Humans ; Child ; Nasal Bone ; Neurilemmoma/surgery*

Objective: To identify the internal nasal valve (INV) and to evaluate its key parameters in the established 3D models of nasal cavity space via Mimics from CT images, in order to provide evidence for quantitative diagnosis of nasal valve compromise. Methods: A total of 32 Han adults without nasal diseases who underwent maxillofacial CT test in Shanghai Ninth People's Hospital from January 2015 to December 2018 were retrospectively recruited, including 16 males and 16 females, with the age ranged from 20 to 80 years (50% age<50 years old). Maxillofacial CT images were used to create 3D model of nasal cavity space. The INV was identified and the following parameters were measured: the angle between the INV and the nasal bone (θ_INV-B), unilateral cross-sectional area of the INV (A_INV-R, A_INV-L), total cross-sectional area of the INV (A_INV), unilateral height of the INV (H_INV-R, H_INV-L), unilateral nasal valve angle (α_INV-R, α_INV-L), and the sum of nasal valve angle (α_INV). The A_INV in our study was compared with the results of the previously adopted planes (Plane_C, perpendicular to the hard palate and Plane_B, plane perpendicular to the nasal bone). The parameters above were compared among genders, age and race groups. SPSS 26 and GraphPad Prism 9 software were used for statistical analysis and mapping of data. Results: The A_INV in our study was (214.87±52.94) mm², which was significantly less than that of Plane_C (254.97±47.80) mm² and Plane_B (226.07±57.36) mm². The measured parameters were as follows: θ_INV-B was (82.07±7.06)°; A_INV-R was (112.66±31.39) mm²; A_INV-L was (102.21±27.14) mm²; A_INV was (214.87±52.94) mm²; H_INV-R was (24.87±4.62) mm; H_INV-L was (24.35±4.86) mm; α_INV-R was (20.48±2.99)°; α_INV-L was (19.65±3.82)°; α_INV was (40.13±6.24)°. The A_INV-R was larger than A_INV-L (t=2.33, P<0.05); The H_INV, A_INV-R, A_INV-L and A_INV of males were more than those of females (t value was 5.77, 3.21, 2.91 and 3.52, respectively, all P<0.01). The A_INV of the young group (<50 years) was larger than that of the old group (t=2.83, P<0.01); The θ_INV-B was different between the Han people and the Caucasian (t=2.92,P<0.01). The α_INV of the Han people was larger than that of Caucasians (Z=-6.92, P<0.01), but the H_INV was smaller (Z=-3.89, P<0.01). Conclusion: The A_INV carried out in 3D models of nasal cavity space is significantly smaller than that obtained by the previous methods of CT evaluation. INV static parameters differ among genders, age and race groups.
Adult ; Female ; Humans ; Male ; Young Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Nasal Cavity/diagnostic imaging* ; Retrospective Studies ; China ; Nose ; Nasal Bone

OBJECTIVE: To carry out prenatal diagnosis for a fetus with absent nasal bone by using cytogenetic and molecular techniques. METHODS: Chromosomal karyotyping, single nucleotide polymorphism array (SNP-array) and fluorescence in situ hybridization (FISH) assays were applied for the diagnoses. Peripheral blood samples were also taken from the parents for chromosomal karyotyping and FISH analysis. RESULTS: The fetus was found to have a 46,XX,add(21)(p11.2) karyotype, and SNP-array has revealed a 11.3 Mb duplication at 21q22.12q22.3 (hg19: 36 762 648-48 093 361), which was confirmed by FISH. Both parents were found to be normal by chromosomal karyotyping and FISH analysis. The fetus was ultimately found to have a karyotype of 46,XX,der(21)t(21;21)(p11.2;q22.1), resulting a de novo partial trisomy of 21q22.1. CONCLUSION Combined use of various techniques has enabled accurate prenatal diagnosis and genetic counseling for the fetus.
Female ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Nasal Bone ; Pregnancy ; Prenatal Diagnosis ; Trisomy/genetics*

BACKGROUND: The big data provided by Health Insurance Review and Assessment (HIRA) contains data from nearly all Korean populations enrolled in the National Health Insurance Service. We aimed to identify the incidence of facial fractures and its trends in Korea using this big data from HIRA.METHODS: We used the Korean Standard Classification of Disease and Cause of Death 6, 7 for diagnosis codes. A total of 582,318 patients were included in the final analysis. All statistical analyses were performed using SAS software and SPSS software.RESULTS: The incidence of facial fractures consistently declined, from 107,695 cases in 2011 to 87,306 cases in 2016. The incidence of facial fractures was the highest in June 2011 (n = 26,423) and lowest in January 2014 (n = 10,282). Nasal bone fractures were the most common, followed by orbit and frontal sinus fractures. The percentage of nasal bone fractures declined, whereas those of orbital fractures increased from 2011 to 2016 (P < 0.001). Among orbital fractures, inferior wall fractures were the most common, followed by medial wall fractures. Among mandibular fractures, angle fractures were the most common, followed by condylar process and symphysis fractures. Although it was difficult to predict the most common type of zygomatic and maxilla fractures, their incidence consistently declined since 2011.CONCLUSION: We observed trends in facial fractures in Korea using big data including information for nearly all nations in Korea. Therefore, it is possible to predict the incidence of facial fractures. This study is meaningful in that it is the first study that investigated the incidence of facial fractures by specific type.
Cause of Death ; Classification ; Diagnosis ; Facial Bones ; Fractures, Bone ; Frontal Sinus ; Humans ; Incidence ; Insurance, Health ; Korea ; Mandibular Fractures ; Maxilla ; Nasal Bone ; National Health Programs ; Orbit ; Orbital Fractures

