Cheek Area Research Articles

Effects of the filter microstructure and ambient air condition on the aerodynamic dispersion of sneezing droplets: A multiscale and multiphysics simulation study.

Concerns have been ramping up with regard to the propagation of infectious droplets due to the recent COVID-19 pandemic. The effects of filter microstructures and ambient air flows on droplet dispersion by sneezing are investigated by a fully coupled Eulerian–Lagrangian computational modeling with a micro-to-macroscale bridging approach. Materials that are commonly applied to face masks are modeled to generate two different virtual masks with various levels of filtration efficiency, and the leakage percentages through the unsealed nose and cheek areas were set to 11% and 25%, respectively. The droplet propagation distance was simulated with and without mask wearing in still and windy conditions involving head wind, tail wind, and side wind. The results demonstrate that wearing a face mask reduces the transmittance distance of droplets by about 90%–95% depending on the mask type; nonetheless, the droplets can be transmitted to distances of 20–25 cm in the forward direction even with mask-wearing. Thus, a social distance of at least 20 cm between people would help to prevent them from becoming exposed to ejected droplets. This study is significant in that important aspects of mask materials, in this case the porous microstructure-dependent filtration efficiency and permeability under varied ambient flow conditions, were considered for the first time in an evaluation of the barrier performance against droplet transmittance through a multiphase computational fluid dynamics simulation of air-droplet interaction and turbulence flow dynamics.

Kinesio tape for edema control after bichectomy: A randomized trial study

Bichectomy surgery has been increasingly widespread and performed as an aesthetic, functional, or aesthetic-functional treatment. This study aims to describe the surgical technique of bichectomy with the application of the Kinesio tape to verify its effectiveness in controlling edema formation, with the measurement in four postoperative periods. Through a split-mouth, double-blind, randomized study, 13 participants who had an indication for the surgery were selected and divided into two groups - Control Group: bichectomy surgery and cryotherapy for a period of 12 hours, without external application of the Kinesio tape (KT) and Experimental Group: bichectomy surgery, cryotherapy for a period of 12 hours, and application of KT in the outer cheek area of the face, for 2 days. A millimeter measuring tape was used to measure three reference points on the face before and after the surgical procedure (preoperative, 24 hours, 48 hours, and 7 days postoperatively). Quantitative data were subjected to statistical analysis using the Sigma Plot 12.0 program (Exakt graphs and data analysis, San Jose, USA). The comparisons were made according to the edema measurements for the two experimental groups (2 levels: Kinesio tape versus cryotherapy) and the periods of analysis (4 levels: Preoperative, 24 hours, 48 hours and 7 days postoperatively). After obtaining the data, and the statistical analysis, the application of Kinesio Tape proved to be more effective when compared to the use of cryotherapy alone, in the control of postoperative edema in patients who underwent bichectomy surgery. The study contributes to the literature regarding the applicability of the KT and expands the therapeutic possibilities in an aesthetic-functional procedure that is increasingly sought after by patients.

Facial scanning accuracy depending on the alignment algorithm and digitized surface area location: An in vitro study

ObjectivesTo measure the accuracy (trueness and precision) of a facial scanner depending on the alignment method and the digitized surface area location. MethodsFourteen markers were adhered on a head mannequin and digitized using an industrial scanner (GOM Atos Q 3D 12 M; Carl Zeiss Industrielle Messtechnik GmbH). A control mesh was acquired. Subsequently, the mannequin was digitized using a facial scanner (Arc4; Bellus3D) (n = 30). The control mesh was delineated into 10 areas. Based on the alignment procedures, two groups were created: reference best fit (RBF group) and landmark-based best fit (LA group). The root mean square was used to calculate the discrepancy between the control mesh and each facial scan. A 2-way ANOVA and Tukey pairwise comparison tests were used to compare trueness and precision between the 2 groups across 10 areas (α = .05). ResultsBoth alignment algorithms (P = .007) and digitized area (P < .001) were significant predictors of trueness with a significant interaction between the two predictors (F (9, 580) =25.13, P < .001). Tukey pairwise comparison showed that there was a significant difference between mean trueness values of RBF (mean=0.53 mm) and LA (mean=0.55 mm) groups. Moreover, a significant difference was detected among the trueness values across surface areas. The A9-area (left tragus area) had the highest and A5-area (right cheek area) had the lowest mean trueness. Both alignment algorithm (P < .001) and digitized surface area (P < .001) were significant predictors of precision with a significant interaction between the two predictors (F (9, 580) =14.34, P < .001). Tukey pairwise comparison showed that there was a significant difference between mean precision values of RBF (mean=0.38 mm) and LA (mean=0.35 mm) groups. Moreover, a significant difference was detected among the precision values across surface areas. Comparing the surface areas, A9-area had the highest and A10-area (forehead area) had the lowest mean precision. ConclusionsAlignment procedures influenced on the scanning trueness and precision mean values, but the facial scanner accuracy values obtained were within the clinically acceptable accuracy threshold of less or equal than 2 mm. Furthermore, the scanning accuracy (for both trueness and precision) depended on the location of the scanned surface area, being more accurate on the middle of the face than on the sides of the face.

