This 37 year-old male patient underwent high resolution CT imaging of the face including paranasal sinuses following trauma. Computed tomography (CT) has a well-established role in the assessment of the facial bones in the context of trauma, in particular for fractures involving the paranasal sinuses and orbit. High resolution imaging permits isotropic reconstruction in multiple planes. Its use in imaging the contents of orbit itself is more select, with both direct clinical examination and even orbital ultrasound used to assess the globe and lens of the eye.1 Traumatic dislocation of the lens of the eye may entail the partial or complete translocation of the lens from its normal position within the anterior aspect of the eye.2 The high attenuation lens ‘floats’, within the vitreous of the globe (Figures 1, 2 and 3). Following trauma to the face the injuries may be multiple and cross sub-speciality boundaries, but one should be alert to all injuries. In reviewing CT images one should be forensic in the review of all the anatomy covered, even it is not related to the original clinical query or not pertinent to one’s own clinical speciality. As an old mentor once told me, ‘Before you take the film down, have one last paranoid look.’ Learning Point: Always review the entirety of the imaging performed despite the focus of one’s clinical or speciality interest.
Eye ; Face

Face ; Facial Paralysis ; Humans

Humans ; Child ; Face ; China

OBJECTIVETo evaluate the symmetry rate of nasal floor width and the influencing factor for the unilateral complete cleft lip (UCCL) after repair with Huaxi technique.

METHODS27 UCCL patients repaired with Huaxi technique were photographed before repair, 1 week and 1 year after surgery. The distance from columella point to facial midline, the nasal floor width and the fissure width were measured. The approach rate of the columella point, the symmetry rate and the change of the nasal floor width were calculated. The statistical analysis was completed by SPSS 13.0.

RESULTSThere was statistical difference of the approach rate for the columella point between 1 week and 1 year after surgery (54.06%, 63.96%; P < 0.05), no statistical difference was found of the symmetry rate for the nasal floor between 1 week and 1 year after surgery (69.12%, 75.93%; P > 0.05). There was statistical difference of the change for nasal floor width between the cleft side and the non-cleft side in a week (P = 0.000), but no statistical difference was found in a year (P = 0.262). The linear correlation was obtained between the distance from columella point to facial midline 1 week after surgery and the distance from columella point to facial midline (r = 0.465, P = -0.014) and the fissure width (r = 0.486, P = 0.010) before surgery. No linear correlation was obtained between other index after surgery and before surgery (P > 0.05).

CONCLUSIONThe symmetry rate of nasal floor width is stable after surgery with Huaxi technique, and the growth changes have not significant impact on the effect of the surgery in a short-term.

OBJECTIVETo investigate the hard and soft tissue changes following the treatment of Class II division 1 malocclusion using Twin-block appliance.

METHODS50 Class II division 1 malocclusion subjects whose handwrist radiographs were in FG-G stage were selected. One group (27 patients) was treated with Twin-block appliance, the other group (23 patients) was observed without treatment The acquired data of cephalometric of two groups were analyzed statistically with SPSS 11.0.

RESULTSSoft tissue changes, Ls-E, Li-E, U1-Stms, Stms-Stmi, NsLs-FH, LsNsLi, LsNsPg', the angle of H decreased. Sn-Stms, Stmi-Me', Ns-Me', Sn-Me', NsLi-FH, NsPg'-FH, A'Ls-FH, B'Li-FH, LiB' Pg', CmSnLs, GSnPg', the angle of Z increased, there was statistically significant difference (P < 0.05). Hard tissue changes, SNB, L1-NB, IMPA increased, ANB, U1-SN, U1-NA, FMIA decreased, there was statistically significant difference (P < 0.05).

CONCLUSIONSagittal relationship between upper- and lower-jaws is effectively improved after orthopedics with Twin-block appliance. Lower face height increases. Soft tissue profile tends to be straight-styled.

Anxiety ; Face ; Humans ; Mouth ; Syndrome

Objective: To determine the usability of a smartphone application (ImageMeter) by ENT surgeons for pre-operative photographic analysis of facial angles for rhinoplasty using the USE questionnaire. 

Methods:

Design:           Post-Test Only Non-Experimental Evaluation Study

Setting:           Tertiary Private Training Hospital Outpatient Clinic

Participants: Twenty-five (25) ENT residents and consultants

Results: Of 45 ENT surgeons invited, 25 ENT residents and consultants (16 males, 9 females) aged 28 to 52-years-old (mean age 36 years old) trialed the use of the Image Meter application in measuring the naso-facial, naso-frontal, and naso-labial angles of pre-selected lateral images of 10 volunteers and completed our survey.  The usability of the application was measured using the USE questionnaire, through usefulness (Cronbach ? = 0.99), ease of use (? = 0.85), ease of learning (? = 0.66), and satisfaction (?= 0.69).  On a scale of 1-7, results showed that for the ENT surgeons surveyed, the app was generally useful (M = 6.10, SD = 0.73), easy to use (M = 6.13, SD = 0.63), easy to learn (M = 6.31, SD = 0.62) and satisfactory (M = 6.06, SD = 0.7).  As for overall outcome, the ENT surgeons found the application usable (M = 6.15, SD = 0.11).

Conclusion: When applied to human facial analysis, the ImageMeter measurement of angles feature may be a usable tool for ENT surgeons in the pre-operative evaluation of patients undergoing rhinoplasty.  Based on USE questionnaire responses, it is easy to use, quick to learn, useful, and satisfactory in the preoperative measurement of facial angles. 

Keywords: imageMeter; photography; esthetic; rhinoplasty; face; anthropometry

We use Z type skin flap to repair face slant diastema by combining nasal bottom and infraorbital border. The therapeutic efficacy was satisfactory. The dislocated nostril, eversioned eyelid and lowered eyeball was resettled.
Diastema ; Face ; Female ; Humans ; Nose ; Surgical Flaps

OBJECTIVETo identify certain craniofacial characteristics of untreated prepubescence Class II patients with deep and shallow mandibular notching.

METHODS18 untreated preadolescent Class II patients with deep mandibular notching and 17 untreated preadolescent Class II patients with shallow mandibular notching were selected. Each subject's pretreatment lateral cephalogram was traced. Seventeen angular and eleven linear measurements were made. The means and standard deviations were calculated for each parameter. The significance of difference between mean values was evaluated by the Independent-Samples T test. Differences were considered statistically significant when the P value was 0.05 or less.

RESULTSThere was no difference in ANB between two groups, but deep notch cases had more retrusive maxillary and mandibles with shorter maxillary and corpus. In vertical direction, subjects with a deep mandibular notch had a longer lower facial height and more vertically directed mandibular plane angle than did shallow notch cases, these may be caused by the increasing of alveolar height of maxillary, smaller ramus height and greater gonial angle.

CONCLUSIONThere were some differences in the craniofacial morphologies between deep and shallow notching groups of preadolescent Class II patients. Compared with shallow notching group, the mandibles with the deep notching rotated downward and backward and have more vertical directed tendency, but there have no obviously difference in horizontal relationship of maxillary and mandible between two groups.

Face ; pathology ; surgery ; Humans ; Myocutaneous Flap