Lower Cheek Research Articles

Exploring Progression and Differences in Facial Asymmetry for Hemifacial Microsomia and Isolated Microtia: Insights from Extensive 3D Analysis.

Aiming to measure and compare asymmetry of facial hard and soft tissues in patients with HFM and isolated microtia, examining how it evolves. This cross-sectional study assessed facial asymmetry in male East Asian patients aged 5-12 diagnosed with unilateral hemifacial microsomia (Pruzansky-Kaban types I and IIA) or isolated microtia. Using 3D imaging of computed tomography scans, it measured root-mean-square (RMS) values for surface deviations across facial regions. Statistical analyses explored differences between conditions and the relationship of age with facial asymmetry. A total of 120 patients were categorized into four groups by condition (HFM or isolated microtia) and age (5-7 and 8-12 years). Patients with HFM exhibited the greatest asymmetry in the lower cheek, while those with isolated microtia showed primarily upper face asymmetry. Significant differences, except in the forehead and nasal soft tissue, were noted between the groups across age categories. Notable distinctions in hard tissue were found between age groups in the nasal and mid-cheek areas for patients with HFM (median RMS (mm) 0.9 vs. 1.1, P = 0.02; 1.5 vs. 1.7, P = 0.03) and in the nasal and upper lip areas for patients with isolated microtia (median RMS (mm) 0.8 vs. 0.9, P =0.002; 0.8 vs. 1.0, P = 0.002). Besides these areas for HFM, no significant age-asymmetry correlation was detected. Significant differences in facial asymmetry were observed between HFM and isolated microtia, with the asymmetry in specific area evolving over time. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A case report on an epidermoid cyst in the lower cheek

A case report on an epidermoid cyst in the lower cheek

Myoepithelioma in the Buccal Mucosa: An Unprecedented Case Report

Myoepithelioma is a benign salivary gland tumor that mainly occurs at the parotid gland and, less commonly, affect minor salivary glands. This case report described the first case of myoepithelioma occurring in the buccal mucosa of a 13-year-old adolescent. The patient’s complaint was a mass in the lower cheek that could be felt inside his mouth, with 7 years of evolution, showing a recent growth spurt. Clinically, a normal, painless nodular lesion, with a sessile base, easily mobilized, of softened consistency, and measuring about 3 cm in its largest diameter could be seen. The patient underwent excisional biopsy of the lesion, histopathological, and immunohistochemical analysis, with final diagnosis of myoepithelioma originated from minor salivary glands. This unprecedented case contributes to report a both unusual location and age group of a rare benign neoplasm in the buccal mucosa.

A comprehensive comparison of facial skin hydration based on capacitance and conductance measurements in Chinese women.

The aim of this study was to compare the data of conductance and capacitance measurements of facial skin hydration and to evaluate and discuss the advantages and disadvantages of the different approaches. We measured skin capacitance (Corneometer® CM 825) and skin conductance (Skicon-200EX®) on 30 pre-defined facial sites of 125 Chinese women, resulting in 3750 readings per device. The data were analysed and compared, and continuous colour maps were generated on a 3D avatar for capacitance, conductance, relative difference (Δ%) and correlation (R-value) by interpolating between the individual readings and converting the values to colours. This visualization allows a better interpretation of the results. The complexity of facial skin hydration is revealed by this approach. The similarities and discrepancies in the facial hydration maps are clearly apparent. Due to the superiority of the Skicon in measuring high hydration levels, differences in skin hydration were evident on the forehead compared with the Corneometer maps, which may be related to the more superficial measurement of the Skicon within the stratum corneum. Conversely, a greater understanding of the complexity of facial skin hydration in the nasolabial fold was obvious when using the Corneometer. The best congruence between the instruments was found at two specific but separated facial areas, one around the inner eye region and the other one on a line between the nasolabial sulcus and the oblique, lateral jaw. Interestingly, the data were not normally distributed for both instruments and they had opposite skews. All facial clusters were statistically different from each other (p< 0.001), except the cheek and jaw for the Skicon. Larger than expected percentage coefficients of variance were found for the Corneometer on some facial sites that might be explainable by differences in stratum corneum physiology and biochemistry. Corneometer values of 48 AU and Skicon values of 132 μS were taken as the cutoff for normally hydrated facial skin. Both devices have their advantages and disadvantages suggesting that bio-instrumental measurement of skin hydration is actually more complicated than commonly thought and that the different facial zones and the use of multiple instrumentation have not been adequately considered.

