Narrow Nose Research Articles

Manipulating subcategory salience: exploring the link between skin tone and social perception of Blacks

AbstractGuided by the model of social category salience proposed by M. Blanz (1999), the present paper explores factors affecting the salience of skin tone‐based subcategories among Blacks in the United States. Adapting the group discussion paradigm developed by S.E. Taylor and colleagues (1978), Experiment 1 demonstrated that a manipulation of issue relevance enhanced the category salience of skin tone. Participants made more within‐ than between‐category errors when the topic of conversation was related to perceiver's skin tone‐based beliefs. Experiment 2 demonstrated that the influence of the issue relevance manipulation was independent of the presence of structural and/or normative fit. Merely discussing the topic of race relations was sufficient to increase encoding and use of skin tone. These studies provide evidence linking skin tone and social beliefs in memory. In addition, they demonstrate support for a category‐based perspective in the study of skin tone bias. Additional factors affecting the salience of skin tone are discussed. Copyright © 2004 John Wiley & Sons, Ltd.

Oculodentodigital dysplasia: study of ophthalmological and clinical manifestations in three boys with probably autosomal recessive inheritance

Oculodentodigital dysplasia (ODDD) is a rare inherited disorder affecting the development of the face, eyes, teeth, and limbs. The majority of cases of ODDD are inherited as an autosomal dominant condition. There are few reports of probable autosomal recessive transmission. Affected patients exhibit a distinctive physiognomy with a narrow nose, hypoplastic alae nasi, and anteverted nostrils, bilateral microphthalmos, and microcornea. Sometimes iris anomalies and secondary glaucoma are present. There are malformations of the distal extremities such as syndactyly. In addition, there are defects in the dental enamel with hypoplasia and yellow discoloration of the teeth. Less common features include hypotrichosis, intracranial calcifications, and conductive deafness secondary to recurrent otitis media. We describe three brothers with ODDD. Their parents are first cousins and present no features of ODDD. These data are in favor of autosomal recessive inheritance and suggest genetic heterogeneity for this entity.

Differing characteristics in 100 consecutive secondary rhinoplasty patients following closed versus open surgical approaches.

Open rhinoplasty has unquestionably become more popular during the past two decades because of the putative diagnostic and technical advantages that direct transcolumellar access offers. To test the hypothesis that patients initially treated by the opened or closed approaches differed in the secondary deformities that developed, a retrospective study was conducted of 100 consecutive secondary rhinoplasty patients (66 women and 34 men) operated on by the author before February of 1998. Sixty-four percent had previously undergone closed rhinoplasties and 36 had undergone open rhinoplasties; the incidence of prior open rhinoplasty had increased steadily over the survey years, from 21 percent in 1996 to more than 50 percent in 1998, 1999, and 2000 (p < 0.05). The data generated indicate the following. First, the open rhinoplasty patients had undergone more operations (3.1 versus 1.2) and had more presenting complaints (5.8 versus 2.6) than the closed rhinoplasty patients. Second, although the most common presenting complaint among prior closed rhinoplasty patients was an overresected dorsum (50 percent) or tip (33 percent) or internal valvular obstruction (42 percent), prior open rhinoplasty patients complained more frequently than the closed rhinoplasty patients of these problems and also external valvular obstruction (50 percent, p < 0.0001), short nose (39 percent, p < 0.001), wide columella (36 percent, p < 0.001), narrow nose (31 percent, p < 0.001), columellar scar (25 percent, p < 0.001), and symptomatic columellar struts (19 percent, p < 0.001). Only excessive nasal length was more prevalent among closed rhinoplasty patients (20 percent, p < 0.01). Third, ranking of deformities differed significantly (p < 0.0001) between the two groups, so that complaints related to the nostrils, nasal tip, nasal length, or columella were more common among the open rhinoplasty patients than among those previously treated endonasally. Fourth, the relative frequencies of surgical complaints also differed: whereas patients previously treated endonasally were 6.7 times more likely to complain of long noses, patients previously treated by open rhinoplasty complained more frequently of the following: excessive columellar width (open approach, 36 percent of patients; closed approach, none), hard columellar struts (open approach, 19 percent of patients; closed approach, none), external valvular obstruction (4.5 times as frequent with the open approach as it was with the closed approach), alar/nostril distortion (four times as frequent), and narrow nose (3.9 times). Although the most common complaints among all postrhinoplasty patients remain the overresected dorsum, tip, or (internal valvular) airway obstruction, the author's data suggest that patients previously treated by the open approach are more likely to have postsurgical deformities and complaints referable to those anatomic structures most easily reached by transcolumellar exposure and to techniques that can be performed more readily or aggressively through that access route.