The human nervus terminalis (terminal nerve) and the nerves to the vomeronasal organ (VNON) are both associated with the olfactory nerves and are of major interest to embryologists. However, there is still limited knowledge on their topographical anatomy in the nasal septum and on the number and distribution of ganglion cells along and near the cribriform plate of the ethmoid bone. We observed serial or semiserial sections of 30 fetuses at 7–18 weeks (crown rump length [CRL], 25–160 mm). Calretinin and S100 protein staining demonstrated not only the terminal nerve along the anterior edge of the perpendicular lamina of the ethmoid, but also the VNON along the posterior edge of the lamina. The terminal nerve was composed of 1–2 nerve bundles that passed through the anterior end of the cribriform plate, whereas the VNON consisted of 2–3 bundles behind the olfactory nerves. The terminal nerve ran along and crossed the posterior side of the nasal branch of the anterior ethmoidal nerve. Multiple clusters of small ganglion cells were found on the lateral surfaces of the ethmoid's crista galli, which are likely the origin of both the terminal nerve and VNON. The ganglions along the crista galli were ball-like and 15–20 µm in diameter and, ranged from 40–153 in unilateral number according to our counting at 21-µm-interval except for one specimen (480 neurons; CRL, 137 mm). An effect of nerve degeneration with increasing age seemed to be masked by a remarkable individual difference.
Calbindin 2 ; Ethmoid Bone ; Fetus ; Ganglion Cysts ; Humans ; Individuality ; Masks ; Nasal Septum ; Nerve Degeneration ; Neurons ; Olfactory Nerve ; Vomeronasal Organ

BACKGROUND: Prophylactic antibiotic administration after surgery for a nasal bone fracture is performed due to concerns about infection-related complications, such as, toxic shock syndrome. To evaluate the validity and efficacy of antibiotic use, we compared the results obtained and the bacterial profiles of nasal packing materials in patients that underwent closed reduction for a nasal bone fracture with or without prophylactic antibiotic administration. METHODS: Thirty consecutive patients with a nasal bone fracture, but without an open wound, that underwent closed reduction during March to August 2017 were included in the present study. Fifteen of these 30 patients were randomly assigned to a control group, members of were administered postoperative intravenous antibiotics once at the day of surgery and then oral antibiotics for 4 days. The other 15 patients were assigned to an experimental group and not administered any antibiotic postoperatively. Antibiotic ointment was not applied to nasal packing in either group. Nasal packing was removed on postoperative day 4 in all cases. Removed nasal gauze packings were culture tested and strains identified in the two groups were compared. RESULTS: Bacterial strain types cultured from packings were similar in the experimental and control groups and no patient showed signs of clinically significant infection. CONCLUSION: The findings of this study suggest postoperative prophylactic antibiotic use is not clinically required after closed reduction of a nasal bone fracture. Furthermore, the non-use of postoperative antibiotics is biologically beneficial, as it reduces the occurrence of resistant strains and medical costs, and is more convenient for patients.
Anti-Bacterial Agents ; Fractures, Bone ; Humans ; Nasal Bone ; Prospective Studies ; Shock, Septic ; Wounds and Injuries

BACKGROUND: The epidemiology of nasal fractures varies according to factors such as the era and area of the study, as well as the age of the patient. We compared the characteristics and causes of pediatric nasal fractures. METHODS: A total of 2,321 patients with nasal fractures from 2010 to 2017 were examined. The patients were divided into age groups using the Korean school system of age classification. The causes of injury were divided into five groups: violence, fall or slip down, sports, road traffic accidents, and others. Fractures were classified using the Stranc and Robertson standard: vector of force and plane of fracture. RESULTS: Violence was the most common cause of nasal fracture in patients older than 12 years. Violence was a significantly less frequent cause among patients younger than 12 years old than among adolescent and adult patients. Nasal fractures due to violence were not observed in patients younger than 10 years. Plane 2 and lateral force fractures were the most common; however, in patients younger than 12 years, frontal force fractures were significantly more frequent than were lateral force fractures. CONCLUSION: As children may simply be injured due to a fall or slip down, it is important for the parents and guardians to ensure their safety. As they become older, children should abstain from violence and be monitored. It is therefore very important to ensure that the environment is free of violence in order to prevent such injuries.
Accidents, Traffic ; Adolescent ; Adult ; Child ; Classification ; Epidemiology ; Fractures, Bone ; Humans ; Nasal Bone ; Parents ; Pediatrics ; Sports ; Violence