Flap selections in the reconstruction of tongue squamous cell carcinoma following glossectomy

Tongue SCC comprises 20% of all SCC involving oral cavity which increase in incidence worldwide. Glossectomy either sub-total or total is the mainstay of treatment for tongue SCC to achieve cure with optimum functionality. Various surgical might be used based on tumor burden. Reconstruction method for defect following the surgeries has always been challenging with variable options of flaps and variable outcomes. These case series reporting 4 cases of tongue SCC treated with glossectomy, neck dissection and standard therapy. Approaches used were lateral mandibulotomy, lower cheek and visor flap approach. Each treated with different reconstructive technique following the surgery. Case 1 was reconstructed with pectoralis major flap, case 2 with latissimus dorsi flap, case 3 with sternocleidomastoid flap and case 4 with supraclavicular island flap. Despite the well-known benefits and disadvantages for every above-mentioned method for defect closure, all these flaps in our reports gave satisfactory result in tongue mobility including articulation and swallowing, as well as the local aspect such as flap survival, wound healing, and no involvement of significant post-operative complication. In conclusion, anatomical, functional and aesthetical outcomes after glossectomy using different type of flaps are generally comparable.

Accuracy of Three-Dimensional Soft-Tissue Prediction Considering the Facial Aesthetic Units Using a Virtual Planning System in Orthognathic Surgery.

Virtual surgical planning (VSP) is commonly used in orthognathic surgery. A precise soft-tissue predictability would be a helpful tool, for determining the correct displacement distances of the maxilla and mandible. This study aims to evaluate the soft-tissue predictability of the VSP software IPS CaseDesigner® (KLS Martin Group, Tuttlingen, Germany). Twenty patients were treated with bimaxillary surgery and were included in the study. The soft-tissue simulation, done by the VSP was exported as STL files in the engineering software Geomagic Control XTM (3D systems, RockHill, SC, USA). Four months after surgery, a 3D face scan of every patient was performed and compared to the preoperative simulation. The quality of the soft-tissue simulation was validated with the help of a distance map. This distance map was calculated using the inter-surface distance algorithm between the preoperative simulation of the soft-tissue and the actual scan of the postoperative soft-tissue surface. The prediction of the cranial parts of the face (upper cheek, nose, upper lip) was more precise than the prediction of the lower areas (lower cheek, lower lip, chin). The percentage of correctly predicted soft-tissue for the face in total reached values from 69.4% to 96.0%. The VSP system IPS CaseDesigner® (KLS Martin Group; Tuttlingen, Germany) predicts the patient’s post-surgical soft-tissue accurately. Still, this simulation has to be seen as an approximation, especially for the lower part of the face, and continuous improvement of the underlying algorithm is needed for further development.

Profiles of facial soft tissue changes during and after orthodontic treatment in female adults

BackgroundSome female adults who received orthodontic treatment often complain about thinner faces, protruding cheekbones and sunken temples, even at the beginning of treatment. The present research aimed to explore facial soft tissue changes during and after orthodontic treatment, as well as the related factors affecting facial soft tissue changes.MethodsThis study used 3dMD stereo photography technology to compare facial soft tissue changes among adult females who received orthodontics. A total of 52 adult females (24 teeth extraction, 28 non-teeth extraction cases) were included and potential correlations between related factors (facial morphology features, the change of occlusal height and dental arch width) were evaluated during different treatment periods.ResultsOverall, 3D-negative soft tissue changes of the buccal region moderately correlated with distances of nasion-menton and subnasale-menton (both rs = 0.30, P < 0.05) as well as the ratio of subnasale-menton/right gonion-left gonion (rs = 0.33, P < 0.05) and nasion-menton/right zygomatic point-left zygomatic point (rs = 0.30, P < 0.05). Among the 3D angle measurements, the right chelion-median upper lip point-left chelion angle was found to have a moderate correlation with 3D negative changes of the upper cheilion region (rs = 0.31, P < 0.01). Analysis of occlusal height changes revealed that an increase in the posterior facial height (nasion-gonial distance) may be a risk factor for negative changes in the zygomatic arch area. In addition, a moderate positive correlation between the maxillary first molar width changes and 3D-negative changes of the lower cheek region was found (rs = 0.41, P < 0.05).ConclusionsAfter orthodontic treatment, adult females with wide and short faces may be prone to negative soft tissue changes. Changes of posterior facial height and arch width between the first molars were also risk factors for negative changes of facial soft tissues. Extraction is not a major factor producing facial soft tissue changes.