Facial injuries in children and adolescents victims of aggression

Child maltreatment may occur as the intentional use of power, effective or attempted, against children under 18 years old, that results or may result in actual or potential harm. It affects a vulnerable population, causing physical and/or emotional consequences persisting throughout their lives. This study aimed to characterize episodes of child maltreatment, with focus on facial injuries, in a Brazilian city (Teresina, PI). This is a retrospective study with a quantitative approach, carried out in the database at the Institute of Forensic Medicine in Teresina, between the years 2017 and 2019. All reports of bodily injury of children from 0 to 18 years were collected and statistically analyzed (SPSS 22.0). During the period analysis, 811 reports of bodily injury were identified. There was a predominance of female victims aged between 12 and 18 years old, the involvement of men with some family relationship with the victim was highly associated. Facial injuries represented 35.8% of the whole sample and 98.6% of those found in the head and neck region (41,6% of the total). The orbital (29.0%) was the most affected site, followed by the frontal (25.9%), malar (23.4%), labial (17.6%) and cheek area (11.4%). There is a high prevalence of injuries to the head and neck region, this fact emphasizes the importance of a trained professional, especially a dental surgeon, in the analysis and interpretation of these injuries during forensic examination.

Atypical manifestations of atopic dermatitis

Atopic dermatitis or atopic eczema is a complex heterogeneous inflammatory skin condition, typified by classic distribution pattern in most cases. Typically, in infancy it involves the cheeks, and over time, as it settles over the cheek area, extensors tend to get involved, and by 2 years of age flexural distribution predominates. Acral pattern is largely seen in adult population but may unusually be seen in children. This review article focuses on the atypical manifestations of atopic dermatitis.

Three-dimensional topography of facial soft tissues for the safer and effective threading procedures.

To reduce complications caused by the procedure, the target layer for thread lifting should be the superficial fat or superficial musculoaponeurotic system of the face. The aim of this study was to establish the thicknesses of the facial skin and superficial fat using a 3D scanning system to provide basic clinical data for thread lifting. Thirty fixed Korean and Thai cadavers (male: 17, female: 13) were used. The depths of the skin and superficial fat were measured using a three dimensional (3D) structured-light scanner. Facial images of both undissected and removed skin and superficial fat were taken with the 3D scanner. The paths from the temple and the front of the tragus to the infraorbital, perioral, cheek, and mental areas were displayed on the 3D image. The thickness along the path was measured by calculating the difference between the undissected and dissected 3D images. The means and standard deviations of thicknesses of the skin and superficial fat were 2.1 ± 0.4 mm and 5.2 ± 1.9 mm in the 11 pathways. The facial skin became thicker going toward the lower aspect of the face from temple to infraorbtial and perioral regions. The thickness of the superficial fat around the marionette line showed the biggest change. The present findings indicate that a 3D scanning system can yield crucial anatomical information about the thickness of the facial skin and superficial fat for use in various minimally invasive clinical procedures including thread lifting.

Extraorale vasculaire anomalieën van de hoofd-halsregio

Extraoral vascular anomalies in the head and neck area Vascular anomalies have a prevalence of 4.5%, of which most occur in the head and neck area. In this retrospective cohort study, extraoral vascular anomalies are categorized based on the classification of the International Society for the Study of Vascular Anomalies (ISSVA). Subsequently, an analysis of the clinical presentation, treatment and complications of the 75 included patients was performed. The proportion of vascular tumors and malformations in this study was 24% (n = 18) and 76% (n = 57) respectively. Most of the extraoral vascular tumors and malformations occurred respectively in the lip (66.7%; n = 12) and cheek area (40.4%; n = 23). The most frequent complaint when patients presented with a vascular tumor, was the wish to be diagnosed (77.8%; n = 14). Swelling was the most frequent complaint when patients (35.1%; n = 20) presented with a vascular malformation. In 48.1% (n = 26) of the patients receiving interventional treatment, at least one recurrence was seen (n = 54), and almost exclusively in vascular malformations (96.2%; n = 25). Interventional therapy of vascular malformations is complex and associated with a pronounced risk of complication and recurrence, which is why multidisciplinary care for these patients is often an added value. The treatment of vascular tumors results in minimal morbidity or recurrence.

