• Journal of Korean Ophthalmic Optics Society
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• v.15 no.2
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• pp.155-160
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• 2010

Purpose: The purpose of this study was to evaluate how phoria variations would vary with head positions, as well as to review the need to differentiate prism placement over either eye in a relation to the imbalance of the extraocular muscle. Methods: This study was carried out with 44 males (88 eyes) and 16 females (32 eyes) aged between 20 and 30. For all subjects, testings were performed using cover test, subjective refraction, phoria and vergence test. To analyze phoria variations comparatively for the head tilt test and the face turn test, phoria deviation were measured using the von Graefe. Results: For the phoria variation related with head tilt and face turn, a significant difference was observed in the group judged to be abnormal on the horizontal phoria of Morgan' norm (p<0.05); especially in patients who needed near prescription of Sheard's criterion, a higher variation was observed (p<0.05). The abnormal group was composed of patients who needed distance prescription of Sheard's criterion and ones who did not need the prescription, all of whom showed phoria variations, but the mean value was less than the near. Conclusions: With regard to the head tilt and face turn related phoria level, the patients who needed near horizontal prism prescription of Sheard's criterion showed a remarkably higher variation. Altogether, it is deemed to check whether extraocular muscles are ill-balanced in both eyes previously to determine the prism power on phoria level to the end that each of prism powers may be accurately determined.

• Journal of Korean Ophthalmic Optics Society
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• v.18 no.3
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• pp.341-346
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• 2013

Purpose: The purpose of this study was to evaluate whether a relationship exists between head posture and phoria, and usefulness in examining habitual head posture. Methods: Twenty two subjects (20 males and 2 females, mean age $23.6{\pm}2.7$ years) with abnormal phoria from participants randomized were enrolled in this study. For all subjects, testing included case history, cover test, refraction, phoria and vergence test. Habitual head posture (head posture, head tilt and face turn) was measured by Impression IST, and observed by examiners. Results: The abnormal head posture was revealed in some subjects with abnormal phoria. Spearman' correlation ($\rho$=0.524, p=0.045) showed significant correction between face turn and phoria at distance in 15 subjects with prism prescription. No significant relationship between head posture and phoria was found in subjects with abnormal phoria. The objective measurement and subjective observation of head posture showed insignificant correction but there was a distinct difference. The former was detail and the latter was discriminate. Conclusions: Presence of abnormal head posture was found in phoric subjects. The results indicate the need to observe habitual head posture at all major positions of gaze in phoria.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.2
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• pp.90-97
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• 2019

Purpose: Previous studies related with occlusal contact area were limited that interocclusal thickness level or the method of measurement has not been accurate in measuring. The purpose of this study was to investigate the relation between head posture and occlusal contact area using photo occlusion analysis. Materials and Methods: 54 subjects with complete dentition (44 men, 10 women / 23 to 33 years of age) were included. To identify the relationship between head posture and occlusal contact area, subjects took interocclusal record in maximal intercuspal position with three different positions(supine position ($0^{\circ}$) / inclined position ($45^{\circ}$) / upright position ($90^{\circ}$)) on the dental unit chair. Occlusal contact area was analyzed using photo occlusion analysis. Statistical analyses were performed with SPSS ver.25.0 at 95% confidence interval. Results: Head posture has no significant effect on the changes of occlusal contact area (P > 0.05). Conclusion: When interocclusal relation is stable, head posture does not change a interocclusal record because head posture has no significant effect on occlusal contact area. Analysis of occlusal contact area using photo occlsion analysis device is useful due to its material property and simplicity.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.31-39
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• 2011