Correction of cleft lip nasal deformity in Orientals with a cantilevered iliac bone graft.

We describe our technique for correcting a nasal deformity associated with cleft lip in oriental people. Cantilevered iliac bone grafts are used to provide additional structural support and to achieve the desired nasal projection and profile. Augmentation of the nasal bridge creates the illusion of a narrower nose. This technique was used in 20 patients with severe nasal deformities. Clinically and radiographically it consistently produced good, long-lasting results.

Evaluation of soft-tissue morphology of the face in 1,050 young adults.

Anthropometry of the face has always been an interesting subject for artists and plastic surgeons. Since ancient times, many rules have been proposed for the ideal face. The authors measured directly vertical and horizontal proportions of the face and inclinations of the soft-tissue facial profile in 1050 young Turkish adults. Differences between the facial measurements of subjects from seven different geographic regions were analyzed. Some of the measurements were compared further with the measurements of other populations in the literature, and the validity of the neoclassical canons were tested. The special head height measure was shorter than the special face height in the majority of our study group (women/men: equal height, 13%/15%; longer special head height, 28%/30%; shorter special head height, 59%/55%). Faces with three equally high-profile sections were not seen in women or in men. When the forehead height was compared with the nose height, equality was present in a small percentage of the population (women/men: equal height, 17%/18%; longer forehead, 41%/ 42%; shorter forehead, 42%/40%). The nose height was equal to the lower face height in a minority of the population (women/men: equal height, 10%/11%; longer nose, 9%/11%; shorter nose (81%/78%). The forehead height was shorter than the lower face height in the majority of the population (women/ men: equal height, 8%/9%; longer forehead, 12%/13%; shorter forehead, 79%/78%). The intercanthal distance was shorter than the nose width in the majority of the population (women/men: equal width, 20%/19%; wider intercanthal distance, 35%/37%; narrower intercanthal width, 65%/68%). The population was distributed evenly in regard to the variations of the orbital proportion canon (women/men: equal intercanthal width and eye fissure length, 31%/36%; wider intercanthal distance, 34%/27%; narrower intercanthal width, 35%/37%). The mouth width was greater than 1.5 times the nose width in the majority of the population (women/men: equal width, 6%/5%; wider mouth, 53%/54%; narrower mouth, 41%/41%). The nose width was narrower than one quarter of the face width in the majority of the population (women/men: equal width, 4%/3%; wider nose, 30%/39%; narrower nose, 66%/58%). The nose inclination was equal to the ear inclination in a very small fraction of subjects (women/ men: equal inclination, 3%/3%; greater nose inclination, 88%/87%; less nose inclination, 9%/9%). To sketch an outline of the average facial profile in the population studied, a convex facial profile is revealed, with the forehead and the chin retrodisplaced minimally with respect to the midface. The neoclassical canons were found to be invalid for the majority of the population in this study, and different proportional analytic results were obtained.