Impact of low-frequency coding variants on human facial shape

The contribution of low-frequency variants to the genetic architecture of normal-range facial traits is unknown. We studied the influence of low-frequency coding variants (MAF < 1%) in 8091 genes on multi-dimensional facial shape phenotypes in a European cohort of 2329 healthy individuals. Using three-dimensional images, we partitioned the full face into 31 hierarchically arranged segments to model facial morphology at multiple levels, and generated multi-dimensional phenotypes representing the shape variation within each segment. We used MultiSKAT, a multivariate kernel regression approach to scan the exome for face-associated low-frequency variants in a gene-based manner. After accounting for multiple tests, seven genes (AR, CARS2, FTSJ1, HFE, LTB4R, TELO2, NECTIN1) were significantly associated with shape variation of the cheek, chin, nose and mouth areas. These genes displayed a wide range of phenotypic effects, with some impacting the full face and others affecting localized regions. The missense variant rs142863092 in NECTIN1 had a significant effect on chin morphology and was predicted bioinformatically to have a deleterious effect on protein function. Notably, NECTIN1 is an established craniofacial gene that underlies a human syndrome that includes a mandibular phenotype. We further showed that nectin1a mutations can affect zebrafish craniofacial development, with the size and shape of the mandibular cartilage altered in mutant animals. Findings from this study expanded our understanding of the genetic basis of normal-range facial shape by highlighting the role of low-frequency coding variants in several novel genes.

Гендерные, этнические и другие особенности кожной чувствительности

We considered the current problem of determining pain sensitivity of different sections of the human body to find the most painless and safe zones for different medical procedures. The study involved 3 groups of students, 8 people in each group. In the first group were Russian boys, in the second – Russian girls, in the third – African girls aged 18–22 years. We carried out studies in 8 areas of the body, which are most often used in medicine for injecting: cheek, shoulder, forearm, wrist, underarm, shin behind (under the knee), iliac and gluteal areas. These areas are most commonly used for various medical procedures. We determined objective differences of sensitivity thresholds of different body sections. As the threshold increases (decrease in sensitivity), these are: underarm, forearm, iliac region, lower leg behind, gluteal region, shoulder. There were no pronounced sexual features of pain sensitivity among boys and girls 18–20 years old. We revealed ethnic features of skin sensitivity. The overall sensitivity of African students is higher than that of Russians. Taking into account the features of tactile and pain sensitivity will reduce the negative sensations of patients during pain-provoking procedures.

Chloroform skin injury after endodontic Chloroform skin injury after endodontic retreatment: Case report

A nonsurgical root canal retreatment was initiated for the upper right second premolar in a 35-year-old healthy female patient as part of her comprehensive dental treatment. She reported severe pain during the treatment, and then the procedure was discontinued due to time limitations. The next day, she returned back to the clinic complaining of a skin injury on the right side of her face. According to the patient's history, she felt a burning sensation during the procedure when the treating clinician began using a solution from a syringe. Extraoral clinical examination revealed a dry, pink-brown skin injury extending from the right labial commissure to the middle cheek area. Since the only solution used during the first visit was chloroform, the skin injury was diagnosed as a first-degree chemical burn due to accidental chloroform skin exposure. The patient was reassured and instructed to use petroleum jelly (Vaseline) until healing was complete. After 2 weeks, the burn had healed completely without scarring, with only slight hyperpigmentation remaining in the affected area. Chloroform use should be limited to cases in which mechanical gutta-percha removal is ineffective. It should be handled with extreme caution. Chemical burns can be prevented if exposure is detected immediately and the area washed thoroughly. This clinical case is made to increase the clinicians' awareness of the hazards of chloroform.

Giant Parotid Stone Causing Mucosal Ulceration and Pus Discharge: Report of a Rare Case

Introduction: Sialolith is the most common condition of the salivary gland disorders after mumps, which usually occurs in the submandibular gland. A rare case of giant parotid sialolith is described. Case Report: A 58-years-old man with a complaint of swelling in the buccal area referred to the Department of Oral Medicine of the Dental School of Semnan University. A mild swelling was observed in the right cheek area in front of Ramus during the extraoral examination. Iintraoral evaluation revealed a 2.5 × 2 cm swelling with same color of the mucous membrane, adjacent to the maxillary first molar at the Parotid Papilla area, and with a stony-hard consistency. In the radiographic imaging, an estimated 18×6 mm homogenous opaque lesion was recognized; hence, the sialolith diagnosis was suggested. Surgical removal with electrocautery was done and no complaints were reported one month after the surgery. Conclusion: Since giant sialolith can lead to complications which may affect patients’ quality of life, surgical treatment of such lesion is strongly recommended.