BACKGROUND: Closed reduction of nasal fracture with various instrument is performed to treat nasal fracture. Depending on the type of nasal fracture and the situation in which it is being operated, the surgeon will determine the surgical tool. The objective of this study was to investigate whether a periosteal elevator (PE) was a proper device to perform closed reduction for patients with simple nasal fractures. METHODS: From March 2018 to December 2018, 50 cases of simple nasal bone fracture underwent closed reduction performed by a single surgeon. These patients were divided into two groups randomly: nasal bone reduction was performed using only PE (freer) and nasal bone reduction was performed using Walsham, Asch forcep, and Boies elevator (non-freer, non-PE). RESULTS: The paranasal sinus computed tomography was performed on patients before and after operation to carry out an accurate measurement of reduction distance at the same level. According to the results, the interaction between instruments and fracture types had a significant influence on reduction distance (p = 0.021). To be specific, reduction distance was significantly (p= 0.004) increased by 2.157 mm when PE was used to treat patients with partial displacement compared to that when non-PEs were used. CONCLUSION: Closed reduction using PE and other elevator is generally an effective treatment for nasal fracture. In partial-displacement type of simple nasal fracture, closed reduction using PE can have considerable success in comparison with using classic instruments.
Elevators and Escalators ; Facial Bones ; Fractures, Closed ; Humans ; Nasal Bone ; Rubber ; Surgical Instruments ; Treatment Outcome

Fibrous dysplasia (FD) is a non-malignant bone tumor that typically behaves as a slow and indolent growing mass lesion. We report the case of a female patient presenting with headache and facial deformity and later diagnosed with polyostotic fibrous dysplasia (PFD). A 29-year-old woman visited Mealhada Primary Health Care Unit complaining of headache, nasal congestion, and hyposmia for several weeks. She also presented with facial deformity and painful swelling of the upper left orbit. X-ray imaging revealed a suspicious opacity in the left frontal sinus and a right shift of the nasal septum. Computed tomography and bone scintigraphy later confirmed a tumor involving the ethmoid and frontal bone. The patient was referred to the neurosurgery and otorhinolaryngology departments of a central hospital and the suspected diagnosis of PFD was confirmed. A watchful waiting approach with regular imaging screenings was proposed and accepted by the patient, who is now free of symptoms and more acceptant of the benign condition of her tumor. With this case, we aim to make family physicians more aware of this rare but relevant condition that can be difficult to diagnose. FD is a rare but benign tumor that occurs mainly in adolescents and young adults. Symptoms depend on the location and type of the tumor and include facial deformity, vision changes, nasal congestion, and headache. No clear guidelines exist for its treatment, and options include monitoring the progression of the tumor, in addition to medical or surgical approaches.
Adolescent ; Adult ; Bone Neoplasms ; Congenital Abnormalities ; Diagnosis ; Estrogens, Conjugated (USP) ; Female ; Fibrous Dysplasia of Bone ; Fibrous Dysplasia, Polyostotic* ; Frontal Bone ; Frontal Sinus ; Headache ; Humans ; Mass Screening ; Nasal Septum ; Neurosurgery ; Orbit ; Otolaryngology ; Physicians, Family ; Primary Health Care* ; Radionuclide Imaging ; Watchful Waiting ; Young Adult

BACKGROUND: After closed reduction, patients are sometimes concerned that their external nasal shapes have changed. The aim of this study was to investigate and explain changes in nasal shape after surgery through objective photogrammetric anthropometry measurements taken through three-dimensional (3D) reformed computed tomography (CT) images. METHODS: Our study included 100 Korean patients who underwent closed reduction of isolated nasal bone fracture from January 2016 to June 2017. Using the ruler tool in Adobe Photoshop CS3, we measured preoperative and postoperative nasal base heights, long nostril axis lengths, both nasal alar angles, and amount of nasal deviation through the 3D reformation of soft tissue via CT scans. We then compared the dimension of nose. RESULTS: The amount of postoperative correction for nasal base height was 1.192 mm. The differences in nostril length between each side were found to be 0.333 mm preoperatively and 0.323 mm postoperatively. The differences in the nasal alar angle between each side was 1.382° preoperatively and 1.043° postoperatively. The amount of nasal deviation was found to be 5.248 mm preoperatively and 1.024 mm in postoperatively. CONCLUSION: After the reduction of nasal bone fractures, changes in nasal dimensions were noticeable in terms of nasal deviation but less significant in nasal tips, except for changes in nasal alar angles, which were notable.
Anthropometry ; Humans ; Nasal Bone ; Nose ; Tomography, X-Ray Computed