- Correlation Between the Existing Classifications of Nasal Bone Fractures and Subjective Patient Satisfaction. [Journal Article]
- JCJ Craniofac Surg 2018 Sep 17
- Since the nose is at the center of the face, small changes to it can cause a big overall change. Therefore, a nasal fracture needs to be operated on when deformity is expected. Although many taxonomi...
Since the nose is at the center of the face, small changes to it can cause a big overall change. Therefore, a nasal fracture needs to be operated on when deformity is expected. Although many taxonomies have been developed for nasal bone fractures, no study has aimed to predict individual patient satisfaction. Herein, the authors tried to determine any correlation between the existing classifications of nasal bone fractures and subjective patient satisfaction. A retrospective study and telephone survey were conducted in 149 patients who underwent closed reduction for a pure nasal bone fracture. Pretraumatic, prereduction, and postoperative patient satisfactions were measured on a numerical scale from 1 to 5. The difference between pretraumatic and prereduction satisfactions was calculated to confirm the change in short-term satisfaction after trauma. The difference between pretraumatic and preoperative satisfactions was measured to determine change in long-term satisfaction postoperatively. The Stranc Robertson classification, modified Murray classification, and the presence of septal fracture were used to classify fractures. Independent and Jonckheere-Terpstra t tests were used in statistical analysis. Only 86 of 149 were included in the study. There was no significant difference in patient satisfaction among frontal/lateral (P = 0.70, 0.56), frontal I/II (P = 1.00, 0.24), and lateral I/II groups (P = 0.57, 0.67) according to the Stranc Robertson classification. Septal fracture (P = 0.21, 0.44) and the modified Murray classification (P = 0.14, 0.47) also had no effect on satisfaction. Existing classification systems have the advantage of reflecting and distinguishing the characteristics of fractures, but there is a limit in their ability to reflect subjective patient satisfaction.
- Modified anterior transposition of the inferior oblique muscle. [Journal Article]
- JAJ AAPOS 2018 Sep 15
- CONCLUSIONS: Modified ATIO was comparable to traditional ATIO in correcting vertical deviation and IOOA and had a lower risk of antielevation syndrome compared with traditional ATIO.
- Otolaryngological features in a cohort of patients affected with 22q11.2 deletion syndrome: A monocentric survey. [Journal Article]
- AJAm J Med Genet A 2018 Sep 12; :e40518
- Otorhinolaryngologic manifestations are common in 22q11.2 deletion syndrome (22q11.2DS), but poorly described. This study aimed to better define the ear-nose-throat (ENT) phenotype of 22q11.2DS patie...
Otorhinolaryngologic manifestations are common in 22q11.2 deletion syndrome (22q11.2DS), but poorly described. This study aimed to better define the ear-nose-throat (ENT) phenotype of 22q11.2DS patients, in the attempt to best detect subjects requiring subspecialist intervention. We enrolled 25 patients affected with 22q11.2DS. Anatomic and functional ENT findings were investigated using clinical, laboratory, and instrumental data. Immunophenotype and frequency of infections were evaluated. Univariate and multivariate analyses were performed. ENT anomalies were found in 88% of patients, and in 20% congenital palate defects required surgery. Adenoid or palatine tonsil hypertrophy was noted in 80% and 48%. Forty-eight percent of subjects had rhinolalia/phonia, severe in half of these. We also found nasal regurgitation or laryngeal penetration/aspiration in 20% and 16%, respectively. Instrumental exams revealed a mild conductive hearing loss in 32% (bilateral in most cases), tympanometric anomalies in 28%, and swallowing abnormalities in 16%. Statistical univariate analysis showed a direct association between rhinolalia/phonia and episodes of laryngeal aspiration (p = .016) and between tympanometric anomalies and increased adenoid volume (p = .044). No association between episodes of food aspiration and palatal anomalies was found. Moreover, no statistically significant association was observed between the number of airway infections and the ENT findings. This study contributes to better define the ENT phenotype in patients with 22q11.2DS, helpful to prevent potential complications. Furthermore, the identification of a subcategory of patients may allow the early adoption of specific speech therapy programs to improve the clinical outcome of 22q11.2DS patients.
- Impact of Fractional Ablative Carbon Dioxide Laser on the Treatment of Rhinophyma. [Journal Article]
- ASAesthet Surg J 2018 Sep 11
- CONCLUSIONS: Fractional ablative CO2 laser treatment is associated with high levels of rhinophyma patient satisfaction and significant improvement in self-esteem.
- Disruption of Symmetry: A Quantitative Assessment of Facial Skeleton Anatomy in Children born with Unilateral Cleft Lip and Palate. [Journal Article]
- CAClin Anat 2018 Sep 11
- CONCLUSIONS: Regions derived from the maxillary and nasal prominences demonstrated the most DA. These results are important for medical practitioners for identifying the extent to which patients with UCLP deviate from the norm. This article is protected by copyright. All rights reserved.
- Effectiveness of endoscopic septoplasty in different types of nasal septal deformities: our experience with NOSE evaluation. [Journal Article]
- AOActa Otorhinolaryngol Ital 2018; 38(4):323-330
- Septal deviations are the most frequent cause of nasal obstruction, and represent a common complaint in rhinologic practice. Since the first description of Lanza et al. in 1991, the use of the endosc...
