• Title/Summary/Keyword: Nasal deviation

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Three-dimensional Assessment of Facial Soft Tissue after Orthognathic Surgery in Patients with Skeletal Class III and Asymmetry

  • Lee, Jong-Hyeon;Choi, Dong-Soon;Cha, Bong-Kuen;Park, Young-Wook;Jang, Insan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.6
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    • pp.360-367
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    • 2013
  • Purpose: The purpose of this study was to perform three-dimensional (3D) assessment of facial soft tissue in patients with skeletal Class III and mandibular asymmetry after orthognathic surgery. Methods: Samples consisted of 3D facial images obtained from five patients with A point-nasion-B point angle less than 2 degrees, and more than 5 mm of menton deviation. All patients had been treated at Gangneung-Wonju National University Dental Hospital from 2009 to 2012. They had undergone orthognathic surgery of Lefort I, and sagittal split osteotomy for correction of skeletal deformity, and orthodontic treatment. Facial scanning was performed before treatment (T1) and post-surgical orthodontic treatment (T2). Linear and angle variables of soft tissue landmarks, antero-posterior facial depth, and facial volume were measured. Results: No significant differences in width of the alar base, mouth width, and nasal canting were observed between T1 and T2. However, lip deviation, menton deviation, alar canting, lip canting, and menton deviation angle were significantly reduced at T2. Antero-posterior facial depth on the axial plane parallel to the left cheilion was significantly reduced on the deviated side and significantly increased on the non-deviated side at T2. Volume of the lower lateral and lower medial parts of the face was reduced on the deviated side, and volume of upper lateral and lower lateral parts on the non-deviated side was significantly increased at T2. Conclusion: After orthognathic surgery, facial asymmetry of soft tissue was improved following skeletal changes, especially the mandibular region. Although the length of the alar base and mouth width did not change, lip and soft tissue menton were displaced to the medial side after treatment. Facial depth also became symmetric after treatment. Facial volume showed a decrease on the lower part of the deviated side and that on lateral parts of the non-deviated side showed an increase after treatment.

Odor Thresholds and Breathing Changes of Human Volunteers as Consequences of Sulphur Dioxide Exposure Considering Individual Factors

  • Kleinbeck, Stefan;Schaper, Michael;Juran, Stephanie A.;Kiesswetter, Ernst;Blaszkewicz, Meinolf;Golka, Klaus;Zimmermann, Anna;Bruning, Thomas;Van Thriel, Christoph
    • Safety and Health at Work
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    • v.2 no.4
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    • pp.355-364
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    • 2011
  • Objectives: Though sulfur dioxide (SO2) is used widely at workplaces, itseffects on humans are not known. Thresholds are reportedwithout reference to gender or age and occupational exposure limits are basedon effects on lung functioning, although localized effects in the upper airways can be expected. This study's aim is to determine thresholds with respect to age and gender and suggests a new approach to risk assessment using breathing reflexes presumably triggered by trigeminal receptors in the upper airways. Methods: Odor thresholds were determined by the ascending method of limits in groups stratified by age and gender. Subjects rated intensities of different olfactory and trigeminal perceptions at different concentrations of $SO_2$. During the presentation of the concentrations, breathing movements were measured by respiratory inductive plethysmography. Results: Neither age nor gender effects were observed for odor threshold. Only ratings of nasal irritation were influenced bygender. A benchmark dose analysis on relative respiratory depth revealed a 10%-deviation from baseline at about 25.27 mg/$m^3$. Conclusion: The proposed new approach to risk assessment appearsto be sustainable. We discuss whether a 10%-deviation of breathingdepth is relevant.

An Acoustical Study on the Syllable Structures of Korean Numeric Sounds

  • Yang, Byung-Gon
    • Speech Sciences
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    • v.14 no.1
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    • pp.137-147
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    • 2007
  • The purpose of this study was to examine the syllable structures of ten Korean numeric sounds produced by ten students. Each sound was normalized by its maximum intensity value and divided into onset, vowel, and coda sections after finding abrupt or visible changes in energy values or cumulative values of lower spectral energy at each pulse point using four Praat scripts. Then, segmental durations and cumulative intensity values of each syllable were obtained to find a statistical summary of the syllable structure. Intensity values at 100 proportional time points were also collected to compare the ten sounds. Results showed as follows: Firstly, there was not much deviation from the grand average duration and intensity for the majority of the sounds except the two diphthongal sounds on which their boundary points varied among the speakers. Secondly, the onset point for the CV or CVC category sounds and the boundary between the vowel and the nasal or lateral sound were easy to identify, which may be automatically traced later. Thirdly, there seems some tradeoff among the sections maintaining the same total duration per each syllable. Further studies on syllables with various onsets or codas would be desirable to make a general statement on the Korean syllable structure.

