ABSTRACT
Objective: The multifactorial etiology of cleft can be due to environmental factors or genetic factors or combination of both. Many studies were conducted to detect the epidemiology of the clefts and the genetic factors causing clefts. There is no or very less studies conducted in India to identify the risk of pesticidal exposure in occurrence of nonsyndromic clefts. The present study is to investigate the risk of parental pesticidal exposure in causing clefts in the craniofacial region. Methods: The case-control study included 179 cases of cleft in the craniofacial region and 200 healthy controls matched for age and gender. The data were collected in the proforma from the study group in the departments of plastic surgery, Obstetrics and Gynaecology, and Paediatrics of Vydehi Institute of Medical Sciences and Research Centre. Result: Majority (55.3%) of the parents from the cleft group were exposed to pesticides but only 4.5% parents of the control group were exposed which is statistically significant (p=0.001). Compared to other cleft group, more parents of cleft lip palate exposed to pesticides was also significant (p=0.041).The cleft cases which were exposed to pesticides (86%) were from the rural area and the controls which were not exposed (79%) were from the urban area and is statistically significant (p<0.001). Conclusion: Parental pesticidal exposure is a risk factor for clefts in the craniofacial region. Among all the clefts, the risk is increased for the cleft lip palate.
ABSTRACT
Objective To study the curved planar reformation (CPR) imagings of bony canals in craniofacial region with multislice spiral CT.Methods CPR of the bony canals in craniofacial regions were performed in 267 cases by using Philips Mx8000 multislice spiral CT,including facial nerve canal (FNC) in 217 cases,optic nerve canal (ONC) in 28 cases,mandibular canal in 9 cases,carotid canal in 7 cases, jugular foramen in 4 cases and hypoglossal canal in 2 . Scanning parameters were as followed : 120 kV , 200~250 mAs , collimation 0.5mm, pitch 0.625 or 0.875,scan time 0.75s/ring, matrix 512?512.Collimation and reformation interval were 0.5~1.0 mm and 0.2~0.5 mm separately, except for FNC,in which were 0.5 mm and 0.2 mm separately.Reformation matrix was all 1024?1024.Results Of all cases , the images of CPR in 11 were unsatisfied because of the head shaking during the scanning, in other 256 cases , images could show the whole length of canals clearly. In FNC,178 cases were normal , 18 cases had congenital abnormal in the external , middle or inner ear accompanied with changes of length , course and position. 8 cases of otomastoiditis accompanied with cholesteatoma involving facial canal. In 21 cases of temporal bone trauma accompanied with traumatic facial palsy, fracture lines or bony fragments of the FNC were found in 9 cases. 2 cases of facial nerve tumor and 2 cases of jugular foramen schwannoma accompanied with facial canal destruction.24 cases of ONCs were normal. Fracture lines or bony fragments of ONCs were found in 3 cases. Narrowing of ONC was found in 1 cases of fibrous dysplasia.Normal carotid canal was seen in 2 cases, there were 2 cases of carotid canal fracture.1 cases of bony destruction of carotid canal caused by cholesteatoma of petrous apex. Jugular foramen was normal in 2 cases. Destruction and enlargement of jugular foramen were found in 2 cases of schwannoma. In 1 cases, hypoglossal nerve canal was normal. Destruction and enlargement of hypoglossal nerve canal were found in the other cases of schwannoma. Mandibular canal were normal in 4 cases and was involved in 2 cases by mandibular osteomyelitis and mandibular fracture,respectively, and 1 case by mandibular tumor. Conclusion The bony canals in craniofacial regions can be shown clearly by CPR with multislice spiral CT . It can provide more valuable informations than that of the axial scan and multiplanar reformation in the diagnosis of diseases of craniofacial region and was the important supplement of routine CT scan.