Diagnosis of maxillofacial lesions is very difficult. Recent developments in computed tomography enable the production of three dimnesional images of complex anatomical structures from a series of conventional computed tomographic sections. Methods of three-dimensional analysis of computed tomographic images have recently been described. Mostly, reports have concentrated on applications relative to congenital deformities. In this report, one method of three dimensional reformatting is reviews. Images formed by this method have solid surface appearance and can be color enhanced and manipulated to isolate anatomic structures of interest. The program allows tissue densities, volumes, and distances. This report emphasizes maxillofacial applications other than those previously reported in the surgical and radiological literature.]]>
Congenital Abnormalities ; Diagnosis ; Surgery, Oral

The purpose of this study was to aid the case analysis and diagnosis of the maxillofacial deformities for orthognathic surgery. The applied method for analysis was a Cephalometrics Orthognathic Surgery (COGS) by Burstone. Lateral cephalograms werer obtained from 59 subjects over 21 years old, that consisted of 30 males and 29 females with normal occlusion, acceptable profile. The results were as follows: 1. The author made the tables of means, standard deviations in each item, sex. 2. The author performed whether there was significance (P<0.05) between the registered male and female's measurement in each item.
Adult* ; Congenital Abnormalities ; Diagnosis ; Female ; Humans ; Male ; Methods ; Orthognathic Surgery

This is an analysis of 6 patients with enteric duplications seen over an 8 year period at the Department of Pediatric Surgery, Dongsan Medical Center. They were all males but one. All duplications were cystic, and single except one. Locations of duplications were in the duodenum in one patient, in the jejunum in one, and in the terminal ileum in four. Five of the 6 patients were seen within 1 year of life. Three were newborn infants who had symptoms of intestinal obstruction with palpable mass since birth. Duplication cyst acted as a leading point of intussusception in 4 month and 8 month old infants respectively. One jejunal duplication was found in an 11-year-old boy who had malrotation of the midgut with Ladd's bands. Clinical presentation, embryogenesis of duplication, and management are discussed.
Child ; Congenital Abnormalities/diagnosis/surgery ; Female ; Humans ; Infant ; Infant, Newborn ; Intestine, Small/*abnormalities ; Male

OBJECTIVETo study the pathogenesis, the diagnostic criterion and the surgical methods of congenital nasal ethmoidal sinus malformation with false triple nostrils appearance.

METHODSFrom Feb 1993 to Mar 2006, a total of 13 cases of rare congenital nasal deformity had been investigated in pathogenesis, clinical manifestations, differential diagnosis and the methods of operation. The concept of congenital nasal sinus was presented. In this series, one-stage rehabilitation was achieved by using compositive operation techniques, including excision of the sinus, reconstruction of the hatch of ethmoidal sinus, transplantation of the dorsal nasal musculoaponeurotic flap as well as the nasolabial fold flap and the reconstruction of the cartilage-muscle ring in the wing of the nose.

RESULTSThe symptom disappeared in all of the 13 cases with no morbidity. The symmetrical double sides were observed and the nasal figure was satisfied.

CONCLUSIONSBy using such compositive operation techniques, including excision of the sinus, reconstruction of the hatch of ethmoidal sinus in middle nasolabial, transplantation of the dorsal nasal musculoaponeurotic flap as well as the nasolabial fold flap and the reconstruction of the cartilage-muscle ring in the wing of the nose, one-stage rehabilitation could be reached. It was an ideal, safe and reliable method to cure this kind of rare congenital nasal deformity.

Adolescent ; Child ; Congenital Abnormalities ; diagnosis ; surgery ; Female ; Humans ; Male ; Paranasal Sinuses ; abnormalities

Ear Diseases ; congenital ; diagnosis ; surgery ; Ear, External ; abnormalities ; Ear, Middle ; abnormalities ; Humans

Acetabulum ; abnormalities ; diagnostic imaging ; Adolescent ; Adult ; Cartilage ; abnormalities ; Female ; Hip Dislocation, Congenital ; diagnosis ; surgery ; Hip Joint ; abnormalities ; surgery ; Humans ; Ligaments ; abnormalities ; Male ; Orthopedic Procedures ; Young Adult

Rectovestibular fistula is the most common type of anomaly found in a female newborn with anorectal malformation. However, when the baby is found to have two orifices in the introitus, rectovaginal fistula is much less common and suspected. The rare differential diagnosis of Müllerian agenesis, a condition in which the rectum shifts anteriorly and the vagina is absent, is seldom considered. In many cases, the diagnosis of Müllerian agenesis is made only during definitive anorectoplasty. In view of its impact on management, a proper examination under anaesthesia, imaging studies and a diagnostic laparoscopy may be required to confirm the presence or absence of Müllerian structures in such patients. We herein describe a patient with the rare coexistence of VACTERL association and Müllerian agenesis, and discuss the management of anorectal malformations in female patients with Müllerian agenesis.
Abnormalities, Multiple ; diagnosis ; Anal Canal ; abnormalities ; surgery ; Anorectal Malformations ; Anus, Imperforate ; complications ; diagnosis ; surgery ; Child ; Diagnosis, Differential ; Esophagus ; abnormalities ; Female ; Heart Defects, Congenital ; complications ; Humans ; Infant, Newborn ; Kidney ; abnormalities ; Laparoscopy ; Limb Deformities, Congenital ; complications ; Mullerian Ducts ; abnormalities ; Rectal Fistula ; diagnosis ; Rectum ; abnormalities ; surgery ; Spine ; abnormalities ; Trachea ; abnormalities ; Vagina ; abnormalities

