Cleft Lip and Palate: LeFort I Distraction with Halo and Hybrid Internal Maxillary Distractors.

Distraction osteogenesis is a viable treatment option for patients with a cleft associated with severe maxillary retrusion. A rigid external distraction device and a hybrid internal maxillary distractor have been used to advance the maxilla allowing for predictable and stable results. These techniques can be applied by itself or as an adjunct to traditional orthognathic procedures. The technical aspects are presented. These procedures tend to be simpler and demonstrate great stability compared to traditional surgical methods. The reasons for stability are discussed.

Rigid Video Laryngoscopy for Intubation in Severe Pierre Robin Sequence: A Retrospective Review.

OBJECTIVES/HYPOTHESIS: The anatomy of children with severe Pierre Robin sequence can present a challenge for direct laryngoscopy and intubation. Advanced techniques including flexible fiberoptic laryngoscopic intubation have been described but require highly specialized skill and equipment. Rigid video laryngoscopy is more accessible but has not been described in this population. STUDY DESIGN: Retrospective cohort study. METHODS: A retrospective review was completed at a tertiary care center of all children between January 2016 and March 2020 with Pierre Robin sequence who underwent a mandibular distraction osteogenesis procedure. Intubation events were collected, and a descriptive analysis was performed. A univariate logistic regression model was applied to direct laryngoscopy and flexible fiberoptic laryngoscopy with rigid video laryngoscopy as a reference. RESULTS: Twenty-five patients were identified with a total of 56 endotracheal events. All patients were successfully intubated. Direct laryngoscopy was successful at first intubation attempt in 47.3% (9/19) of events. Six direct laryngoscopy events required switching to another device. Rigid video laryngoscopy was successful at first intubation attempt in 80.5% (29/36) of events. Two cases required switching to another device. Flexible fiberoptic laryngoscopy was found successful at first intubation attempt in 88.9% (8/9) of events. Direct laryngoscopy was 4 times more likely to fail first intubation attempt when compared to rigid video laryngoscopy (P < .05). There was no significant difference between rigid video laryngoscopy and flexible fiberoptic laryngoscopy for intubation. CONCLUSIONS: For children with Pierre Robin sequence rigid video laryngoscopy should be considered as a first attempt intubation device both in the operating room and for emergent situations. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:1647-1651, 2021.

Nasal septal and craniofacial form in European- and African-derived populations.

As a component of the chondrocranium, the nasal septum influences the anteroposterior dimensions of the facial skeleton. The role of the septum as a facial growth center, however, has been studied primarily in long-snouted mammals, and its precise influence on human facial growth is not as well understood. Whereas the nasal septum may be important in the anterior growth of the human facial skeleton early in ontogeny, the high incidence of nasal septal deviation in humans suggests the septum's influence on human facial length is limited to the early phases of facial growth. Nevertheless, the nasal septum follows a growth trajectory similar to the facial skeleton and, as such, its prolonged period of growth may influence other aspects of facial development. Using computed tomography scans of living human subjects (n = 70), the goal of the present study is to assess the morphological relationship between the nasal septum and facial skeleton in European- and African-derived populations, which have been shown to exhibit early developmental differences in the nasal septal-premaxillary complex. First we assessed whether there is population variation in the size of the nasal septum in European- and African-derived samples. This included an evaluation of septal deviation and the spatial constraints that influence variation in this condition. Next, we assessed the relationship between nasal septal size and craniofacial shape using multivariate regression techniques. Our results indicate that there is significant population variation in septal size and magnitude of septal deviation, both of which are greater in the European-derived sample. While septal deviation suggests a disjunction between the nasal septum and other components of the facial skeleton, we nevertheless found a significant relationship between the size of the nasal septum and craniofacial shape, which appears to largely be a response to the need to accommodate variation in nasal septal size.

An inexpensive, versatile mosquito rearing chamber for field, laboratory, and classroom investigations.

An inexpensive mosquito rearing chamber for field, laboratory, and classroom investigations is described. The rearing chamber is made from plastics recycled from peanut butter jars and room deodorizers. The top of the chamber requires mesh material and gluing. The cost for the rearing chamber is negligible. The design of the chamber allows for direct field collecting of larvae and for easy knock down/cold storage of emerged adults. In addition to its use in field and laboratory investigations, the chamber is an excellent device for classroom study of insect metamorphosis.