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Differences in positions of cone-beam computed tomography landmarks in patients with skeletal Class III facial asymmetry according to midsagittal planes

  • Hyung-Kyu Noh;Ho-Jin Kim;Hyo-Sang Park
    • The korean journal of orthodontics
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    • v.53 no.4
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    • pp.219-231
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    • 2023
  • Objective: This study aimed to clarify differences in the positions of cone-beam computed tomography (CBCT) landmarks according to different midsagittal planes (MSPs) in patients with skeletal Class III facial asymmetry. Methods: Pre-treatment CBCT data from 60 patients with skeletal Class III were used. The patients were classified into symmetric (menton deviations of < 2 mm) or asymmetric (menton deviations of > 4 mm) groups. Six MSPs were established based on previous studies, and three-dimensional analyses were performed for the planes in both the groups. The measurement outcomes were compared statistically. Results: A statistically significant interaction (p < 0.01) was observed between MSPs and facial asymmetry. No significant differences were observed among MSPs in the symmetric group. However, significant differences in linear measurements were identified among MSPs in the asymmetric group. Specifically, the upper facial MSP revealed both maxillary and mandibular transverse asymmetries. On the other hand, anterior nasal spine (ANS)-associated MSP could not identify maxillary asymmetry. Furthermore, the menton deviation was approximately 3 mm lower when estimated using the ANS-associated MSP than that using upper facial MSP. Conclusions: The choice of MSP can significantly affect treatment outcomes while diagnosing patients with asymmetry. Therefore, care should be taken when selecting MSP in clinical practice.

Accuracy of posteroanterior cephalogram landmarks and measurements identification using a cascaded convolutional neural network algorithm: A multicenter study

  • Sung-Hoon Han;Jisup Lim;Jun-Sik Kim;Jin-Hyoung Cho;Mihee Hong;Minji Kim;Su-Jung Kim;Yoon-Ji Kim;Young Ho Kim;Sung-Hoon Lim;Sang Jin Sung;Kyung-Hwa Kang;Seung-Hak Baek;Sung-Kwon Choi;Namkug Kim
    • The korean journal of orthodontics
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    • v.54 no.1
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    • pp.48-58
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    • 2024
  • Objective: To quantify the effects of midline-related landmark identification on midline deviation measurements in posteroanterior (PA) cephalograms using a cascaded convolutional neural network (CNN). Methods: A total of 2,903 PA cephalogram images obtained from 9 university hospitals were divided into training, internal validation, and test sets (n = 2,150, 376, and 377). As the gold standard, 2 orthodontic professors marked the bilateral landmarks, including the frontozygomatic suture point and latero-orbitale (LO), and the midline landmarks, including the crista galli, anterior nasal spine (ANS), upper dental midpoint (UDM), lower dental midpoint (LDM), and menton (Me). For the test, Examiner-1 and Examiner-2 (3-year and 1-year orthodontic residents) and the Cascaded-CNN models marked the landmarks. After point-to-point errors of landmark identification, the successful detection rate (SDR) and distance and direction of the midline landmark deviation from the midsagittal line (ANS-mid, UDM-mid, LDM-mid, and Me-mid) were measured, and statistical analysis was performed. Results: The cascaded-CNN algorithm showed a clinically acceptable level of point-to-point error (1.26 mm vs. 1.57 mm in Examiner-1 and 1.75 mm in Examiner-2). The average SDR within the 2 mm range was 83.2%, with high accuracy at the LO (right, 96.9%; left, 97.1%), and UDM (96.9%). The absolute measurement errors were less than 1 mm for ANS-mid, UDM-mid, and LDM-mid compared with the gold standard. Conclusions: The cascaded-CNN model may be considered an effective tool for the auto-identification of midline landmarks and quantification of midline deviation in PA cephalograms of adult patients, regardless of variations in the image acquisition method.

