Anatomical Patterns of the Nasopalatine Canal and Incisive Foramen in an African Setting: A Cross-Sectional Study.

Study Design: Descriptive cross-sectional. Objective: To determine the morphology and morphometry of the nasopalatine canal (NPC) and incisive foramen (IF) in an African population. Methods: Measurements of the NPC and the IF were carried out on 150 Cone-Beam computed tomography (CBCT) scans. The maxillary bone thickness anterior to the NPC was measured at 3 levels. Independent t-test and Chi-square test were performed to determine the presence of sexual dimorphism. Results: The presence of one Stenson's foramen was most prevalent. The mean length of NPC was 13.21 ± 3.25 mm with significantly longer canals in males. The most prevalent shape of NPC was cylindrical in sagittal view and a single canal in coronal view. The mean angulation of NPC was 118.42° to the horizontal plane. The average dimensions of the IF were 3.53 mm and 3.07 mm in the anteroposterior and mediolateral diameter, respectively, while the most common shape was round. The anterior maxillary bone was thicker in males and generally reduced in thickness from the anterior nasal spine superiorly towards the alveolar crest inferiorly. Conclusion: This study highlights the anatomical characteristics of the NPC and IF, with significant sexual dimorphism observed regarding the number of Stenson's foramina, length of NPC, shapes of the NPC and IF, as well as alveolar bone thickness anterior to NPC.

A Cross-Sectional Study to Determine and Compare the Craniofacial Anthropometric Norms in a Selected Kenyan and Chinese Population.

Background: Craniofacial anthropometry provides essential data for diagnosis and treatment planning, with the norms for many races having been investigated. The results reveal that facial morphometry varies greatly because of geographical, ethnic, and racial variations. This study aims to gather the normative anthropometric data and compare the differences in facial morphometry between the Kenyan population and that of the Chinese. Methods: Four vertical measurements (trichion-nasion, nasion-subnasale, subnasale-gnathion, and superaurale-subaurale) and 6 horizontal measurements (zygion-zygion, exocanthion-endocanthion, endocanthion-endocanthion, pupil-pupil, alare-alare, and chelion-chelion) were obtained manually from subjects with no craniofacial abnormality. Results: A total of 180 participants (90 Kenyans and 90 Chinese) were included. Among the Kenyans, males generally had greater dimensions in comparison to the Kenyan females with the exception of the upper third, lower third, and intercanthal, and interpupillary distances. Among the Chinese, there was a significant difference between the 2 genders with the exception of intercanthal distance. All measurements were greater in Chinese males in comparison to the females. Comparison between races shows that Kenyans had greater vertical measurements with exception of the ear length for both genders. The Chinese males had increased facial width and intercanthal distance, while the Chinese females showed increased intercanthal distance compared to Kenyans. Kenyans exhibited hyperleptoprosopic-type face, while Chinese exhibited mesoprosopic-type face, with none of the 2 groups conforming to the neoclassical canons. Conclusion: Kenyans generally have greater craniofacial measurements versus Chinese, except for the facial width and intercanthal distance for males and interorbital distance for females.

Historique: L'anthropométrie craniofaciale fournit des données essentielles pour planifier le diagnostic et le traitement, et les normes de nombreuses races ont été explorées. Les résultats révèlent que la morphométrie change énormément en fonction des variations géographiques, ethniques et raciales. La présente étude vise à colliger les données anthropométriques normatives et à comparer les différences entre les morphométries faciales des populations kényane et chinoise. Méthodologie: Les chercheurs ont effectué quatre mesures verticales (trichion­nasion, nasion­point sous-nasal, point sous-nasal­gnathion et point superaural­point subaural) et six mesures horizontales (zygion­zygion, exocanthion­endocanthion, endocanthion­endocanthion, pupille-pupille, point alaire­point alaire, chélion­chélion) manuellement chez des sujets que ne présentaient pas d'anomalies craniofaciales. Résultats: Au total, 180 participants (90 Kényans et 90 Chinois) ont participé. Les dimensions étaient généralement plus grandes chez les Kényans que chez les Kényanes, à l'exception du tiers supérieur, du tiers inférieur et des distances intercanthale et interpupillaire. Chez les Chinois, on constatait une différence importante entre les deux sexes, à l'exception de la distance intercanthale. Toutes les mesures étaient plus grandes chez les hommes chinois que chez les femmes. La comparaison entre les races révèle que les Kényans avaient de plus grandes mesures verticales, à l'exception de la longueur des oreilles pour les deux sexes. Les hommes chinois présentaient une face plus large et une plus grande distance intercanthale, et les femmes chinoises, une plus grande distance intercanthale que les Kényans. Les Kényans avaient une face de type hyper-leptoprosope et les Chinois, une face de type mésoprosope, et aucun des deux groupes ne correspondait aux canons néo-classiques. Conclusion: En général, les Kényans ont des mesures craniofaciales plus grandes que les Chinois, sauf la largeur de la face et la distance intercanthale chez les hommes et la distance interorbitale chez les femmes.

An Interesting Case of Fatal Myasthenic Crisis Probably Induced by the COVID-19 Vaccine.

A myasthenic crisis is a severe, life-threatening exacerbation of myasthenia gravis that causes a rapid onset of muscle weakness and fatigue that may result in tetraparesis, dyspnea, respiratory insufficiency, aspiration, and death. Bulbar muscle functions are markedly affected resulting in depressed cough reflex, swallowing, and speech. Thus, mechanical ventilation, supportive feeding, and critical care are essential for the survival of patients in a myasthenic crisis. Numerous precipitating factors of this condition are well known and include infections, various medications, pregnancy, and childbirth. Patients with myasthenia gravis are at a considerably higher risk of developing a debilitating coronavirus disease 2019 (COVID-19) infection due to the associated immunosuppression resulting from long-term corticosteroid use, which makes vaccination of such individuals necessary. However, the relationship between an exacerbation of myasthenia gravis and the COVID-19 vaccination is currently unknown. In this paper, we report the case of a 55-year-old male patient who developed a myasthenic crisis after receiving the first dose of the ChAdOx1-S (recombinant) vaccine (AstraZeneca batch number 210157; AstraZeneca plc, Cambridge, United Kingdom). Despite the administration of aggressive and intensive treatment over a period of 29-day hospitalization, the myasthenic crisis could not be reversed and the patient ultimately deteriorated and succumbed from multiple myocardial infarction events and organ failures. While it is still uncommon, evidence associating the effects of the vaccine to the development of a crisis is mounting; therefore, it is crucial for clinicians to promptly identify clinical features that suggest an exacerbation of myasthenia gravis in order to intervene at the earliest possible stage for a more favorable outcome. The myasthenia gravis patient should be informed about the possible association between COVID-19 vaccination and the development of a myasthenic crisis.