Peripheral paralysis of the facial nerve is the most frequent of all cranial nerve disorders. Despite advances in facial surgery, the functional and aesthetic reconstruction of a paralyzed face remains a challenge. Graduated minimally invasive facial reanimation is based on a modular principle. According to the patients' needs, precondition, and expectations, the following modules can be performed: temporalis muscle transposition and facelift, nasal valve suspension, endoscopic brow lift, and eyelid reconstruction. Applying a concept of a graduated minimally invasive facial reanimation may help minimize surgical trauma and reduce morbidity. Twenty patients underwent a graduated minimally invasive facial reanimation. A retrospective chart review was performed with a follow-up examination between 1 and 8 months after surgery. The FACEgram software was used to calculate pre- and postoperative eyelid closure, the level of brows, nasal, and philtral symmetry as well as oral commissure position at rest and oral commissure excursion with smile. As a patient-oriented outcome parameter, the Glasgow Benefit Inventory questionnaire was applied. There was a statistically significant improvement in the postoperative score of eyelid closure, brow asymmetry, nasal asymmetry, philtral asymmetry as well as oral commissure symmetry at rest (p < 0.05). Smile evaluation revealed no significant change of oral commissure excursion. The mean Glasgow Benefit Inventory score indicated substantial improvement in patients' overall quality of life. If a primary facial nerve repair or microneurovascular tissue transfer cannot be applied, graduated minimally invasive facial reanimation is a promising option to restore facial function and symmetry at rest.

  12. The Neuropsychology of Facial Identity and Facial Expression in Children with Mental Retardation

    ERIC Educational Resources Information Center

    Singh, Nirbhay N.; Oswald, Donald P.; Lancioni, Giulio E.; Ellis, Cynthia R.; Sage, Monica; Ferris, Jennifer R.

    2005-01-01

    We indirectly determined how children with mental retardation analyze facial identity and facial expression, and if these analyses of identity and expression were controlled by independent cognitive processes. In a reaction time study, 20 children with mild mental retardation were required to determine if simultaneously presented photographs of…

  13. Alveolar Bone Grafting in Cleft Patients from Bone Defect to Dental Implants

    PubMed Central

    Vuletić, Marko; Jokić, Dražen; Rebić, Jerko; Žabarović, Domagoj; Macan, Darko

    2014-01-01

    Cleft lip and palate is the most common congenital deformity affecting craniofacial structures. Orofacial clefts have great impact on the quality of life which includes aesthetics, function, psychological impact, dental development and facial growth. Incomplete fusion of facial prominences during the fourth to tenth week of gestation is the main cause. Cleft gaps are closed with alveolar bone grafts in surgical procedure called osteoplasty. Autogenic bone is taken from the iliac crest as the gold standard. The time of grafting can be divided into two stages: primary and secondary. The alveolar defect is usually reconstructured between 7 and 11 years and is often related to the development of the maxillary canine root. After successful osteoplasty, cleft defect is closed but there is still a lack of tooth. The space closure with orthodontic treatment has 50-75% success. If the orthodontic treatment is not possible, in order to replace the missing tooth there are three possibilities: adhesive bridgework, tooth transplantation and implants. Dental implant has the role of holding dental prosthesis, prevents pronounced bone atrophy and loads the augmentation material in the cleft area. Despite the fact that autologous bone from iliac crest is the gold standard, it is not a perfect source for reconstruction of the alveolar cleft. Bone morphogenic protein (BMP) is appropriate as an alternative graft material. The purpose of this review is to explain morphology of cleft defects, historical perspective, surgical techniques and possibilities of implant and prosthodontic rehabilitation. PMID:27688373

  14. Facial bite wounds: management update.

    PubMed

    Stefanopoulos, P K; Tarantzopoulou, A D

    2005-07-01

    Bite wounds are frequently located on the face; injuries inflicted by dogs are most common, especially in children. Bacteriology of infected dog and cat bite wounds includes Pasteurella multocida, Staphylococcus aureus, viridans streptococci, Capnocytophaga canimorsus, and oral anaerobes. Infected human bites yield a similar spectrum of bacteria except for Pasteurellae and C. canimorsus; instead human bites are frequently complicated by Eikenella corrodens. Antibiotic therapy against these bacteria is indicated both for infected bite wounds and fresh wounds considered at risk for infection. Amoxicillin-clavulanate (and other combinations of extended-spectrum penicillins with beta-lactamase inhibitors) and moxifloxacin offer the best in vitro coverage of the pathogenic flora. Initial wound management consisting in irrigation and debridement is at least equally important with antibiotics for prevention of infection. The need for prophylaxis against systemic infectious complications, particularly tetanus, should also be evaluated. Primary surgical repair is the treatment of choice for most clinically uninfected facial bite wounds, whereas delayed closure should be reserved for certain high risk or already infected wounds. Avulsive injuries with significant tissue loss represent the most difficult cases for definitive management and are also those most likely to require hospitalization.

  15. [Potter's reno-facial syndrome].