A clinical study of allergic rhinitis (알레르기 비염에 관한 임상적 연구)

  • 채병윤
    • The Journal of Korean Medicine
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    • v.21 no.3
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    • pp.149-165
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    • 2000
  • As recent developments of Immunology and Nuclear medicine, serum IgE and IgG values are helpful in the diagnosis and evaluation of the therapeutic effects of nasal allergies. But in Korea, air pollution and the increased use of food additives have become leading factors in nasal allergies, It seems to be induced by environmental change, especially industrialization and urbanization, so allergic rhinitis in our environment has changed in accordance with the changes made in the living environment. Therefore this study is attempted in order to observe a clinical analysis which places more importance on allergic rhinitis. We studied 200 patients who had visited Kyunghee Oriental Medical Center with allergic rhinitis from January 1, 1999 to December 31, 1999 The results were as follows: 1. The sex distribution was 114 males(57%) and 86 females(43%). In age distribution, the average age was 25. In males, ages ranged from 3 to 66 years old and the average was 23.81. In females, ages ranged from 4 to 67 years old and the average was 28.57. The peak age was 30~39 years old(24%); under 9 years old and 10~19 years old were each 18%; 20~29 years old was 22%; 40~49 years old was 11 %; over 50 years old 6.5%. The gulf between males and females showed a statistically significant difference(P<0.025). 2. In the age of onset, male' s maximum was 62.5, minimum was 0.25; female s maximum was 59.5, minimum was 0.2. Under 9 years old was the most with 34%(male 24%, female 10%), 10~19 years old was 18%, 20~29 years old was 22.5%, 30~39 years old was 13.50%, over 40 years old was 12%, The gulf between males and females were showed statistically significant difference.(p<0.014) 3. The average duration of the disease was 5.67 years. In male and female, the maximum was 30, the minimum was 0.05; under 5 years old was the most with 62%(male 34.50%, female 27.50%); 6~10 years old was 23%. So, under 10 years old was 85%. There was no statistically significant difference in the duration of disease. 4. Regarding type of residence, 47.50% of patients with allergic rhinitis lived in apartments, 52.50% lived in houses. In males, 29.50% lived in apartments, 27.50% lived in houses. In females, 18% lived in apartments, 25% lived in houses. There was no statistically significant difference in the residence by T-test and chi-test. 5. In the distribution of season, spring is the most with 29.5% of patients, winter 28%, fall 25.5%, and summer 17%. But there was no statistically significant difference. 6. After observing 200 patients with allergic rhinitis, classifying main symptoms into 5 types, sneezing was the main symptom in 177cases(88.50%), nasal obstruction in 176cases(88%), rhinorrhea in 169cases(84.5%), post nasal discharge in 87cases(43.50%), and itching in I04cases(52%). The Cumulus ration is 98.50% and symptoms overlapped with an average 3.57±0.1 times but in an analysis of variance of these symptoms, the gulf between males and females was not recognized as statistically significant by T-test and ANOVA. 7. Patients whose families have allergic diseases account for 90 cases(45%) : 49cases(24.50%) male and 41cases(20.50%) female. There were 4 cases (71.11 %) whose families have allergic rhinitis, 9cases(10%) of asthma, and 7.78% with allergic dermatitis. There were 61 (67.80%) cases of patients whose parents have allergic diseases; cases wherein the patient s child had allergic diseases numbered 13 (14.45%); and cases with a sibling with allergic diseases totalled 16cases (17.80%). There was no statistically significant difference in allergic disease regarding sex, parents, or siblings by chi-test. 8. Blood type: For males, type A is the most common, with 37cases(18.5%), followed by type B with 32cases(16%), type O 28cases(l4%) and type AB 13cases(6.5%). For females, type B is the most common, with 30cases(15%), followed by type O with 23cases(l1.5%), type A with 18cases(9%) and type AB with 13cases(6.5%). There was no statistically significant difference in blood type by chi-test. 9. In the selection of prefered food, most patients prefer cool food, with 98 such cases(49%), tepid food in 54cases(27%) and warm food in 48cases(24%). These showed a statistically significant difference in the selection of prefered food between males and females by chi-test(p<0.009). 10. The state of Past History was classified into II types. chronic hypertrophic rhinitis is the most common with 11cases (18.64%), tonsil and adenoid hypertrophy is 8cases(l3.56%), sinusitis is 6cases(10.17%), nasal septum deviation is 4cases, nasal polyp is 2cases, others are 10cases(l6.95%). No statistically significant difference in past history between males and females was shown, but a statistically significant difference was shown when males and females were compared with total cases by T-test(p<0.002, P<0.0008). 11. Regarding complications, 37 patients (28.91%) had sinusitis: 22cases(17.19%) in male, 15cases(11.72%) in female. Chronic hypertrophic rhinitis was found in 15cases(11.72%). Others are under 10%. There was no statistically significant difference in the type of complications between males and females, but a statistically significant difference was shown when males and females were compared with total cases by T-test(P<0.00l, P<0.007). 12. In the treatment, medication was used 1691 times, an average of 2.58 times. No.34 was used 370 times for 124 cases, an average of 2.98 times. No. 152 was used 318 times for 106 cases, an average of 3.00 times. No.151 was used 307 times for 97cases, an average of 3.16 times. No. 31 was used 117 times for 33 cases, an average of 3.55 times. No 25 was used 116 times for 33 cases, an average of 3.52 times. 13. In the duration of treatment, the most frequent is 1 week(69cases, 34.50%), the maximum is 20weeks, and the minimum is 1week. A treatment period of 2~3 weeks accounted for 32% of cases, a period of 4~5weeks accounted for 13.5%. The gulf between males and females showed a statistically significant difference in the duration of treatment.(p<0.01). There was a statistical significance when the males were compared with total cases by ANOVA(P<0.03). 14. A comparison between before-treatment and after-treatment showed a statistically significant difference in treatment by T-test (p<0.01) and F-test (p<0.0058).