Microinjections with hyaluronic acid in combination with glycerol: How do they influence biophysical viscoelastic skin properties?

Skin quality improvement with hyaluronic acid microinjections is increasing as a clinical treatment indication and as a scientific issue. This present study assessed changes in biomechanical viscoelastic skin properties after microinjections with the skin quality booster CPM-HA20G (Belotero Revive). Fifteen subjects have been randomized in a 2:1 ratio to receive either three treatments (total 3ml per side) or a single-dose treatment (total 1.5ml per side) with CPM-HA20G at dermal level into the lower cheeks via microinjections. Treatments were provided 4 weeks apart. Biophysical measurements were performed describing the viscoelastic skin properties and the underlying skin structure. The measurements were performed before injection (week 0) and on follow-up visits 4, 8, 16, 24, and 36 weeks after the last injection treatment. One (p=0.028) as well as three (p=0.003) consecutive treatments with CPM-HA20G improved statistically significant skin firmness (R0). For the multiple-treatment group improved significant differences were observed for skin fatigue (R3; p=0.007) and skin density (p=0.017) with stable skin thickness levels (p>0.05), too. There were zero-to-weak correlations between skin thickness and biomechanical skin properties (R0, rs =0.084; R3, rs =0.093). Overall, microinjections with CPM-HA20G improved biomechanical viscoelastic skin properties with a stronger and more pronounced effect in the multiple-treatment group. The observed changes may explain some of the skin quality improvements observed after treatment with CPM-HA20G.

Clinical Implication of the Regional Thickness of the Lower Facial Skin, Superficial Fat, and Superficial Musculoaponeurotic System on High-Intensity Focused Ultrasound Treatment.

Knowledge of the topographic thickness of the skin and soft tissues is necessary when performing a high-intensity focused ultrasound (HIFU) procedure. Thermal tissue injury to the superficial musculoaponeurotic system (SMAS) or deeper can injure the facial nerve and its branches. To demonstrate the topographic thickness of the lower facial skin, superficial fat, and SMAS. The ultrasound data of 200 healthy patients who underwent lower facial rejuvenation were retrospectively reviewed. The mean age was 41.1 ± 13.7 years (range, 19-76 years). The jowl had thinner skin, thicker superficial fat, and deeper superficial and deep margins of the SMAS than the preauricle or lower cheek. The thickness of the superficial fat decreased with age, especially on the preauricle, lower cheek, and jowl. Women had thicker superficial fat than men on the preauricle and lower cheek. The superficial and deep margins of the SMAS were located more superficially in old and male patients with a slim facial figure than in young and female patients with a chubby facial figure. The present findings provide anatomical information regarding the superficial fat and SMAS, which is useful in determining the focal penetration depth of HIFU treatment for lower face rejuvenation.

Facial asymmetry assessment in skeletal Class III patients with spatially-dense geometric morphometrics.

Quantification and visualization of the location and magnitude of facial asymmetry is important for diagnosis and treatment planning. The objective of this study was to analyze the asymmetric features of the face for skeletal Class III patients using spatially-dense geometric morphometrics. Three-dimensional facial images were obtained for 86 skeletal Class III patients. About 7160 uniformly sampled quasi-landmarks were automatically identified on each face using template mapping technique. The pointwise surface-to-surface distance between original and mirror face was measured and visualized for the whole face after robust Procrustes superimposition. The degree of overall asymmetry in an individual was scored using a root-mean-squared-error. Automatic partitioning of the face was obtained, and the severity of the asymmetry compared among seven facial regions. Facial asymmetry was mainly located on, but not limited to, the lower two-thirds of the face in skeletal Class III patients. The lower cheek and nose asymmetry were detected to have more extensive and of a greater magnitude of asymmetry than other facial anatomical regions but with various individual variations. The overall facial asymmetry index and the regional facial asymmetry indices were higher in males and patients with chin deviation. Soft tissue asymmetry is predominately presented in the lower-third of the face in skeletal Class III patients and with various variations on other facial anatomical regions. Morphometric techniques and computer intensive analysis have allowed sophisticated quantification and visualization of the pointwise asymmetry on the full face.

