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  1 / 1937 MEDLINE  
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Fotocopia
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PMID:28425617
Autor:Cho I; Jo MG; Choi SW; Jang JY; Wang SG; Cha W
Dirección:Department of Otorhinolaryngology-Head and Neck Surgery and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
Título:Some posterior branches of extralaryngeal recurrent laryngeal nerves have motor fibers.
Fuente:Laryngoscope; 127(11):2678-2685, 2017 Nov.
ISSN:1531-4995
País de publicación:United States
Idioma:eng
Resumen:OBJECTIVES/HYPOTHESIS: Anatomical variations of the recurrent laryngeal nerve (RLN), such as extralaryngeal branching, are a well-known risk factor for RLN injury during thyroid surgery. This study aimed to analyze the surgical anatomy and to investigate the existence of posterior branch motor fibers of extralaryngeal RLNs. STUDY DESIGN: Prospective consecutive observational study. METHODS: This was a prospective cohort study of 366 patients between January 2014 and February 2016. Operative data included the type of operation, incidence of nerve bifurcation, the distances among anatomical landmarks. The motor fibers were evaluated using neurostimulation with laryngeal palpation. RESULTS: A total of 667 RLNs at risk were analyzed in this study, and of these 103 (14.5%) nerves were bifurcated or trifurcated before the laryngeal entry point (LEP). More extralaryngeal branched RLNs were observed on the right side than on the left (17.5% vs. 13.3%, P = .294). The mean distance of the LEP point of division was longer on the left side (16.2 ± 6.7 mm) than on the right (14.7 ± 5.9 mm, P = .132). All branched RLNs had a palpable laryngeal twitch when stimulating anterior branches. When stimulating posterior branches, 28.2%(29/103) of branched RLNs showed palpable laryngeal twitch. Overall incidence of posterior motor branch in total RLNs was 4.3% (29/667). CONCLUSIONS: The motor fibers of the RLN are all located in the anterior branch, whereas some posterior branches have motor function. Identification of all of the branches of the RLN may be mandatory to decrease the risk of postoperative nerve injury. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2678-2685, 2017.
Tipo de publicación:JOURNAL ARTICLE; OBSERVATIONAL STUDY


  2 / 1937 MEDLINE  
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PMID:28766355
Autor:Nadazdyova A; Samohyl M; Stefankova E; Pintesova S; Stanko P
Título:Human race as indicator of 3D planning of soft tissue of face and multidisciplinary approach.
Fuente:Bratisl Lek Listy; 118(7):431-436, 2017.
ISSN:0006-9248
País de publicación:Slovakia
Idioma:eng
Resumen:OBJECTIVE: The aim of this study was to determine the optimal parameters for 3D soft tissue planning for ortognatic treatment by gender and increases the effectiveness of multidisciplinary cooperation. METHODS: Craniofacial parameters which were analysed: nose breadth (al-al), bi-entocanthion breadth (en-en), bi-zygomatic breadth (zy-zy), bi-gonial breadth (go-go), total facial height (n-gn), mouth breadth (ch-ch), morphologic face height (sn-gn), upper-lip height (Ls-Stm), lower-lip height (Stm-Li) and pupils - mid-face (right). The statistically significant level was determined at p values < 0.05. RESULTS: We have determined the optimal parameters of chosen proportions for men and women as the common goal for ortodontist and maxilofacial surgeon. The gender and age influenced the variability of following parameters: bi-gonial breadth, total facial height and morphologic face height. CONCLUSION: The soft tissue values for craniofacial parameters can be used to identify the surgical-orthodontic goal for patient - europoid race. Due to the immigration and the mix of races it is necessary to take this fact into account (Tab. 3, Fig. 1, Ref. 41).
Tipo de publicación:JOURNAL ARTICLE