Purpose: Helical Tomotherapy allows only coplanar beam delivery because it does not allow couch rotation. We investigated a method to introduce non-coplanar beam by tilting a patient's head for Tomotherapy. The aim of this study was to compare intrafractional movement during Tomotherapy between coplanar and non-coplanar patient's setup. Materials and Methods: Helical Tomotherapy was used for treating eight patients with intracranial tumor. The subjects were divided into three groups: one group (coplanar) of 2 patients who lay on S-plate with supine position and wore thermoplastic mask for immobilizing the head, second group (non-coplanar) of 3 patients who lay on S-plate with supine position and whose head was tilted with Variable Axis Baseplate and wore thermoplastic mask, and third group (non-coplanar plus mouthpiece) of 3 patients whose head was tilted and wore a mouthpiece immobilization device and thermoplastic mask. The patients were treated with Tomotherapy after treatment planning with Tomotherapy Planning System. Megavoltage computed tomography (MVCT) was performed before and after treatment, and the intrafractional error was measured with lateral(X), longitudinal(Y), vertical(Z) direction movements and vector ($\sqrt{x^2+y^2+z^2}$) value for assessing overall movement. Results: Intrafractional error was compared among three groups by taking the error of MVCT taken after the treatment. As the correction values (X, Y, Z) between MVCT image taken after treatment and CT-simulation image are close to zero, the patient movement is small. When the mean values of movement of each direction for non-coplanar setup were compared with coplanar setup group, X-axis movement was decreased by 13%, but Y-axis and Z-axis movement were increased by 109% and 88%, respectively. Movements of Y-axis and Z-axis with non-coplanar setup were relatively greater than that of X-axis since a tilted head tended to slip down. The mean of X-axis movement of the group who used a mouthpiece was greater by 9.4% than the group who did not use, but the mean of Y-axis movement was lower by at least 64%, and the mean of Z-axis was lower by at least 67%, and the mean of Z-axis was lower by at least 67%, and the vector was lower by at least 59% with the use of a mouthpiece. Among these 8 patients, one patient whose tumor was located on left frontal lobe and left basal ganglia received reduced radiation dose of 38% in right eye, 23% in left eye, 30% in optic chiasm, 27% in brain stem, and 8% in normal brain with non-coplanar method. Conclusion: Tomotherapy only allows coplanar delivery of IMRT treatment. To complement this shortcoming, Tomotherapy can be used with non-coplanar method by artificially tilting the patient's head and using an oral immobilization instrument to minimize the movement of patient, when intracranial tumor locates near critical organs or has to be treated with high dose radiation.

• Journal of Veterinary Clinics
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• v.20 no.1
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• pp.26-32
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• 2003

The clinical results of 10 consecutive total ear canal ablation combined with lateral bulla osteotomy (TECA-LBO) in six dogs with chronic otitis externa and media were evaluated by the postoperative recovery and long-term follow-up. All dogs were selected for TECA-LBO on the basis of following five clinical symptoms. First, medical treatment couldnt improve clinical signs at least for eve. 2 months. Second, tympanic membrane was completely disappeared. Third, radiopacity was increased in tympanic cavity. Forth, petrous temporal bone was sclerosed. Fifth, ear canal calcification was progressed. And all cases were satisfied all five clinical symptoms. At 14. days after operation, the preoperative symptoms of chronic otitis externa and media which were scratching ear, pain, and hardening ear canal were resolved, and postoperative swelling, erythema, head tilt, and exudate from Penrose drainage were not existed In all cases. Loss of eye blink was happened in 4 cases, but these were disappeared between 14 days a(ter operation except one case on 3 months. All dogs were discharged form hospital at 14 days after operation. Between 3.5 and 6.5 months after discharging from hospital, para-aural abscessation was happened only in all Cocker spaniels. But this complication was solved by ventral bulla osteotomy (VBO). The dogs which didn't show para-aural abscessation after TECA-LBO didn't show scratching, pain, hardening of ear and hearing ability was improved, at 7.5 months after TECA-LBO. And the dogs which showed para-aural abscessation after TECA-LBO also didn't show scratching, pain, hardening of ear and hearing ability was also improved, at 7.5 months after VBO. In conclusion, After TECA-LBO, all dogs were recovered well without complication within 2 weeks except Cocker spaniel. And loss of eye blink can be cured naturally within 2 weeks after surgery. And para-aural abscessation can be happened between 4 and 7 months after TECA-LBO, so surgeon must follow-up until 8 months.