Superficial Fascia of the Cheek Shown in P45 Sheet Plastination.

In this paper, the authors attempted to determine the extent of the superficial fascia of the cheek using P45 sheet plastination.Three head and neck specimens were sliced in horizontal (46 slices), coronal (30 slices), and sagittal (29 slices) sections using P45 sheet plastination (special polyester resin corrosion-resistant method designed to preserve biological sectional specimens in situ). Through slicing, bleaching, dehydration, casting, forced impregnation, curing, cutting, and sanding the molds, P45 plastination sheets provided good light transmission, allowing the internal structures within the sheet to reveal clearly in their intact form.P45 sheet plastination revealed that the superficial fascia in the cheek area is generally composed of 3 layers: a superficial fatty layer, a membranous layer, and a deep fatty layer. Anteriorly, the membranous layer of superficial fascia (MSF) extended to the posterior border of the zygomaticus major muscle, enveloping this muscle, and then to the lateral border of the orbicularis oculi muscle. Posteriorly, the MSF extended to the anterior border of the parotid gland, and then was continuous with the parotid fascia. Superiorly, the MSF extended to the line from the tragus to the alar base. Inferiorly, the MSF extended to the line from the mandibular angle to the mouth corner. Below this line, the SMAS continued to the upper border of the platysma muscle.Our results using P45 plastination concorded well with Mitz's original drawing. We suggest that the results of the present study may be helpful for practicing surgeons to apply in subcutaneous dissection or sub-SMAS dissection in facelift procedures.

Defining Metaniches in the Oral Cavity According to Their Microbial Composition and Cytokine Profile.

The human oral microbiota consists of over 700 widespread taxa colonizing the oral cavity in several anatomically diverse oral niches. Lately, sequencing of the 16S rRNA genes has become an acknowledged, culture-independent method to characterize the oral microbiota. However, only a small amount of data are available concerning microbial differences between oral niches in periodontal health and disease. In the context of periodontitis, the cytokine expression in the gingival crevicular fluid has been studied in detail, whereas little is known about the cytokine profile in hard and soft tissue biofilms. In order to characterize oral niches in periodontal health, the oral microbiota and cytokine pattern were analyzed at seven different sites (plaque (P), gingival crevicular fluid (GCF), saliva (S), tongue (T), hard palate (HP), cheek (C) and sublingual area (U)) of 20 young adults using next-generation sequencing and multiplex immunoassays. Site-specific microbial compositions were detected, which clustered into three distinct metaniches (“P-GCF”, “S-T-HP” and “C-U”) and were associated with niche-/metaniche-specific cytokine profiles. Our findings allow the definition of distinct metaniches according to their microbial composition, partly reflected by their cytokine profile, and provide new insights into microenvironmental similarities between anatomical diverse oral niches.

Horizontally Oriented V-Y Flap may Diminish Lower Lid Retraction

Recently enhanced reconstructive techniques have greatly improved facial oncologic reconstruction. Concerns about tumor margins, probable radiotherapy, and lymph node dissection makes surgeons to have different plans to overcome complications. Cheek area as one of attractive and aesthetic facial elements, is predisposed to cutaneous malignancies. There are optional solutions to cover the resultant skin defect , which demands selective technique according to final pathology and free margins [1].

Rhabdomyosarcoma of the Cheek Area: About Two Cases and Review of the Literature

Rhabdomyosarcoma of the Cheek Area: About Two Cases and Review of the Literature

Endoscopic trans nasal excision of pterygopalatine fossa schwannoma: case report and review of literature

&lt;p class="abstract"&gt;The pterygopalatine fossa is a difficult area for surgical access and lesions in this area traditionally advocated open external trans maxillary approaches. With endoscopic techniques, it is possible to not only access and explore this area but also plan complete excision of lesions in the pterygopalatine fossa. We present a case report of a 26-year-old lady with complaints of pain in the area of the left cheek for 6 months. She had no other co-morbidities. On clinical examination, no abnormality was detected. Radiological examination with magnetic resonance imaging showed a lesion possibly a schwannoma in the left pterygopalatine fossa behind the left maxillary sinus. Complete excision was achieved using trans nasal endoscopic technique through the left maxillary sinus. Histopathological examination confirmed the diagnosis of schwannoma. Post-operative period was uneventful and she was free from any pain and neurological symptoms on subsequent follow up. Schwannomas in the pterygopalatine fossa are rare entities. Endoscopic techniques are safe and effective in accessing the pterygopalatine fossa for excision of lesions situated in this area. This technique obviates the need for external facial incisions or intra oral incisions and helps in good surgical outcomes and quick healing and recovery. &lt;/p&gt;