  3 / 1937 MEDLINE  
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PMID:28163206
Autor:Wilden A; Feiser J; Wöhler A; Isik Z; Bendella H; Angelov DN
Dirección:Anatomical Institute I, University of Cologne, Germany.
Título:Anatomy of the human orbital muscle (OM): Features of its detailed topography, syntopy and morphology.
Fuente:Ann Anat; 211:39-45, 2017 May.
ISSN:1618-0402
País de publicación:Germany
Idioma:eng
Resumen:The human orbital muscle (OM) is not readily accessible during ordinary anatomical teaching because of insufficient time and difficulties encountered in the preparation. Accordingly, its few anatomical descriptions are supported only by drawings, but not by photographs. The aim of this study was to present OM in dissected anatomic specimens in more detail. Following microscope-assisted dissection, its location, syntopy and morphology were analyzed in 88 orbits of 51 cadavers. Together with the periorbital connective tissue OM filled the infraorbital fissure (IOF) and extended back to the cavernous sinus. As a new finding, we here report that in 34% of the orbits we observed OM-fibers, which proceeded from IOF caudally to the facies infratemporalis of the maxilla. OM had a mean width of 4±1mm, a mean length of 22±5mm and its mean mass was 0.22±0.19g. The subsequent histological analysis of all specimens showed features of smooth muscle tissue: long, spindle-like cells with a centrally located cell nucleus (hematoxylin-eosin staining) which were innervated by tyrosine-hydroxylase immunopositive adrenergic fibers. We conclude that precise knowledge on OM might be very helpful not only to students in medicine and dentistry during anatomical dissection courses, but also to head and neck surgeons, ear-nose-throat specialists and neurosurgeons working in this field.
Tipo de publicación:JOURNAL ARTICLE


  4 / 1937 MEDLINE  
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PMID:28163203
Autor:Pretterklieber B
Dirección:Medical University of Vienna, Center for Anatomy and Cell Biology, Division of Anatomy, Waehringer Strasse 13, 1090, Vienna, Austria. Electronic address: bettina.pretterklieber@meduniwien.ac.at.
Título:The high variability of the chiasma plantare and the long flexor tendons: Anatomical aspects of tendon transfer in foot surgery.
Fuente:Ann Anat; 211:21-32, 2017 May.
ISSN:1618-0402
País de publicación:Germany
Idioma:eng
Resumen:As tendon transfer of the flexor hallucis longus (FHL) and the flexor digitorum longus (FDL) is an established procedure, exact knowledge of the formation of the chiasma plantare is of great interest. Although the quadratus plantae (QP) appears to play a major role, it has been rarely addressed in previous studies. The aim of the present study was to reinvestigate the formation of the chiasma plantare and the composition of the long flexor tendons in order to clarify the inexact and partly contradictory descriptions published from 1865 onward. The chiasma plantare and the long flexor tendons in both feet of 50 formalin-fixed specimens of body donors (25 men and women) were analyzed by gross anatomical dissection. It was composed of one (3%), two (69%) or three layers (28%) which were variably established by the tendinous and muscular fibers of the FHL, the FDL and the QP. In 61% the FHL gave one or more slips to the FDL, and in 39% there was a bidirectional interconnection between the two tendons. The slip from the FHL to the FDL largely reinforces the second (45%), or the second and third tendon (46%). Thus, the FHL is involved in the first tendon in all cases, in the second one in 97% of cases, and in the third tendon in about one half of cases (53%). In all instances, the FDL contributes to the third to fourth, in 98% the second, and in at least 39% to the first tendon. The QP reinforces the second to fourth tendon in nearly all cases, the fifth in about one half of cases, and even the first tendon in 14% of cases. In addition, the individual composition of the five long flexor tendons arising from the chiasma plantare was analyzed in detail. Special emphasis was placed on the evaluation of side and sex differences as well as individual symmetry. Furthermore, biomechanical, developmental and phylogenetic aspects were outlined. In terms of the outcome of this study, the FHL appears to be the better donor for tendon transfer to restore lost function, but harvesting the FDL seems to be more suitable to prevent long-term functional damage. The decision depends on the individual patient's needs and should be made with due care.
Tipo de publicación:JOURNAL ARTICLE