    PubMed

    Rachdi, Radhouane; Kaabi, Mahdi; M'Hamdi, Hichem; Chtioui, Ines; Basly, Mohamed; Messaoudi, Fethi; Zayene, Houcine; Messaoudi, Lotfi; Chibani, Mounir; Gaigi, Soumaya

    2004-07-01

    Potter's reno-facial syndrome is a rare innate abnormality. We bring 4 observations repertoried at the maternity of military hospital of Tunis over a period of 6 years (1997 - 2002). The purpose of our work is to determine after a review of the literature the echographic and foetopathologic characteristics, and the forecast of this syndrome. The frequency of the bilateral renale agenesis is of 0.27 per thousand. Positive diagnosis bases essentially on the ultrasound of the 2th, or the 3-th trimester. The signs of appeal are essentially the oligoamnios associated to an hypotrophy. The caryotype is systematic to eliminate an associeted chromosomic abnormality. Foetopathologic exam is usefull for the diagnosis. Main abnormality except the urinary pathology is the lung hypoplasia. Therapeutic interruption of the pregnancy in this situation not compatible with the extra-uterine life., only type IV authorize the development of the pregnancy according to echographic data and of foetal urinaire biochemistry. We insist on the early practice of the morphological ultrasound between 20 - 22 weeks for the diagnosis of foetal abnormalities and the place of the genetic advice in association with the geneticist in the coverage of the couple.

  16. Your Bones

    MedlinePlus

    ... shoulder blade or scapula (say: SKA-pyuh-luh), a large triangular bone on the upper back corner of each side of the ribcage. The arm is made up of three bones: the humerus (say: HYOO-muh-rus), which is above your elbow, and the radius (say: RAY-dee-us) and ulna (say: UL- ...

  17. Talking Bones.

    ERIC Educational Resources Information Center

    Johnson, Jaclyn; Kassing, Sharon

    2002-01-01

    Describes cooperation with the Saint Louis Zoo to provide opportunities for elementary school students to learn about bones, how animals move, what they eat, and how much they grow. Uses biofacts which include bones, skulls, and other parts to make the laboratory a hands-on experience for students. (YDS)

  18. Facial Dog Bite Injuries of a 19-Month-Old Child: A Case Report.

    PubMed

    Oueis, Hassan; Tann, Richard; Stenger, James

    2015-01-01

    It is estimated that 4.5 million Americans are bitten by dogs each year, and half of those are children. One in five dog bites results in injuries that require some form of medical attention. Children between 5 and 9 years of age are the most affected age group for this type of injury. A 19-month-old boy was admitted to the emergency department of Children's Hospital of Michigan for treatment of injuries due to a dog attack. Injuries were limited to the face of the child. Dental injuries included avulsion of upper lateral incisors, severe luxation of upper central incisors, and fracture of the facial alveolus bone. Surgical management of facial wounds was accomplished through irrigation, debridement and suturing. Dental treatment included extraction of central incisors and suturing soft tissues.

  19. Face processing in children with autism spectrum disorder: independent or interactive processing of facial identity and facial expression?

    PubMed

    Krebs, Julia F; Biswas, Ajanta; Pascalis, Olivier; Kamp-Becker, Inge; Remschmidt, Helmuth; Schwarzer, Gudrun

    2011-06-01

    The current study investigated if deficits in processing emotional expression affect facial identity processing and vice versa in children with autism spectrum disorder. Children with autism and IQ and age matched typically developing children classified faces either by emotional expression, thereby ignoring facial identity or by facial identity disregarding emotional expression. Typically developing children processed facial identity independently from facial expressions but processed facial expressions in interaction with identity. Children with autism processed both facial expression and identity independently of each other. They selectively directed their attention to one facial parameter despite variations in the other. Results indicate that there is no interaction in processing facial identity and emotional expression in autism spectrum disorder.

  20. Quantitative evaluation of three-dimensional facial scanners measurement accuracy for facial deformity

    NASA Astrophysics Data System (ADS)

    Zhao, Yi-jiao; Xiong, Yu-xue; Sun, Yu-chun; Yang, Hui-fang; Lyu, Pei-jun; Wang, Yong

    2015-07-01

    Objective: To evaluate the measurement accuracy of three-dimensional (3D) facial scanners for facial deformity patients from oral clinic. Methods: 10 patients in different types of facial deformity from oral clinical were included. Three 3D digital face models for each patient were obtained by three facial scanners separately (line laser scanner from Faro for reference, stereophotography scanner from 3dMD and structured light scanner from FaceScan for test). For each patient, registration based on Iterative Closest Point (ICP) algorithm was executed to align two test models (3dMD data & Facescan data) to the reference models (Faro data in high accuracy) respectively. The same boundaries on each pair models (one test and one reference models) were obtained by projection function in Geomagic Stuido 2012 software for trimming overlapping region, then 3D average measurement errors (3D errors) were calculated for each pair models also by the software. Paired t-test analysis was adopted to compare the 3D errors of two test facial scanners (10 data for each group). 3D profile measurement accuracy (3D accuracy) that is integrated embodied by average value and standard deviation of 10 patients' 3D errors were obtained by surveying analysis for each test scanner finally. Results: 3D accuracies of 2 test facial scanners in this study for facial deformity were 0.44+/-0.08 mm and 0.43+/-0.05 mm. The result of structured light scanner was slightly better than stereophotography scanner. No statistical difference between them. Conclusions: Both test facial scanners could meet the accuracy requirement (0.5mm) of 3D facial data acquisition for oral clinic facial deformity patients in this study. Their practical measurement accuracies were all slightly lower than their nominal accuracies.