Expression of angiogenic growth factors in canine squamous cell cancers

ABSTRACT Skin and subcutaneous tissue tumors are the most common neoplasms in dogs. The most common sites of origin in dogs include digits, skin and the oral cavity including cheek and retromandibular area. We investigated canine squamous cell carcinoma (SCC) samples from 15 dogs and classified them histopathologically according to the degree of differentiation. bFGF, VEGF-C, TGF-β, PDGF-A, PDGF-C and PDGFR-α expressions were assessed using immunohistochemistry to determine the roles of growth factors during SCC. We found that TGF-β1 immunolabeling was elevated significantly compared to healthy controls in SCC originating from nailbeds, while expression of other growth factors did not change significantly. Our findings might explain the role of TGF-β1 in the infiltrative and malignant behavior of SCC originating from nailbeds.

Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes.

Radical ablative surgery is the gold standard treatment of head skin cancer. The authors expose their experience with a new artificial dermis (Pelnac®), analyzing retrospectively the overall morbidity and aesthetic outcomes. 16 consecutive patients underwent two surgical procedures under local anesthesia. The first involved the tumor removal and application of the ADM. In the second, the exposed tissue was covered with a split-thickness skin graft. On follow-up (6 months), tumor recurrences, quality of scars (using the Vancouver Scar Scale), and patient reported outcomes (using FACE-Q Skin Cancer Module) were evaluated. 10 were males and 6 females, with a mean age of 73 years (61–89). The follow-up ranged from 12 to 48 months (mean: 30). The sites of skin tumor were scalp (12 cases), forehead (2), cheek (1), and zygomatic area (1). Nine patients underwent previous local surgery; two received radiotherapy. The average length of hospital stay was 3.2 days. The mean surface area of the defect was 59.15 cm2 (16.9–89.5). In three cases, the surgical bed was bone without periosteum. The malignant tumors excised were basal cell carcinoma (68.75%), squamous cell carcinoma (18.75%), malignant melanoma (6.25%), and sarcoma (6.25%). The mean operating time was 41 minutes for the first operation (25–55) and 34 for the second (25–48). No significant problems were observed and 15 patients (93.75%) had 100 percent intake of graft. The mean time of healing was 39 days (32–45). At 6 months post-op, no tumor recurrence. Satisfactory cosmetic and functional results were obtained in all patients as shown by the VSS Scale and FACEQ skin cancer module mean scores. We believe that the artificial dermis is a reliable alternative to flaps and should be considered an excellent option in head reconstruction for skin cancer, especially in critical patients (old, with large and deep defects, with recurrent tumors, required radiotherapy).

Identifying the Optimal Features in Multimodal Deception Detection

Facial thermal imaging is a non-contact technology which can be useful for ubiquitous deceptive anxiety recognition. To date, studies investigating this technology have produced equivocal results in classification accuracy and finding the most correlated regions on the face. This study was conducted using our dataset with 41 subjects using two different protocols and three modalities (thermal, GSR and PPG). We selected and tracked five regions of interest (ROI) on each facial thermal imprint including periorbital, forehead, cheek, perinasal and chin that were mostly used in previous papers. By employing six statistical features, four feature reduction techniques and three classifiers, we attempted to identify the ROIs which are mostly associated with activation of the sympathetic nervous system to increase the final classification accuracy rate. The results of linear classification models show significant improvement of classification accuracy by using ROC feature selection method. We achieved 90.1% and 74.7% accuracy rate for thermal features in mock crime and best friend scenarios, respectively. Our experimental results show that perinasal and cheek areas have greater discriminatory power in comparison with other ROIs on the face.

Sublingual Tablets : An Overview

Drug delivery via the oral mucous membrane is considered to be a promising alternative to the oral route. Sublingual route is a useful when rapid onset of action is desired with better patient compliance than oraly ingested tablets. In terms of permeability, the sublingual area of the oral cavity (i.e. the floor of the mou) is more permeable than the buccal (cheek) area, which in turn is more permeable than the palatal (roof of the mouth) area. A rapid onset of pharmacological effect is often desired for some drugs, especially those used in the treatment of acute disorders. Sublingual tablets disintegrate rapidly and the small amount of saliva present is usually sufficient for achieving disintegration of the dosage form coupled with better dissolution and increased bioavailability.