  5 / 1937 MEDLINE  
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PMID:28608764
Autor:Ayoub N; Thamboo A; Hwang PH; Walgama ES
Dirección:1 Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
Título:Radioanatomic Study of the Greater Palatine Canal Relevant to Endoscopic Endonasal Surgical Landmarks.
Fuente:Otolaryngol Head Neck Surg; 157(4):731-736, 2017 Oct.
ISSN:1097-6817
País de publicación:England
Idioma:eng
Resumen:Objective A radioanatomic study of surgically relevant variations in the greater palatine canal (GPC) on computed tomography (CT) was performed to determine susceptibility during endoscopic endonasal procedures. Study Design Blinded radioanatomic analysis. Setting Tertiary university hospital. Subjects and Methods Fifty consecutive paranasal CT scans (100 sides) were analyzed. Measurements were standardized to landmarks such as the inferior turbinate (IT) and floor of the nasal cavity (FNC) to assess variability and vulnerability of the nerve. Measurements included (1) incidence of maxillary sinus pneumatization posterior to the GPC, (2) distance from the posterior wall of the maxillary sinus to the GPC at the IT and FNC, (3) width of bone containing the GPC, (4) incidence of medial GPC dehiscence, and (5) angle of the GPC extending from the IT to FNC. Results Ninety-one percent of maxillary sinuses were pneumatized posterior to the GPC. The distance from the posterior wall of the maxillary sinus to the GPC was 2.8 ± 1.7 mm (range, -2.3 to 5.9) at the posterior attachment of the IT and 4.1 ± 3.1 mm (range, -6.3 to 11.9) at the FNC. The width of bone containing the GPC was 3.3 ± 1.3 mm (range, 1-8.9), and the medial bony GPC was dehiscent in 38% of cases. In the sagittal plane, the angle of the GPC between the IT and the FNC was 31.9 ± 6.9 degrees (range, 10.8-45). Conclusion The GPC has considerable anatomic variability relative to important surgical landmarks in endoscopic procedures. Preoperative review of CTs to assess vulnerability may prevent postoperative complications.
Tipo de publicación:JOURNAL ARTICLE


  6 / 1937 MEDLINE  
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PMID:28583461
Autor:Belykh E; Xu DS; Yagmurlu K; Lei T; Byvaltsev VA; Dickman CA; Preul MC; Nakaji P
Dirección:Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA; Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia; School of Life Sciences, Arizona State University, Tempe, Arizona, USA.
Título:Repair of V2 Vertebral Artery Injuries Sustained During Anterior Cervical Diskectomy.
Fuente:World Neurosurg; 105:796-804, 2017 Sep.
ISSN:1878-8769
País de publicación:United States
Idioma:eng
Resumen:BACKGROUND: The V2 segment of the vertebral artery (VA) typically runs through the transverse foramen of C2-C6. V2 injury may occur during anterior approaches to the cervical spine and can cause significant morbidity. We describe landmarks and microsurgical V2 repair techniques through the standard anterolateral cervical diskectomy approach. METHODS: Five silicone-injected cadaveric heads (necks-C7) were dissected bilaterally. An anterolateral approach with C3-4, C4-5, and C5-6 diskectomies and an ipsilateral VA injury were simulated. VA approach and repair were performed using microdissection techniques. Landmarks to the VA were identified, and distances from landmarks to the VA were measured in horizontal and vertical planes. Operative photographs of stepwise approach and repair techniques were processed for stereoscopic illustration. An illustrative case describes microsurgery to successfully repair an inadvertent VA injury during a C3-C6 diskectomy and fusion procedure. RESULTS: The anatomic landmarks delineated were the intervertebral disk, uncinate apices, and anterior tubercles of C4-C6 transverse processes. After temporary hemostasis with packing, VA exposure and repair included dissection of the longus colli muscle, removal of the anterior root of the transverse processes above and below the injury level, intertransversarii muscle removal, vertebral plexus opening, VA handling, and microsuturing. In 30 dissected cadaver intertransverse intervals, 13 medial, 7 lateral, and 3 anterior branches of the V2 were encountered at C3-C6 levels. CONCLUSION: Familiarity with relevant vascular surgical anatomy allows neurosurgeons to be prepared in cases of VA injury and may facilitate repair when the VA is injured during anterior cervical spine surgery.
Tipo de publicación:JOURNAL ARTICLE