The Influence of Different Light Angles During Standardized Patient Photographic Assessment on the Aesthetic Perception of the Face

Background2D baseline and follow-up clinical images are potentially subject to inconsistency due to alteration of imaging parameters. However, no study to date has attempted to quantify the magnitude by which such images can be influenced.ObjectiveThe objective of the present study is to identify the magnitude by which images can be influenced by changing the imaging light angle.MethodsThis study is based on the evaluation of 2D frontal images of the face and included a total of 51 subjects of which n = 14 were males and n = 37 were females. Faces were photographed at 0°, 30°, and 60° light angle under identical and standardized conditions. Images were randomized and rated by 27 blinded raters for age, facial attractiveness, body mass index (BMI), temporal hollowing, lower cheek fullness, nasolabial sulcus severity, and jawline contour.ResultsFacial attractiveness decreased, facial unattractiveness increased and the evaluated BMI (based on facial assessment) increased statistically significantly at 60°. The assessment of regional facial scores, i.e., temporal hollowing, lower cheek fullness, and jawline contour, showed no statistically meaningful changes both at 30° and at 60° light angle.ConclusionThe results indicate that there might be an observed blind range in light angle (0°–30°) which does not influence facial assessment. Increasing the light angle past the threshold value to 60° might result in a statistically significant impact on facial perception which should be accounted for when documenting and/or presenting facial 2D images.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

New species of Yuomys (Rodentia, Ctenodactyloidea) from the upper Eocene of eastern Ningxia, China

ABSTRACT A new species, Yuomys robustus of the ctenodactyloid rodent Yuomys, is described in the paper. It is from the Western margin of the Ordos Basin District in eastern Ningxia Hui Autonomous Region, China. Yuomys robustus is characterized by a combination of features: large size, high tooth crown, having a postparacrista on M2 and lacking hypocone on P4. We also emended the diagnosis of type species of Yuomys, Y. cavioides. It is characterized by the absence of hypocone on P4, having a distinct ridge connecting the metaconule to the protocone on M1–M3, a postparacrista on M1, a mesostyle on M2, and a small ridge or spur on the mesial side of the protoloph on P4 and M1; the hypoconid smaller than the protoconid and is elongated, the paraconid absent and the mesostylid faintly visible on p4, but well developed on m1–m3; the talonid basin, sinusid, and posteroflexid are large and open on lower cheek teeth. The occurrence of Lophiomeryx angarae in the same stratigraphic layer as Y. robustus indicates that the horizon is possibly late Eocene in age, not early Oligocene as suggested by previous workers. Body mass estimations of Y. cavioides, Y. eleganes, and Y. robustus show that their weights are roughly in the range of 485–880 g, which is in between those of extant Myospalax and Ratufa. From the middle Eocene to the late Eocene, Yuomys exhibited a trend of gradually enlarging the cheek teeth, and increasing the tooth crown height and body mass.

"Zipper" Concept for Designing Expanded Forehead Flap in Facial-Cervical Reconstruction.

Skin defect of the lower part of the face and neck is a severe condition for many patients with burn and traumatic injuries or skin lesions. The expanded forehead flap with anterofrontal temporal vessel pedicles has been widely used in lower cheeks, chin, and neck reconstruction. (In this study, we introduce a new concept- "Zipper concept" of the flap design.) The aim of this study is to evaluate the feasibility and outcome of using expanded forehead flap with a vertical incision with or without a small transverse incision in the central part. From March 2010 to September 2016, 27 patients who suffered from lower cheeks and chin skin defects were reconstructed by expanded forehead flap with anterofrontal temporal vessel pedicles. After the lesion was excised, the upper or the lower part of the flap was cut in half with a vertical incision with or without a small transverse incision in the middle part as needed for cheeks, upper lip or neck reconstruction, and the other part of the flap was remained to be one piece for chin reconstruction. All flaps survived completely without any congestion or necrosis. All patients achieved satisfactory results both functionally and aesthetically. A vertical incision with or without a small transverse incision in the central part of the expanded forehead flap with anterofrontal temporal vessel pedicles is a safe modification of the flap design. It is practical and could bring the expanded forehead flap to more indications.