Septal deviations are the most frequent cause of nasal obstruction, and represent a common complaint in rhinologic practice. Since the first description of Lanza et al. in 1991, the use of the endoscope for the correction of septal deformities is increasingly more frequent. The purpose of this study is to evaluate the effectivenes of the endoscopic septoplasty for the correction of each of the 7 types of septal deformities according to the Mladina's classification. A retrospective chart review was performed in 59 consecutive patients presenting to our Department for Endoscopic Septoplasty from February 2012 to August 2014. For each deviation, descriptive statistics (mean and standard deviation, significant increase/decrease) was used to asses the corrective capacity and time-dependent effects at follow-up. This study shows that the corrective power of endoscopic septoplasty is different according to the type of deviation. To our knowledge this is the first study that evaluates the corrective capacity of this technique for each deviation by analysing pre- and postoperative objective outcomes as well as subjective outcomes gathered from the validated NOSE questionnaire. Even if endoscopic septoplasty may now be considered a reliable alternative to the classic technique, it is essential to identify the right deformity preoperatively in order to provide the correct therapeutic choice.
- Childhood lensectomy is associated with static and dynamic reduction in Schlemm canal size: a biomechanical hypothesis of post-lensectomy glaucoma. [Journal Article]
- OOphthalmology 2018 Aug 30
- CONCLUSIONS: Lensectomy is associated with a reduction in SC size and a loss of physiological SC dilatation during accommodative effort, which may reflect a reduction in outflow facility and contribute to the development of post-lensectomy glaucoma.
- Gravitational forces, negative pressure and facial structure in the genesis of airway dysfunction during sleep: a review of the paradigm. [Review]
- SMSleep Med 2018 Jul 06; 51:125-132
- The recent and distant literature has extensive discussion of how sleep apnea, adeno-tonsillar growth, and facial structural deformity are related. Conventionally, the order of cause and effect is as...
The recent and distant literature has extensive discussion of how sleep apnea, adeno-tonsillar growth, and facial structural deformity are related. Conventionally, the order of cause and effect is as follows: (1) Inflammatory/infectious process→tonsillar/adenoid tissue growth→(2) airway obstruction and mouth breathing/Obstructive Sleep Apnea (OSA)→(3) altered facial structure (adenoid facies). Using this same reasoning, adenotonsillectomy is the first line of treatment in the prevention of structural abnormalities. However, through a lifetime of clinical research Christian Guilleminault and his colleagues have challenged this paradigm. Through multiple articles and studies, Guilleminault et al., teach that even slight (subclinical) facial structure/muscle tone variations may be the inciting event triggering mouth-breathing and the eventual adenotonsillar growth in most patients. Essentially, this is the reverse of the conventional paradigms. Initial treatments therefore shift from simplified removal of inflammatory tissue to limiting mouth-breathing via musculo-skeletal modification. The purpose of this paper is to synthesize and analyze the recent (and distant) relevant literature to provide support for, and provide a potential anatomic mechanism for Guilleminault et al.'s paradigm-questioning clinical observations.
- Reference values of the ductus venosus pulsatility index for pregnant women between 11 and 13+6 weeks of gestation. [Journal Article]
- JMJ Matern Fetal Neonatal Med 2018 Aug 29; :1-171
- CONCLUSIONS: The value of DV PIV measurements is debated in the literature. Using our cohort, we defined the means and ranges of DV PIV. Determining the normal ranges of DV PIV could be a helpful to anticipate congenital or chromosomal abnormalities. Further studies are needed to demonstrate the clinical importance of DV PIV, especially for patients with abnormal DV PIV measurements.
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- Saethre-Chotzen syndrome: Case report and literature review. [Journal Article]
- DMDent Med Probl 2018 Apr-Jun; 55(2):217-225
- Saethre-Chotzen syndrome (SCS) belongs to a group of rare congenital disorders connected with craniosynostosis and syndactyly. The purpose of this paper is to provide a review of the literature, to c...
Saethre-Chotzen syndrome (SCS) belongs to a group of rare congenital disorders connected with craniosynostosis and syndactyly. The purpose of this paper is to provide a review of the literature, to collect all reported symptoms and to describe the case of an 11-year-old female with SCS. The electronic databases PubMed and Scopus were searched to gain all symptoms of SCS described in the literature. The most common features of SCS described in the literature are synostosis of the coronal suture, syndactyly, facial asymmetry, low hairline, prominent ear crus, prominent nasal bridge, eyelid ptosis, and ocular hypertelorism. Less common symptoms include hearing loss, renal abnormalities and cardiac defects. Intraoral manifestations of SCS include maxillary hypoplasia, mandibular prognathism and high arched palate. Moreover, in some patients mental disability is observed, which may be connected with the size of the deletion in the Twist gene. There are no pathognomonic symptoms of SCS, which would indicate a diagnostic problem. Our patient displayed small dysmorphic changes within the skull and limbs and proper intellectual development. On the basis of an intraoral, extraoral examination and X-rays, she was diagnosed with relative mandibular prognathism. Currently, she is treated with a removable appliance. This report emphasizes a considerable variability of symptoms in SCS and highlights the most common features.