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Relationship between Perception of Facial Asymmetry and Posteroanterior Cephalometric Measurements (안면비대칭에 대한 주관적 인지도와 정모두부방사선사진 분석치의 연관성)

  • Ahn, Jeong-Soon;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.31 no.5 s.88
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    • pp.489-498
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    • 2001
  • This study was aimed at how posteroanterior cephalometric measurements affect the perception of the patient about his/her facial asymmetry. One hundred orthodontic patients, over the age of 12, who required a posteroanterior cep-halogram in the Department of Orthodontics of Chonnam National University Hospital were used as the subjects. They were asked if they thought their faces were asymmetrical. Their responses were classified into 5 groups based on the level of asymmetry as follows : Definitely No, Probably No, Don't Know, Probably Yes, and Definitely Yes. Nine linear and low angular measurements from each posteroanterior cephalometric radiographs were analysed on the standard of the line between crista galli and anterior nasal spine to show the extent of asymmetry. Through this comparative study, the following results were obtained. 1. As the deviation of menton and the midline discrepancy of the upper and lower jaws were greater, the perception of patients about their facial asymmetry was higher. 2. All the measurements from the group 'Don't Know' showed no statistical difference from those of the groups 'Definitely No' or 'Probably No.' 3. All the measurements from the group 'Probably Yes' showed no statistical difference from those of the group 'Definitely yes.' .

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ABNORMAL GROWTH PATTERN OF HUMAN FETAL MAXILLA WITH CLEFT LIP AND PALATE (구순구개열 태아의 비정상적인 상악골 성장형태에 대한 연구)

  • Kim, Soung-Min;Kim, Jung-Hwan;Kim, Ji-Hyuck;Park, Young-Wook;Lee, Jong-Ho;Lee, Suk-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.3
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    • pp.238-246
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    • 2007
  • This study is aimed to elucidate the abnormal growth pattern of human fetal maxilla with cleft lip and palate (CLP). Total 71 fetal maxillae with CLP were obtained from aborted human fetuses. They were examined radiologically for the dimensional changes of maxillary trapezoid (MT) formed by maxillary primary growth centers (MxPGC)(Lee et al., 1992). In palatal radiogram of the CLP maxilla, the MT was traced by the anterior and posterior MxPGCs, and the dimensions of anterior and posterior maxillary widths, maxillary length, and MT length (MTL), and MT area were measured for evaluation of the basic growth pattern of the developing maxilla. The growth of anterior and posterior MxPGCs was severely retarded in the prenatal maxillae with CLPs, showing abnormal shape of MT. Cleft lip subjects without cleft palate also showed arrested growth of MT. Unilateral cleft lipalveolar cleft or cleft palate (UCL-AC/CP) and bilateral cleft lip-alveolar cleft or cleft palate (BCL-AC/CP) showed enhanced abnormal MT pattern. The abnormality of MT was most marked in BCL-AC/CP. It was also observed that the craniofacial malformations other than CLPs produced abnormal MT. In conclusion, the MT growth of prenatal CLP maxilla was severely arrested and resulting in abnormal MT shape on the palatal radiogram. BCL-AC/CP showed more protruded nasal septum than other types of CLPs, while UCL-AC/CP showed severe deviation of the protruded nasal septum towards the non-cleft side. Cleft lip only subjects also showed the abnormal growth of MT. These data suggest that the MT is primarily involved in CLPs, and MT shape could be utilized as a sensitive indicator for the analysis of maxillary malformation in different types of CLPs.