The Equine Gingiva: A Gross Anatomical Evaluation

Equine periodontal disease (ePD) usually starts with food impaction, formation of diastemata, gingival inflammation and formation of periodontal pockets. This process proceeds toward the dentoalveolar space, causing detachment of tooth supporting periodontal fibers. Although several therapeutical procedures have been proposed, ePD is often only diagnosed in advanced stages, requiring dental extraction. A similar dilemma has been observed in small animal medicine, but has been overcome by the introduction of reliable examination protocols for the early diagnosis of periodontal diseases (PD). These protocols are based on detailed anatomical descriptions of healthy gingiva, allowing for the determination of the pathognomonic signs of the onset of PD and providing a basis for grading systems and treatment plans. Consequently, proposals have also been made for periodontal examination protocols in horses. However, these protocols were widely adopted from small animal medicine assuming a similar anatomy of the equine and canine gingiva. To provide a solid anatomical basis for equine specific periodontal examinations, 20 equine heads were examined macroscopically, with special attention to the gingival sulcus, the gingival margin and the interdental papillae. Constant morphological patterns of the gingival margin and the interdental papillae were found for the vestibular and lingual/palatal aspects of the upper and lower cheek teeth arcades, as well as for the incisor arcades. A gingival sulcus measuring greater than 1 mm was present in only 6% of the investigated specimens. The inspection of the gingival margin and the interdental papillae, as well as the recognition of a gingival sulcus, may serve as criteria to establish equine specific periodontal investigation protocols.

A new Eocene cylindrodontid rodent from the Erlian Basin (Nei Mongol, China) and its implications for phylogeny and biochronology

ABSTRACTWe report a new early–middle Eocene cylindrodontid rodent, Gobiocylindrodon ulausuensis, gen. et sp. nov., from the Ula Usu West locality, Erlian Basin, Nei Mongol, China. Gobiocylindrodon ulausuensis is morphologically more primitive than known later cylindrodontids in having lower-crowned molars, less-rounded upper molars in occlusal view, a more oblique hypolophid on p4, a slightly anterolabially extended hypoconid on m1–3, and a narrow posterosinusid posteriorly and a broad mesosinusid anteriorly on the lower cheek teeth. The lower incisor enamel of G. ulausuensis is pauciserial. Our phylogenetic analysis of a data matrix including 14 taxa and 40 morphological characters reveals that G. ulausuensis is a basal cylindrodontid. Gobiocylindrodon ulausuensis casts new light on early cylindrodontid evolution in Asia and provides new evidence for mammalian dispersals between Asia and North America during the early–middle Eocene. Gobiocylindrodon-bearing strata are probably Arshantan in age.

Dental shape variation of Neogene Pachyrukhinae (Mammalia, Notoungulata, Hegetotheriidae): systematics and evolutionary implications for the late Miocene Paedotherium species

Paedotherium was the last representative of the pachyrukhines (Notoungulata, Hegetotheriidae), a small rabbit- or caviomorph rodent-like clade, with hypsodont and simplified dentition. In contrast to the Pliocene Paedotherium species, the Miocene species are less known and mainly represented by teeth. Different systematic studies of Paedotherium based on the same set of subtle trait variations of the cheek teeth have arrived at different proposals. With the aim of testing the validity and analysing the morphological variation of Paedotherium species, and assessing the definition and diagnostic value of teeth traits, we performed a dual approach: a traditional qualitative study and exploratory geometric morphometric analyses of the upper and lower cheek teeth (both, partial and complete series). In addition, the configurations of cheek tooth shape were used as landmark characters, in combination with traditional characters, to perform a phylogenetic analysis. We propose the validity of the late Miocene P. borrelloi Zetti, and the assignment of north-western Argentinian representatives of Paedotherium to P. aff. minor. Paedotherium borrelloi is morphologically more similar and phylogenetically more closely related to the Pliocene P. bonaerense than to other Paedotherium species. Our results suggest that during the late Miocene the coexistence of two Paedotherium lineages was already established, whose main morphological differences persisted or even intensified in Pliocene representatives, supporting a more complex evolutionary scenario than previously believed.

Hipparion material from Gaojiashan locality in the Late Miocene of Linxia Basin, Gansu, China and associated mammalian fossil assemblage

Two Hipparion species, H. forstenae and H. hippidiodus from Gaojiashan locality in the Linxia Basin, Gansu, China are described in this paper, with the first presence of the former in the Linxia Basin. The lower cheek teeth of Hipparion from Gaojiashan bear deep ectoflexids, and after comparisons to other Chinese Hipparion fossils with deep ectoflexids, the mandibles with deep ectoflexids on the lower premolars suggest their attributions to H. forstenae. The presence of a deep ectoflexid on p2 may be interpretable as an intraspecifically variable feature in H. forstenae, and can also be found in H. dermatorhinum. Besides the Hipparion material, at least 8 species of large mammals occur at the Gaojiashan locality, including Adcrocuta eximia, Chilotherium wimani, Shansirhinus ringstroemi, Eucladoceros cf. proboulei, Palaeotragus cf. coelophrys, Giraffidae gen. et sp. indet., and the previously studied Promephitis hootoni and Eostyloceros hezhengensis. Although the sample from Gaojiashan shares five species with the Yangjiashan fauna, the Gaojiashan fossil assemblage may date to the Baodean because of the presence of H. forstenae. The overall taxonomic composition of the Gaojiashan assemblage at least suggests an approximate Baodean age, which would imply survival of C. wimani into the Baodean of the Linxia Basin.

