ABSTRACT
BACKGROUND: The porion (Po) is used to construct the Frankfort horizontal (FH) plane for cephalometrics, and the external auditory meatus (EAM) is to transfer and mount the dental model with facebow. The classical assumption is that EAM represents Po by the parallel positioning. However, we are sometimes questioning about the possible positional disparity between Po and EAM, when the occlusal cant or facial midline is different from our clinical understandings. The purpose of this study was to evaluate the positional parallelism of Po and EAM in facial asymmetries, and also to investigate their relationship with the maxillary occlusal cant. METHODS: The 67 subjects were classified into three groups. Group I had normal subjects with facial symmetry (1.05 +/- 0.52 mm of average chin deviation) with minimal occlusal cant (<1.5 mm). Asymmetry group II-A had no maxillary occlusal cant (average 0.60 +/- 0.36), while asymmetry group II-B had occlusal cant (average 3.72 +/- 1.47). The distances of bilateral Po, EAM, and mesiobuccal cusp tips of the maxillary first molars (Mx) from the horizontal orbital plane (Orb) and the coronal plane were measured on the three-dimensional computed tomographic images. Their right and left side distance discrepancies were calculated and statistically compared. RESULTS: EAM was located 10.3 mm below and 2.3 mm anterior to Po in group I. The vertical distances from Po to EAM of both sides were significantly different in group II-B (p = 0.001), while other groups were not. Interside discrepancy of the vertical distances from EAM to Mx in group II-B also showed the significant differences, as compared with those from Po to Mx and from Orb to Mx. CONCLUSIONS: The subjects with facial asymmetry and prominent maxillary occlusal cant tend to have the symmetric position of Po but asymmetric EAM. Some caution or other measures will be helpful for them to be used during the clinical procedures.
Subject(s)
Chin , Models, Dental , Facial Asymmetry , Maxilla , Molar , OrbitABSTRACT
Tipo de estudio: prospectivo, analítico. Objetivo: describir el contexto general de la reparación de la microtia en el primer tiempo y conocer el manejo del cartílago costal autólogo, en pacientes con microtia. Materiales y métodos: se analizó múltiples variables en 30 pacientes; como sexo, edad de la primera consulta, edad de la primera cirugía, lugar de procedencia, raza, antecedentes patológicos familiares, antecedentes gineco-obstétricos, frecuencia de los tipos de microtia, exámenes, valoración preoperatoria, complicaciones. Se relacionó la edad quirúrgica con las complicaciones y con los resultados posoperatorios. Resultados: de un total de 30 casos de microtia operados, 11 fueron del sexo femenino, y 19 masculino; 9 pacientes presentaban microtia bilateral y 21 microtia unilateral; de estos últimos, 13 pacientes presentaron microtia derecha y 8 microtia izquierda. En cuanto a las complicaciones, 30 presentaron cicatrices hipertróficas en el tórax, 20 presentaron disminución en el marco cartilaginoso, 15 presentaron deformidad en el tórax, en igual proporción dolor en tórax e isquemia de piel parcial, 5 presentaron hematomas. Conclusión: la mayor cantidad de casos de microtia fueron unilaterales con predominio del lado derecho. Se observó que el mayor porcentaje de microtias presentaron conducto auditivo externo permeable.
Type of study: prospective, analytical, and unidirectional. Objective: to describe the general context of the repair of the microtia in a first time and identify the managing of the autologous costal cartilage in patients who suffer from microtia. Materials and methods: multiple variables were analyzed in 30 patients; such as sex, age in the first check-up, age in the first surgery, place of origin, race, family pathological antecedents, gineco-obstetric antecedents, frequency of the types of microtia, examinations, and presurgical tests, complications. The surgical age was compared to the complications and to the post-surgical results. Results: A total of 30 cases of microtia were operated on, 11 were females and 19 males; 9 patients presented bilateral microtia and 21 unilateral microtia; out of the latter, 13 patients presented right microtia and 8 left microtia. Regarding the complications, 30 presented hypertrophic scars in the thorax, 20 presented reduction in the cartilaginous frame, 15 presented deformity in the thorax, in equal proportion, pain in the thorax, and partial skin ischemia, 5 presented haematomas. Conclusion: The highest amounts of cases of microtia were unilateral with predominance on the right side. It was observed that the greatest percentage of microtia presented permeable external auditory meatus.
Subject(s)
Male , Female , Child, Preschool , Child , Congenital Abnormalities , Ear Auricle/abnormalities , Ear Cartilage , Transplantation, AutologousABSTRACT
BACKGROUND: Otomycosis is a mycotic disease of the external auditory meatus. Aspergillus is the most common pathogen. Despite the fact that a great number of fungi are considered as the cause of otomycosis, otomycosis due to dermatophytes occurs with great rarity. OBJECTIVE: The purpose of this study was to investigate clinical and mycological features of dermatophytosis in the external auditory meatus. METHODS: We performed a clinical and mycologic analysis of 17 patients who had been clinically and mycologically diagnosed with dermatophytosis of the external auditory meatus. In addition, amplication of TRS-1 and TRS-2 of the ribosomal DNA nontranscribed spacer was performed on strains of Trichophyton (T.) rubrum and T. raubitshcekii which were isolated from skin lesions of the external ear and cerumen in 6 patients. RESULTS: The ratio of male to female patients was 1.4:1. The age of patients were 6 to 72 and mean age of onset is 36.4. Eleven patients had concomitant dermatophytosis of other sites. Tinea unguium was combined in 7 cases, tinea pedis in 4 cases, tinea corporis in 3 cases, tinea manus in 2 cases and tinea cruris in 1 case. The positive rate of KOH examination was 88.2% and the positive rate of fungal culture on PDAC media was 88.2%. The most common organism cultured was T. rubrum (80.0%), followed by T. raubitschekii (13.3%) and T. mentagrophytes (7.7%). Ten patients were treated with topical terbinafine and seven patients with oral itraconazole, so all patients were cleared of fungi from the external auditory meatus and inflammation was resolved. With TRS-1 and TRS-2 amplication, 4 of 5 pairs of T. rubrum and 3 strains of T. raubitshcekii showed the same types regardless of the site in each patient. CONCLUSION: Dermatophytosis occurs rarely in the external auditory meatus but we experienced 17 cases of dermatophytosis at this site. With suspected otomycosis, dermatophytosis of the external auditory meatus and concomitant dermatophytosis must be investigated and treated simultaneously to prevent any recurrence.