Duplication 17p11.2 in two patients: clinical features and molecular cytogenetic findings

Since patients with duplications or deletions involving the Smith-Magenis syndrome (SMS) region at 17p11.2 are thought to arise by the same mechanism of unequal recombination between a repeat sequence that flanks the SMS region (Chen et al., 1997), it is surprising that the duplication patients have been so rarely reported (Magenis et al., 1986; Kozma et al., 1991, Brown et al., 1996; Chen et al., 1997 and 1998; Summers et al., 1998). These patients are most likely underdiagnosed because of lack of defined clinical features and subtlety of the duplication with routine cytogenetic studies. We report two additional patients and review the common physical features in this duplication syndrome.Patient 1 is an 11 month old male with postnatal growth retardation, length at mean for 5 months, and head circumference average for 6 months. He has ptosis of the left eyelid, narrow nose and palate, small mandible, sacral dimple, overlapping toes, decreased tone, and global developmental delay. Patient 2 is a 6 year old female with a history of failure to thrive in early childhood and developmental delay. Height, weight, and head circumference are at the 50th percentile; she has upslanting, narrow palpebral fissures, broad eyebrows, distal joint laxity, and normal neurologic exam. Developmental testing at age 6 showed a full scale IQ of 65, with performance IQ 60 and verbal IQ 78 and behavior consistent with attention deficit hyperactivity disorder.Cytogenetic analyses with G-banding showed duplication of 17p11.2 with a narrow extra gray band in the middle of the G-negative area in the p11.2 region. The duplication was confirmed with a FISH assay using the D17S258 probe (Oncor) for the SMS region. The D17S122 cosmid probe (Oncor), which hybridizes within the region that is duplicated in Charcot-Marie-Tooth type 1A patients, showed a single signal on each chromosome 17 indicating that this region is not duplicated.Comparison of facial features reveals striking similarities between patient 2 and the patient reported by Magenis. It also appears that despite significant early problems with weight gain and development, these patients have fewer problems as they get older and may function in the low normal to borderline range. Detailed clinical descriptions of patients with duplications of 17p11.2 will be helpful in further delineation and recognition of this duplication syndrome.

An Aesthetic Dorsum: The CATS Graft

Reconstruction of the dorsum following a Joseph hump removal can be accomplished with a properly thinned septal graft. This will camouflage the residual twists in the dorsal septum, the irregularities at the osseocartilaginous function, and an open roof. It is particularly useful in those patients with a prominent hump but can be used in those patients with narrow noses in whom one does not wish to do an infracture following the hump resection.

Otofaciocervical syndrome: a sporadic patient supports splitting from the branchio-oto-renal syndrome

A sporadic patient with OFC syndrome is described. Distinguishing features were a long face with narrow nose, high arched palate, prominent and dysmorphic ears, long neck, sloping shoulders and clavicles, winged, low, and laterally set scapulae, tetralogy of Fallot, and deafness secondary to cochlear malformation. Some features present in the original family, including lateral cervical fistulae, have suggested that OFC syndrome could be a variant of BOR syndrome. The absence of preauricular tags, lacrimal duct stenosis, and renal malformations, and the presence of distinct facial and radiographic findings and markedly downward sloping shoulders in the present patient support OFC syndrome being a unique, clinically recognisable entity.

Use of cantilever iliac bone grafts for reconstruction of cleft lip-associated nasal deformities

Purpose: The purpose of this study was to describe the clinical and radiographic observations on cantilever iliac bone grafts for reconstruction of cleft lip-associated nasal deformities. Materials and Methods: Cantilever iliac bone grafts were performed on 14 patients with a severely deformed cleft lip-associated nose using the open rhinoplasty technique. An approximately 6-cm length of iliac bone was tightly inserted into a subperiosteal pocket over the nasal bones, and the nasal tip was elevated by the distal end of the graft. The clinical follow-up ranged from 7 months to 3 years. Results: All patients were judged to have satisfactory results. The grafted bone decreased slightly in size during the first 2 to 3 months, and irregularities in contour became rounded. During the same period, bony union with the underlying nasal bones was observed in all cases. After about 6 months, further changes did not occur in the grafts. Conclusion: This type of bone graft can be used for additional structural support and to achieve the desired nasal projection and profile. Augmenting the nasal bridge creates the illusion of a narrower nose. The key to success of the operation seems to be the proper fixation of the grafted bone to the underlying nasal bones.

