Development of Computerized Anthropometric Analysis Model in Cleft Lip Nasal Deformity Using 3D Laser Scanned Facial Cast Model

PURPOSE: The purpose of this study is to develop three-dimensional computerized anthropometry(3DCA) and to compare its reliability and accuracy 3DCA with manual anthropometry(MA) for measurement of lips and nasal deformities in unilateral cleft lips and palate(UCLP) patients. METHODS: Samples were consisted of six UCLP patients whose facial plaster models were available immediately before and 3 months after the cleft lip surgery. MA of the facial plaster models was carried out using an electronic caliper. In 3DCA, three-dimensional auto- measuring program was used to digitize landmarks and to measure three-dimensional virtual facial models (3DVFM), which was generated with a laser scanner and 3D virtual modeling program. Intraclass correlation coefficients(ICC) were calculated to evaluate reliability and reproducibility of the variables in both methods, and Wilcoxon's signed rank test was done to investigate the difference in values of the same variables of facial models of each patient between two methods. RESULTS: All ICC values were higher than 0.8, so both methods could be considered reliable. Although most variables showed statistical differences between two methods(p<0.05), differences between mean values were very small and could be considered not significant in clinical situation. CONCLUSION: In clinical situation, 3DCA can be an objective, reliable and accurate tool for evaluation of lips and nasal deformities in the cleft patients.

Ocular Findings in Patients with Fibrous Dysplasia

PURPOSE: Fibrous dysplasia is an uncommon disease that replaces normal bone tissue with fibrous and osteoid tissue. We evaluated patients with fibrous dysplasia involving orbital bones to identify the ocular characteristic findings. METHODS: We recruited 6 patients with fibrous dysplasia of the craniofacial bone. Best corrected visual acuity and facial asymmetry were measured. Slit lamp biomicroscopy, tonometry, strabismus examination, and funduscopy were performed. RESULTS Strabismus, exophthalmos and optic neuropathy were found in 5, 4, and 2 patients, respectively. One patient underwent a strabismus surgery. One patient had McCune-Albright syndrome, exhibiting a cafe-au-lait spot of the skin and precocious puberty. All 6 patients had facial asymmetry and higher superior orbital rims of the affected side in 5 patients. CONCLUSIONS: Ophthalmologic examination may be mandatory for patients with fibrous dysplasia involving the orbit, especially to prevent optic neuropathy. If optic atrophy, strabismus or exophthalmos is found in patients with facial asymmetry, the possibility of fibrous dysplasia must be considered.

Ocular Findings in Patients with Fibrous Dysplasia

PURPOSE: Fibrous dysplasia is an uncommon disease that replaces normal bone tissue with fibrous and osteoid tissue. We evaluated patients with fibrous dysplasia involving orbital bones to identify the ocular characteristic findings. METHODS: We recruited 6 patients with fibrous dysplasia of the craniofacial bone. Best corrected visual acuity and facial asymmetry were measured. Slit lamp biomicroscopy, tonometry, strabismus examination, and funduscopy were performed. RESULTS Strabismus, exophthalmos and optic neuropathy were found in 5, 4, and 2 patients, respectively. One patient underwent a strabismus surgery. One patient had McCune-Albright syndrome, exhibiting a cafe-au-lait spot of the skin and precocious puberty. All 6 patients had facial asymmetry and higher superior orbital rims of the affected side in 5 patients. CONCLUSIONS: Ophthalmologic examination may be mandatory for patients with fibrous dysplasia involving the orbit, especially to prevent optic neuropathy. If optic atrophy, strabismus or exophthalmos is found in patients with facial asymmetry, the possibility of fibrous dysplasia must be considered.

The Various Reconstruction with Hydroxyapatite Powder(Bonesource(R))

Necessity of more biocompatible bone graft material had brought due to the problems of autologous bone graft & synthetic bone substitute materials. Bonesource(R) is a new biomaterial which can be replaced by natural bone when it is implanted. We reviewed our experience with Bonesource(in various reconstruction of bone defect for wide application. From March 2000 to March 2002 at Seoul National University Hospital, we performed various 7 cases of operation with Bonesource(R). These cases were bony depression after mass excision, alveolar cleft, frontal and supraorbital rim fracture, orbital deformity, facial asymmetry, bone defect after cranioplasty, depressive scar. In all cases, results were satisfactory without migration, extrusion, resorption during the follow up period (average 14 months). In 1 case, wound healing was delayed due to redissolution of Bonesource(R) by seroma. This was resolved by drainage without significant loss of volume. Its biocompatibility, excellent bony adhesion(osseointegration) and tendency to be replaced by natural bone(osteoconduction) may make it widely used in plastic surgery. The result of long term follow up and practical technique handling this material effectively are needed to evaluate it further.

Simple Classification of Foot Polydactyly Based on The Status of Metatarsal Bone and Varus Deformity

Polydactyly is a most common congenital anomaly of the foot. As is in the hand, it's classification systems and operative methods are various and complicated, but not much attention is given. We reviewed 129 foot polydactylies of 96 patients since the last 10 years(1993- 2003). Cases were classified morphologically and radiologically by previous classification systems(Wassel's classification, Hirase's classification) and then operative methods, complications, residual deformities were reviewed. Cases from the complications related to surgery including residual deformities were the major concern and 20 cases of unfavorable results were mainly due to varus deformity and metatarsal bone status. Based on our study, cases were reclassified by metatarsal bone status and varus deformity, and in conclusion we found that the new classification system is more helpful in deciding surgical method, predicting complications and residual deformities. Therefore, we suggested a new simple classification system based on the status of metatarsal bone and varus deformity, which is a more suitable system to planning operative method and predicting complication and residual deformity than the previous classification system.