PURPOSE: In maxillofacial surgery, proper preoperative diagnosis is very important in achieving good postoperative results. Although conventional CT scans are useful for visual representations of fractures, they cannot provide direct guidance for reconstructing facial bone fractures. However, the recent technology of multislice scanning has brought many clinical benefits to CT images. Direct correlations can be made between preoperative imaging data and operative planning. The aim of the current study is to evaluate the differences between conventional CT and multidetective three-dimensional CT(3D MDCT) measurements in craniofacial deformities. METHODS: From January 2005 to November 2005, MDCT scans of 41 patients were evaluated by comparing them with conventional CT scans. The 3D MDCT images were assessed and reviewed by using a simple scoring system. RESULTS: The 3D MDCT scans offered easy interpretation, facilitated surgical planning, and clarified postoperative results in malar complex fractures, mandibular fractures, and extensive maxillofacial fractures and cranioplasty. However, 3D MDCT images were not superior to conventional CT scans in the diagnosis of blowout fractures. CONCLUSION: In spite of its limitations, the 3D MDCT provided additional and more comprehensive information than the conventional CT for preoperative assessment of craniofacial deformities. Therefore, the 3D MDCT can be a useful tool for diagnosis and systematic treatment planning in craniofacial skeletal deformities.
Congenital Abnormalities ; Diagnosis ; Facial Bones* ; Humans ; Mandibular Fractures ; Surgery, Oral ; Tomography, X-Ray Computed

In orthodontics and orthognathic surgery, cephalogram has been routine practice in diagnosis and treatment evaluation of craniofacial deformity. But its inherent distortion of actual length and angles during projecting three dimensional object to two dimensional plane might cause errors in quantitative analysis of shape and size. Therefore, it is desirable that three dimensional object is diagnosed and evaluated three dimensionally and three dimensional CT image is best for three dimensional analysis. Development of clinic necessitates evaluation of result of treatment and comparison before and after surgery. It is desirable that patient that was diagnosed and planned by three dimensional computed tomography before surgery is evaluated by three dimensional computed tomography after surgery, too. But Because there is no standardized normal values in three dimension now and three dimensional Computed Tomography needs expensive equipments and because of its expenses and amount of exposure to radiation, limitations still remain to be solved in its application to routine practice. If postoperative three dimensional image is constructed by pre and postoperative lateral and postero-anterior cephalograms and preoperative three dimensional computed tomogram, pre and postoperative image will be compared and evaluated three dimensionally without three dimensional computed tomography after surgery and that will contribute to standardize normal values in three dimension. This study introduced new method that computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms, and for validation of new method, in four cases of dry skull that position of mandible was displaced and four patients of orthognathic surgery, computer-simulated three dimensional image and actual postoperative three dimensional image were compared. The results were as follows. 1. In four cases of dry skull that position of mandible was displaced, range of displacement between computer-simulated three dimensional images and actual postoperative three dimensional images in co-ordinates values was from -1.8 mm to 1.8 mm and 94% in displacement of all co-ordinates values was from -1.0 mm to 1.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). 2. In four cases of orthognathic surgery patients, range of displacement between computer-simulated three dimensional images and actual postoperative three dimensional images in co-ordinates values was from -6.7 mm to 7.7 mm and 90% in displacement of all co-ordinates values was from -4.0 to 4.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). Conclusively, computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms. Therefore, potentiality that can construct postoperative three dimensional image without three dimensional computed tomography after surgery was presented.
Congenital Abnormalities ; Diagnosis ; Humans ; Imaging, Three-Dimensional ; Mandible ; Orthodontics ; Orthognathic Surgery* ; Reference Values ; Skull

Midgut malrotation includes a range of developmental abnormalities that occur during fetal intestinal rotation. Manifestations of intestinal malrotation are generally seen in the paediatric population and are uncommon in adults. Symptomatic patients may present with either acute abdominal pain due to midgut volvulus, or chronic abdominal pain due to proximal midgut partial obstruction in the presence of congenital bands. A limited number of paediatric cases of duodenal occlusion due to duodenal malrotation has been previously reported in the medical literature. We herein report the case of a 57-year-old woman who presented with duodenal obstruction due to organoaxial partial rotation of the distal duodenum associated with midgut malrotation. This is probably the first of such a case diagnosed in adulthood reported in the medical literature. Our patient underwent Roux-en-Y duodenojejunostomy and had symptomatic relief following the successful surgery.
Duodenal Obstruction ; congenital ; diagnosis ; surgery ; Duodenostomy ; Duodenum ; abnormalities ; Female ; Humans ; Middle Aged ; Sri Lanka ; Treatment Outcome