Rhinoplasty using Various Autogenous Tissues (다양한 자가조직을 활용한 비성형술)

  • Han, Ki-Hwan;Yeo, Hyeon-Jung;Choi, Tae-Hyun;Kim, Jun-Hyung;Son, Dae-Gu
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.37-45
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    • 2010
  • Purpose: In Korean rhinoplasty, alloplasts such as silicone rubber have been used for dorsal and tip augmentations. However, alloplasts have produced complications such as deviation, exposure, and infection. Although autogenous tissue is an ideal material, the amount of the cartilage in Korean is not sufficient. Therefore, the authors developed a method to harvest the maximum amount of the septal and conchal cartilage. The authors first performed a complete septal extension graft for short and retruded columella and then performed nasal augmentation using various autogenous tissues. Methods: These surgical techniques were performed on 11 patients. Their average age was 27 years. An open approach with a V-shaped columellar labial incision was performed. At first, the complete septal extension graft was fixed on the entire caudal margin of the septum, and the alar cartilage was suspended to the septal extension graft to make the tip projected and the columella advanced caudally. A temporal fascial ball was used for radix augmentation. For dorsal augmentation, a batten-shaped septal cartilage graft wrapped with or without the temporal fascia or a diced cartilage graft wrapped with the temporal fascia was performed. For nasal tip augmentation, a shield graft and a cap graft or a folded conchal cartilage graft was performed.Results: The mean follow-up period was 11.2 months. The overall results were natural and satisfactory. Two patients underwent slight absorption and caudal displacement. With the exception of these cases, no complications were observed. Conclusion: Korean rhinoplastic surgeons are accustomed to using the alloplasts despite of serious complications. When rhinoplasty using autogenous tissue was performed, some complications occurred such as the displacement of the diced cartilage graft wrapped with the fascia, but many of the complications of alloplastic rhinoplasty were avoided. Therefore, we propose that by this time Korean rhinoplastic surgeons need to change their preference from alloplastic rhinoplasty to autogenous rhinoplasty.

Reproducibility of Lateral Cephalometric Landmarks According to Radiographic Image Enhancement (방사선상 enhancement 정도에 따른 측모두부방사선규격사진 계측점 설정의 재현도)

  • Ryu, Hwang-Sog;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.32 no.1 s.90
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    • pp.59-69
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    • 2002
  • The purpose of this study was to evaluate the reproducibility of lateral cephalometric landmarks according to radiographic image enhancement, and to contribute to the identification of cephalometric landmarks. Lateral cephalograms of ten individuals were taken and stored into computer. The images were then enhanced up to four grades by Quick Ceph Image Pro$^{TM}$ on condition that the gray-scale equalization number was 50 and the detail enhancement number was 50. After thirty two landmarks were identified on monitor images by five observers, the deviations from the mean, the distances estimated between identified points and the mean point of five identified points, were evaluated for each landmark at each enhancement grade. Through the statistical analysis, following results were obtained. 1. In case of unenhanced radiographic images, the inter-observer reproducibility of the landmarks showed a large variation. 2. The comparison of deviation from the mean according to the degree of radiographic image enhancement for each landmark showed that the inter-observer reproducibility was significantly different at 5 landmarks. 3. The landmark of pterygomaxillary fissure showed higher reproducibility at enhancement grade 1 and 2 images than at unenhanced images. So did the landmark of posterior nasal spine at enhancement grade 1 images, and the landmark of menton at enhancement grade 2, 3 and 4 images respectively. The above results suggest that the reproducibility of some landmarks can be increased by radiographic image enhancement during the identification of the lateral cephalometric landmarks on the monitor.