The Association of Quantitative Facial Color Features with Cold Pattern in Traditional East Asian Medicine.

Introduction Facial diagnosis is a major component of the diagnostic method in traditional East Asian medicine. We investigated the association of quantitative facial color features with cold pattern using a fully automated facial color parameterization system. Methods The facial color parameters of 64 participants were obtained from digital photographs using an automatic color correction and color parameter calculation system. Cold pattern severity was evaluated using a questionnaire. Results The a⁎ values of the whole face, lower cheek, and chin were negatively associated with cold pattern score (CPS) (whole face: B = −1.048, P = 0.021; lower cheek: B = −0.494, P = 0.007; chin: B = −0.640, P = 0.031), while b⁎ value of the lower cheek was positively associated with CPS (B = 0.234, P = 0.019). The a⁎ values of the whole face were significantly correlated with specific cold pattern symptoms including cold abdomen (partial ρ = −0.354, P < 0.01) and cold sensation in the body (partial ρ = −0.255, P < 0.05). Conclusions a ⁎ values of the whole face were negatively associated with CPS, indicating that individuals with increased levels of cold pattern had paler faces. These findings suggest that objective facial diagnosis has utility for pattern identification.

Analysis of morphological changes after facial massage by a novel approach using three-dimensional computed tomography.

Photograph-based visual scoring has been used for evaluation of facial morphological changes. Here, we describe a three-dimensional computed tomography (3D-CT) method for objective analysis of facial and intra-facial (subcutaneous) changes. The effects of facial massage were examined using both methods. Subjects were 12 healthy female volunteers without facial scars or deformation (age 30-54 years, mean 39.4 years). Photograph-based scoring of massage-induced morphological changes was done at the nasolabial folds, upper, lower and lateral cheeks and lower eyelids. For 3D-CT evaluation, the virtual center axis (VCA) was set as the cranio-caudal longitudinal line, and the VCA-skin surface distances (VSDs) were measured. Massage-induced changes of VSD were calculated (facial massage-induced change rate, FMCR). Intra-facial (subcutaneous) changes were also evaluated. Photograph-based scoring revealed marked morphological changes of the nasolabial folds after facial massage, and changes of the lower, upper and lateral cheeks and lower eyelid were also observed in more than half of the subjects. FMCR values were significantly changed in the paranasal area, nasolabial fold area and cranial part of the mandibular area. Photograph-based scores at the lower cheek and lower eyelid were well correlated with FMCR in the inferior part of the nasolabial fold and the mandibular area, respectively. Massage-induced changes of subcutaneous fat tissues and facial expression muscles were also apparent on CT images. 3D-CT imaging is useful for objective evaluation of the effects of facial massage, including anatomical changes in subcutaneous structures.

The Late Miocene Hipparion (Equidae, Perissodactyla) fossils from Baogeda Ula, Inner Mongolia, China

New material of Hipparion (Baryhipparion) tchikoicum from Baogeda Ula in Abag, Inner Mongolia, China is described. The latest Miocene (∼6 Ma) occurrence of the species is an important chronological reference for the stratigraphy of Baogeda Ula. Furthermore, the Baogeda Ula Hipparion connects the distribution of this species in the Yushe Basin and Mongolia. The deep ectoflexids of the premolars and the rounded double knots of the lower cheek teeth place the Baogeda Ula specimens in the primitive forms of Hipparion in Eurasia. The two North American species of Hipparion, Hipparion shirleyi and Hipparion tehonense with deep ectoflexids and rounded double knots in the lower premolars, may be the ancestral forms of the subgenus Baryhipparion. Furthermore, their age was much earlier than the first appearance of Baryhipparion in Eurasia, so the period and route of the immigration of North American ancestral forms to Eurasia are still unclear. Nevertheless, the Eurasian expansion of this subgenus is clear: it first appeared in North China during the latest Miocene, and then spread northward to the Mongolian Plateau and Transbaikalia; it migrated westward into Europe through Kazakhstan and Caucasus in the Pliocene; and it survived in Transbaikalia until the Early Pleistocene.