The Treatment of Nasal Valve Obstruction

The purpose of this study is to present the authors' experience with nasal valve obstruction and their management scheme. Between July 1, 1988 and June 30, 1991, 27 patients were seen for nasal valve obstruction. There were 17 males and 10 females, with a median age of 39.2 years. The internal valve alone was involved in 14 patients, the external valve was involved in 2 patients, both valves were involved in 11 patients, and significant septal deviation was seen in 15 patients. Nasal valve obstruction resulted from previous surgery in 13 patients, from trauma in 8 patients, and from a "narrow nose" in 4 patients. Twenty-four patients were treated successfully, while 3 patients, seen early in the series, failed to improve. All patients were followed for a minimum of 1 year. Surgery in the nasal valve is done through an open approach and involves a systematic approach to all the structures surrounding the nasal valve. Surgical repositioning and cartilage grafting are used to reconstruct the nasal valve.

Ｏｐｅｎ ｍｅｔｈｏｄを利用した唇裂鼻形成術の経験

The authors describe their technique for correcting a cleft lip nasal deformity using the open method, which allows easy and precise correction. Repositioning of the displaced lower lateral cartilage on the cleft side is performed to raise the dome. The deviated septal cartilage has to be completely removed to eliminate obstruction of the nasal airways. The harvested septal cartilage is trimmed and placed as a columellar strut to reshape the down wardly displaced nasal tip and alar wing. Open method rhinoplasty is the best way to perform these procedures. In the severely deformed cleft-lip nose, the cantilever bone graft technique is used for additional structural support. Augmenting the nasal bridge creates the illusion of a narrower nose. The cantilever technique is also performed under the direct vision.

Craniofacial anthropometric studies in Waardenburg syndrome type I

A set of 15 surface measurements taken directly from the craniofacial region were determined in 51 patients with Waardenburg syndrome type I (WSI). A roentgencephamometric analysis including 20 linear dimensions was also performed by the use of cephalograms of 28 patients. Pairs between patients and controls of the same sex and age were established for comparison. The head circumference, clivus length and facial depth were smaller in affected individuals. The patients also had narrow nose, marked hypoplasia of the nasal bone, short philtrum, and short and retropositioned maxilla. A discriminant analysis revealed that the inner intercanthal distance, philtrum length, lower facial height and nasal bone length were excellent discriminating parameters of WSI.

Short stature, brachydactyly, small ears, and a pattern of minor anomalies in brother and sister born to consanguineous parents: A Hitherto Unreported syndrome?

A 13-year-old boy and his 28-year-old sister had short stature, obesity, and a pattern of minor anomalies including a sloping, narrow forehead; small ears; a narrow nose with prominent bridge and long septum; short upper lip; receding mandible; and short limbs with brachydactyly and clinodactyly of little fingers. The boy also had hypoplastic external genitalia and elevated FSH. Both are of normal intelligence. There is remote consanguinity of the (normal) parents. The 2 sibs probably represent a hitherto un-recognized syndrome of possibly autosomal recessive inheritance.

Climate-associated anthropometric variation between populations of the Niger bend

A large set of measurements were taken on 512 women and 425 men belonging to ten populations of the Niger bend area, some of which live in the Sahelian, the other in the Sudanian climatic zones about 200 km apart. The two zones differ chiefly by a two-fold higher annual rainfall in the Sudanian zone. The pattern of differences in body weight, skinfold and limb circumferences suggests that the Sahelians allot proportionally more food and/or less physical work to women than the Sudanians . In one or both sexes, Sahelians have significantly longer lower limbs and forearms, larger hands and ears, a narrower face, and a higher and narrower nose. Sexual dimorphism of the shoulder-hip-width proportions is lower in the Sahelians , resulting from the Sahelian males, but not females, having wider hips, whereas Sahelians of both sexes have narrower shoulders. Multivariate analysis using D2 distances shows Sahelian and Sudanian populations forming two separate clusters, with the exception of the Dogon . In the male sex, nose width and sitting height account for the total multivariate interpopulational variation; nose width alone separates the two zonal groups, again with the Dogon as an exception. The position of the Dogon near to Sudanian populations while living in the Sahelian zone is explained by their migration from the Sudanian zone a few centuries ago. Adaptative genetic response to climate is proposed as a partial explanation of the evidence presented.

