ABSTRACT
At present, nasal abnormalities is often classified from different perspectives, such as the alar-columella relationship, nasal base width, and the condition of alar hyperplasia. However, due to the impact of race and region, different people may be applied to different classification methods, resulting in different clinical diagnosis and treatments. So far, there is no unified standard for alar deformity classification to guide clinical treatment. In alar-columella relationship, the retracted ala and the hanging columella, hanging ala and retracted columella are easily confused. According to the classification of nasal base width, it is easy to confuse the alar flare with wide alar base. Therefore, the accurate preoperative evaluation of the nasal ala and the selection of appropriate clinical treatments for different abnormalities are beneficial for surgeons to achieve perfect rhinoplasty results.
Subject(s)
Humans , Cleft Lip , Hyperplasia , Nasal Septum/surgery , Nose , Preoperative Care , Rhinoplasty/methodsABSTRACT
El quiste dermoide es una lesión congénita poco frecuente, secundario a una regresión incompleta de tejido ectodérmico, y su incidencia es de 1/20 000-40 000 nacidos vivos. Debe realizarse una resección quirúrgica oportuna para prevenir el compromiso intracraneal y/o las complicaciones. El estudio imagenológico determina su extensión. Se han recomendado diferentes enfoques quirúrgicos, los cuales deben cumplir con los cuatro principios de Pollock. El siguiente estudio presenta el caso de un paciente pediátrico, de nueve meses de edad, con un quiste dermoide en la base del cráneo asociado con un trayecto fistuloso a punta nasal. La resonancia magnética nuclear (RMN) contrastada evidenció una masa quística en la región anterior a la crista galli comunicada con el tracto fistuloso a la punta nasal. El paciente fue llevado a cirugía para realizar la resección del quiste mediante rinoplastia externa combinada con abordaje endoscópico transnasal. Los resultados funcionales y estéticos fueron satisfactorios, sin recurrencia. Se evidenció una fístula de líquido cefalorraquídeo intraoperatoria corregida en el mismo tiempo quirúrgico.
The dermoid cyst is a rare congenital lesion, secondary to an incomplete regression of ectodermal tissue. Its incidence is 1/20,000-40,000 live births. Timely surgical resection must be performed to prevent intracranial involvement and/or complications. Imaging study determines its extension. Different surgical approaches have been recommended; all must adhere to Pollock's 4 principles. The following study presents the case of a pediatric patient, 9 months old, with a dermoid cyst at the skull base with a fistulous path to the nasal tip. Contrasted nuclear magnetic resonance revealed a cystic mass in the region anterior to the crista galli communicated with a fistulous tract at the nasal tip. The patient was taken to surgery for cyst resection by external rhinoplasty combined with a transnasal endoscopic approach with satisfactory functional and aesthetic results, without recurrence. A Cerebrospinal fluid fistula was evidenced, as an intraoperative complication, it was corrected in the same surgical time.
Subject(s)
Humans , Dermoid Cyst , Child, Preschool , Skull Base , Nasal CavityABSTRACT
The nasal bases and nostrils were classified and measured in 265 Korean adults (male; 176, female; 89) to investigate morphological characteriestics of Korean. The results were as follows. 1. The height of nasal base was 21.7 +/-1.8 mm in male and 20.2 +/-1.9 mm in female; the width of it was 40.7 +/-2.4 mm in male and 37.2 +/-2.3 mm in female; the width of columella was 7.6 +/-0.8 mm in male and 7.3 +/-0.7 mm in female. There were significant differences between both sexes in each value (p<0.05). 2. In male, the height of columella was 9.5 +/-1.3 mm on both sides; and in female, it was 9.0 +/-1.4 mm on the right and 9.0 +/-1.3 mm on the left. In male, length of long nostril axis was 12.0 +/-1.4 mm on the right and 12.1 +/-1.4 mm on the left; and in female, it was 10.8 +/-1.2 mm on both sides. Length of short nostril axis was 6.6 +/-1.1 mm in male and 6.0 +/-1.0 mm in female on both sides. There were significant differences in each value between both sexes (p<0.05), but not between both sides. 3. Nasal alar angle was 87.2 +/-10.5degrees in male and 83.8 +/-9.8degrees in female; the angle between both long axes of nostril was 84.8 +/-24.5degrees in male and 76.9 +/-18.3degrees in female. There were significant differences between both sexes in each value (p<0.05). 4. Ratio of the height to the width in nasal base was 52.9 +/-5.8% in male, 53.9 +/-5.6% in female. Length ratio of long nostril axis to short one was 189.1 +/-37.7% in male, 183.6 +/-36.2% in female. There was no significant difference between both sexes in each value. 5. The shape of nostrils was classified into 7 types by the angle between both long axes of nostril. Type 1 (below 41degrees) was 0.9%, Type 2 (41 ~70degrees) was 32.1%, Type 3 (71 ~100degrees) was 48.8%, Type 5 (101 ~130degrees) was 13%, Type 6 (131 ~180degrees) was 4.7% and Type 7 (above 180degrees) was 0.5%. Type 4, which was not able to be distinguished between long and short axis, could not be found.