Quiste dermoide nasofrontal: presentación de un caso y revisión narrativa / Nasofrontal dermoid cyst: case presentation

Las lesiones de la región nasofrontal en los niños son un reto diagnóstico debido a su rareza, y su potencial comunicación con el sistema nervioso central también aumenta su complicaciones. Dentro de las principales entidades de esta región se encuentran los quistes dermoides, los gliomas nasales y los encefaloceles. Un abordaje diagnóstico y terapéutico inapropiado podría generar desde simples recurrencias hasta fistulas e infecciones en el sistema nervioso central, que podrían contribuir a mayores complicaciones o incluso, poner en riesgo la vida de los pacientes.

Injuries to the naso-frontal region in children are a diagnostic challenge, associated with their rarity, their complexity also implies their potential communication with the central nervous system. Dermoid cysts, nasal gliomas, and encephaloceles are among the main entities in this region. An inappropriate diagnostic and therapeutic approach could generate from simple recurrences (as in our case), to fistulas and infections of the central nervous system that could contribute to greater complications or even put the lives of patients at risk.

Facial Angle Profiles in Turkish Healthy Population

The knowledge of the facial angles is essential for safe and accurate plastic surgery interventions. Facial angles are used as a reference value for comparison during diagnosis and treatment planning. Also, the facial angles will provide valuable data in evaluation of facial aesthetics. So, the aim of this study was to determine the ideal values of the facial angles in Turkish healthy adults.METHODSTwo hundred and forty seven (129 females; 118 males) subjects aged between 18 and 25 years were included in this study. Frankfort horizontal plane was chosen to determine the angles related with face. Photographs were acquired using a Digital SLR Camera with fixed shooting values. (Canon EOS 80D; ISO 100 f/4.5). In all the shoots, a printed scale with known dimensions was present. Acquired images were then transferred to a computer station. Measurements were made using Image J 1.52a with 1/100 mm sensitivity. Statistical analysis was done using SPSS Ver. 22.00. A p<0.05 value was considered as significant. Student’s T Test was used to determine the significance between gender, while Pearson Correlation analysis was done to evaluate the relation between gender.RESULTSStatistically significant difference was found between the genders and the frontonasal angle, the nasofrontal angle, the nasolabial angle, the chin neck angle, and the nasal projection. Also, the fronto nasal angle, chin neck angle, and nasal projection measurements were higher in males than in females, whereas the nasofrontal angle and nasolabial angle were lower in males than in females. Additionally, there was a significant, negative very low correlation between fronto-nasal angle (-0.148), chin-neck angle (r=-0.179) and gender; a significant, negative and low correlation (r=-0.243) between nasal projection and gender, a significant, positive and low correlation between nasolabial angle and gender (r=0.259); and nasofrontal angle and gender (r=0.388).CONCLUSIONSFacial angle values of healthy population provide important and useful knowledge in terms of comparison of abnormalities clinically, and data may be valuable for the representatives of clinical disciplines.

Clinical Application of Cranialization of the Frontal Sinus

Both frontal sinus ablation and osteoplastic frontal surgery with obliteration have limitations in treatment of injury to the frontal sinus that extends into the posterior wall and frontal lobes of the brain. In these problematic cases, cranialization of the frontal sinus is the method of choice. The purpose of the cranialization of the frontal sinus was as follows: (1) ablation of the sinus, precluding later infection or mucocele, mucopyocele formation (2) restoration of a normal aesthetic frontal bony contour (3) protection of frontal lobe by allowing space for the expansion of the edematous brain. From May 1999 to December 2003, we performed cranialization of involved frontal sinus in 23 patients who had malignant tumor, fibrous dysplasia, osteoma, mucoele, and fracture event in the frontal sinus on each other. After the frontal sinus was exposed through a bicoronal incision, the excision of posterior wall and removal of mucosa remaining on the floor of the sinus and residual anterior wall were done. The nasofrontal ducts were occluded with pericranial flap or/and bone source(R), or bone graft. Reconstruction of anterior wall was done with autogenous bone or/and bone source(R), or mesh plate, bone graft, and mesh plate with bone source(R).The average follow-up period was one and half years (from 1 year to 4 years).There were no serious complications including CNS infections, mucocele formation and CSF leakage, with an exception of one person who was expired of recurrence of skull base tumor. Also, the overall functional and aesthetic outcome was excellent except one case in which there was irregularity in the frontal area. The cranialization of the frontal sinus is a safe surgical procedure without complications if prevented.

How to Make the Blockage between the Nasal Cavity and Intracranial Space in Craniofacial Surgery

Craniofacial surgery for facial advancement or correction of severe craniofacial malformations such as orbital hypertelorism, Crouzon's disease and Apert's syndrome may bring about great risk. Especially postoperative infection in the craniofacial surgery is a life threatening complication. Ascending infection via nasofrontal communication in frontofacial monobloc advancement, intracranial Le Fort III osteotomy, correction of hypertelorism(intracranial approach) and acute trauma of cribriform plate can lead to life threatening meningitis and meningoencephalitis. A 4 layer sealing technique for the closure of nasofrontal communication using Gelfoam , the inferiorly based, galeo-pericranial flap, rib bone graft, Tissel is a very effective method. Until the rib bone graft is completely uptaken, Gelfoam is used as a temporary blockage of bony defect and prevents displacement of rib bone graft. We used galeo-periosteal flap for the sufficient blood supply to the rib bone graft. And Tissel is used as a biologic adhesive and blockage of the surrounding gaps.

A study on the nose profile with respect to the skeletodental pattern / 대한치과교정학회지

The purpose of this study was to investigate the relationship of nose profile with respect to skeletodental pattern, by measured and analyzed statistically the lateral cephalograms of 95 females (13 to 30 years old ). The results were summerized as follows; 1. The antero-posterior factors of the nose - nasofrontal angle, nasofacial angle, and dorsal length / ala length ratio were different among the malocclusion groups 2. There were no significant correlation between the vertical nose factors and the skeletal factors 3. The Class I groups had a straight nose profile; the Class II groups had a convex profile ; the Class III groups had a concave profile.