Restoration of the Holotype of Proconsul nyanzae

The crushed palate and lower face of the holotype of Proconsul nyanzae has been prepared using the acetic acid technique. The prepared and conserved fragments have been restored to their natural positions using a synthetic cement and polyethylene glycol wax (Carbowax 4000) to fill the gaps. Preparation revealed the inferior margin of the right orbit, the inferior border of the nasal bones, and a posterior divergence of the palate which has now been corrected. The restored face of P. nyanzae shows the orbits to have been wider apart than those of Proconsul major, both absolutely and relatively, and that it had a long narrow nose and palate. It differs from Proconsul africanus, which has the shortest and broadest face of all Proconsul species, and from P. major which has a much longer narrower face.

THE DREADFUL CONSEQUENCES OF NOT REMOVING THE CHILD'S HYPERTROPHIED TONSILS AND ADENOIDS—AS VIEWED IN 1915

The editorial below published in 1915 in the now defunct Archives of Pediatrics is typical of the prevailing medical attitude at that time toward the putative calamitous effect of hypertrophied tonsils and adenoids. It would seem that everyone must be aware of the deleterious effect of hypertrophied adenoids and tonsils.... It is, however, the fall of the year, the time when the first series of infectious colds runs through the community, when household after household finds one member after another succumbing to sneezing and coryza. The ruggedness gained from months in the country, whose bacteria-free air has permitted a loss of resistance to the germs of the common cold, seems in a day to give place to pallor and weakness. It is now, therefore, that the adenoid question comes bobbing up again after months of retirement, for it is the child with adenoids to whom the first cold of the year comes with greatest injury.... Again, it is the fall of the year, when the schools open. Coming to the schools are hundreds of children, who, through fault of their parents or their physicians, do not come physically fit to profit by the instruction which the schools afford. The school physical examination, which is now so general, detects, among other things, enlarged tonsils, mouth breathing, open mouths, malocclusion, narrow noses, high palatal arches, all bearing a relationship to faulty nasopharyngeal conditions, all lessening in some degree the child's keenness of intellect, retarding him, delaying his mates, and requiring a greater effort on the part of his teachers and a greater cost to the community....

OCULODENTODIGITAL DYSPLASIA SYNDROME Report of Four Cases

Four cases of oculodentodigital dysplasia are reported. Three cases are from the same family, father and two daughers. These three cases have the characteristics typical of this disorder: narrow nose, hypoplastic alae nasi, microphthalmia, defects of the teeth, syndactylyl of the IV and V fingers, and skeletal anomalies. The fourth case differs from the earlier reported cases; he has all the typical findings of oculodentodigital dysplasia but in addition he shows features not previously reported, namely exceptionally poor vision, mental retardation, monilethrix and pili annuli changes of the hair.

The Rabenhorst-Syndrome

A syndrome, apparently not yet described, with following manifestations is presented: 1. Ventricular septal defect and pulmonary stenosis. 2. Narrow face with micrognathia, high and narrow nose with prominent septum, microstomia, attached earlobes. 3. Minor malformations of hands and feet. The inheritance appears to be autosomal dominant.

Experimental cold modification of cranio-facial morphology.

AbstractA possible relationship between cranio‐facial form and growth under cold stress was investigated through a control group (N=17)—experimental group (N=14) comparison. Two groups of young rats were exposed to 90 days of 22°C and 5°C temperatures respectively. Methods of analysis included measurement of overall bodily dimensions as well as detailed examination of the cleaned, dried skulls and femora.Statistical comparison of the cold and non‐cold grown rats showed a number of highly significant mean differences; particularly a narrower nose, rounder neurocranium, and shorter femur was seen in the cold stressed animals. Human anatomical homologs were briefly noted as were their possible genetic and ontogenetic causes.

The genetics of the Australian aborigines.

The genetics of the Australian aborigines.