  7 / 1937 MEDLINE  
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PMID:28306330
Autor:Shokri A; Miresmaeili A; Farhadian N; Falah-Kooshki S; Amini P; Mollaie N
Dirección:1 Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran.
Título:Effect of changing the head position on accuracy of transverse measurements of the maxillofacial region made on cone beam computed tomography and conventional posterior-anterior cephalograms.
Fuente:Dentomaxillofac Radiol; 46(5):20160180, 2017 Jul.
ISSN:0250-832X
País de publicación:England
Idioma:eng
Resumen:OBJECTIVES: This study aimed to assess the effect of head position on the accuracy of transverse measurements of the maxillofacial region on CBCT and conventional posteroanterior (PA) cephalograms. The second objective of this study was to find skull positions with the greatest and smallest effect on transverse measurements in the maxillofacial region. METHODS: PA cephalograms and CBCT scans were obtained from 10 dry human skulls in 7 positions, namely the central position, 10° and 20° rotations, 10° and 20° tilts and 10° and 20° tips. The CBCT scans were converted to PA cephalograms on which distances from six landmarks, namely the nasal cavity, zygomatic arch, jugale, antegonion, condylion and zygomaticofrontal suture to the mid-sagittal plane, were measured on both sides using Dolphin two-dimensional software. The paired t-test was used to compare the mean values separately in each position (for each landmark) with the gold standard (central skull position). The interclass correlation coefficient and the Bland-Altman plot were used to compare the mean values measured by two observers. RESULTS: The mean values of the distances measured on CBCT PA cephalograms were greater than those measured on conventional PA cephalograms; this difference was statistically significant for some landmarks (p < 0.005). The rotated position (as compared with the central position) caused the greatest change in values for most landmarks on both sides (p < 0.005). CONCLUSIONS: The CBCT PA cephalogram was more accurate than the conventional PA cephalogram, and landmarks farther from the midline exhibited greater changes on cephalograms compared with those closer to the midline. Patients are at risk of improper positioning when undergoing extraoral radiography such as PA cephalograms. Changes in head position may affect the transverse measurements and thus the treatment plan.
Tipo de publicación:JOURNAL ARTICLE


  8 / 1937 MEDLINE  
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PMID:28128638
Autor:Tadinada A; Schneider S; Yadav S
Dirección:1 Division of Oral and Maxillofacial Radiology, University of Connecticut, School of Dental Medicine, Farmington, CT, USA.
Título:Evaluation of the diagnostic efficacy of two cone beam computed tomography protocols in reliably detecting the location of the inferior alveolar nerve canal.
Fuente:Dentomaxillofac Radiol; 46(5):20160389, 2017 Jul.
ISSN:0250-832X
País de publicación:England
Idioma:eng
Resumen:OBJECTIVES: Reliable three-dimensional localization of the inferior alveolar nerve canal (IANC) is valuable for a variety of dentoalveolar procedures. Although conventional CBCT offers three-dimensional information at a reasonably low dose, it is still a significant amount of radiation. In this ex vivo study, we evaluated the ability of a 180° rotational CBCT acquisition protocol with lower number of basis projections to create a CBCT data set for reliable localization of the IANC compared with a conventional 360° rotational CBCT acquisition. METHODS: 50 dry human skulls were imaged using 180° and 360° rotational CBCT protocols. Measurements of the IANC throughout its course in the mandible were carried out. Two raters evaluated the measurements and rated the scans based on their ability to visualize the IANC, and the measurements were carried out. RESULTS: The IANC length measurements for the 180° and 360° protocols were identical. There was no difference between evaluations by the two raters for the two protocols. Interexaminer reliability values were >90% for the two protocols. The sensitivity values for the two protocols were >95%. The specificity for both protocols was 100%. CONCLUSIONS: 180° CBCT acquisition protocol is able to accurately locate the IANC with high reliability and is comparable to a conventional 360° protocol.
Tipo de publicación:JOURNAL ARTICLE