Biomechanical considerations for distraction of the monobloc, Le Fort III, and Le Fort I segments.

BACKGROUND: Distraction osteogenesis is effective for correction of severe maxillary and midface hypoplasia. The vectors controlling the segment to be moved must be planned. This requires knowledge of the physical characteristics of the osteotomized bone segment, including the location of the center of mass (free body) and the center of resistance (restrained body). The purpose of this study was to determine the center of mass of the osteotomized monobloc, Le Fort III, and Le Fort I bone segments. METHODS: A dry human skull was used to sequentially isolate three bone segments: monobloc, Le Fort III, and Le Fort I. Each segment was suspended from three different points, and digital photographs were obtained from each suspension. The photographs were digitally superimposed. The center of mass was determined by calculating the intersection of the suspension lines. RESULTS: The center of mass for the monobloc segment was located at a point 43.5 percent of the total height from the occlusal plane to the superior edge of the frontal bone supraorbital osteotomy. For the Le Fort III, it was located 38 percent of the total height from the occlusal plane to the superior edge of the osteotomized base of the nasal bones. For the Le Fort I, it was 53 percent of the total height from the occlusal plane to the superior edge of the osteotomized maxillary bone. CONCLUSION: Knowledge of the location of the center of mass in the monobloc, Le Fort III, and Le Fort I segments provides a starting point for the clinician when planning vectors for advancement with distraction.

Tris(2,4-dimethyl-benzene-thiol-ato)phenyl-tin(IV).

In the title compound, [Sn(C(6)H(5))(C(8)H(9)S)(3)], the Sn atom has an approximately tetra-hedral SNCS(3) geometry, with angles at this atom ranging from 105.13 (3) to 113.54 (9)°. The crystal packing does not involve any significant inter-molecular inter-actions, although the benzene rings are involved in a number of weak intra- and inter-molecular C-H⋯π inter-actions.

Template-controlled synthesis of a planar [16]ane-P2C(NHC)2 macrocycle.

Reaction of tetraphosphine platinum(II) complexes with 2-azidoethyl isocyanide 3 in methanol leads to complexes with two trans-coordinated NH,NH-stabilized carbene ligands 6(X)(2). Complexes 6(X)(2) react with phenyldivinylphosphine under substitution of the remaining phosphine ligands followed by an intramolecular hydroamination reaction to produce complex 1(PF(6))(2) with a macrocyclic [16]ane-P(2)C(NHC)(2) ligand.

Synthesis of NHC complexes by template controlled cyclization of beta-functionalized isocyanides.

Starting from complexes of type [Ru(Cp)Cl(P-P)] (P-P = 2PPh3, 3a; P-P = 2PMe3, 3b: P-P = dppe, 3c; P-P = dppp, 3d) isocyanide complexes [Ru(Cp)(P-P)(CNR) 4a-4d (CNR = CN-CH2-CH2N3, 1) and 7a-7d (CN-C6H4-2N3, 2) have been prepared. Reduction of the azido functions of the coordinated isocyanide ligands with Zn/NH4Cl/H2O in methanol leads to coordinated 2-amino functionalized isocyanides which cyclize to yield the complexes with a saturated NH,NH-stabilized NHC ligand 5a-5d or a benzannulated NH,NH-stabilized NHC ligand 8a-8d. The Zn/NH4Cl/H2O reduction method is of general applicability and allowed the generation of complex 11 bearing three saturated NH,NH-stabilized NHC ligands.

Electrochemical behavior of an aminotrithioether ligand: copper(II)-mediated oxidative C-C bond formation.

A neutral aminotrithioether interacts with CuI, generating a coordination polymer in the solid state. Electrochemical studies indicate that the ligand is prone to oxidation by CuII, which results in a novel C-C bond formation reaction.

O-(2-tert-butyl-6-dimethylthiocarbamoyl-4-methylphenyl) N,N-dimethylthiocarbamate dichloromethane solvate.

In the title compound, C(17)H(26)N(2)OS(2).CH(2)Cl(2), the C=S distances are 1.650 (4) and 1.679 (3) A, and the torsion angle between the planes of the thiocarbamate and carbonothioyl fragments is 54.4 (2) degrees. The steric and electronic effects that these substituents exert on one another determine the observed anti configuration with respect to the phenyl C atoms to which they are attached.