  9 / 1937 MEDLINE  
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PMID:27938943
Autor:Adisen MZ; Misirlioglu M; Yorubulut S; Nalcaci R
Dirección:Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey. Electronic address: m_zahit@hotmail.com.
Título:Correlation of upper airway radiographic measurements with risk status for obstructive sleep apnea syndrome in young dental patients.
Fuente:Oral Surg Oral Med Oral Pathol Oral Radiol; 123(1):129-136.e3, 2017 Jan.
ISSN:2212-4411
País de publicación:United States
Idioma:eng
Resumen:OBJECTIVE: The aim of the present study is to compare radiographic measurements of the upper airway (UA) in young adult patients with different levels of risk status for obstructive sleep apnea syndrome. STUDY DESIGN: The study included 50 patients between 18 and 30 years of age who were referred for dental examination and evaluation of impacted third molars. Case record forms, including habit history, along with the Berlin Questionnaire and the Epworth Sleepiness Scale, were completed by the patients and their relatives. According to the answers, 25 low-risk patients and 25 high-risk patients were selected. Cephalometric radiographs and cone beam computed radiography images were obtained for radiographic analysis when the patients were admitted into the study. RESULTS: There were significant differences in body mass index, neck circumference measurements, Epworth score, and smoking status between risk groups. There were significant differences for UA measurements on radiographic evaluation. Body mass index (BMI) was found to be correlated positively with neck circumference and Epworth scores and negatively with UA measurements for all patients. Velopharyngeal measurements showed the highest correlation with Epworth scores, BMI, and neck circumference. CONCLUSIONS: The radiographic findings correlated with the survey results. Our data suggest that radiographic measurements of UA may be used as a predictor of risk for obstructive sleep apnea syndrome in a young population.
Tipo de publicación:JOURNAL ARTICLE


  10 / 1937 MEDLINE  
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PMID:28577372
Autor:Hatch CD; Wehby GL; Nidey NL; Moreno Uribe LM
Dirección:Predoctoral Dental Student, College of Dentistry, University of Iowa, Iowa City, IA.
Título:Effects of Objective 3-Dimensional Measures of Facial Shape and Symmetry on Perceptions of Facial Attractiveness.
Fuente:J Oral Maxillofac Surg; 75(9):1958-1970, 2017 Sep.
ISSN:1531-5053
País de publicación:United States
Idioma:eng
Resumen:PURPOSE: Meeting patient desires for enhanced facial esthetics requires that providers have standardized and objective methods to measure esthetics. The authors evaluated the effects of objective 3-dimensional (3D) facial shape and asymmetry measurements derived from 3D facial images on perceptions of facial attractiveness. MATERIALS AND METHODS: The 3D facial images of 313 adults in Iowa were digitized with 32 landmarks, and objective 3D facial measurements capturing symmetric and asymmetric components of shape variation, centroid size, and fluctuating asymmetry were obtained from the 3D coordinate data using geo-morphometric analyses. Frontal and profile images of study participants were rated for facial attractiveness by 10 volunteers (5 women and 5 men) on a 5-point Likert scale and a visual analog scale. Multivariate regression was used to identify the effects of the objective 3D facial measurements on attractiveness ratings. RESULTS: Several objective 3D facial measurements had marked effects on attractiveness ratings. Shorter facial heights with protrusive chins, midface retrusion, faces with protrusive noses and thin lips, flat mandibular planes with deep labiomental folds, any cants of the lip commissures and floor of the nose, larger faces overall, and increased fluctuating asymmetry were rated as significantly (P < .001) less attractive. CONCLUSION: Perceptions of facial attractiveness can be explained by specific 3D measurements of facial shapes and fluctuating asymmetry, which have important implications for clinical practice and research.
Tipo de publicación:JOURNAL ARTICLE



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