Nasal Area Research Articles

Reduced Vessel Density in the Mid-Periphery and Peripapillary Area of the Superficial Capillary Plexus in Non-Proliferative Diabetic Retinopathy.

Our aim in this study was to assess the vessel density (VD) and vessel skeleton density (VSD) in the nasal area of the superficial capillary plexus (SCP) of diabetic subjects without diabetic retinopathy (DR), or in those with a non-proliferative diabetic retinopathy (NPDR), and to evaluate the relationship between the VD and VSD and the severity of DR. In this prospective study, the VD and VSD in the SCP were measured and analyzed on 6 × 6-mm macular and nasal optical coherence tomography angiography scans. The three concentric circles of the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid were used and divided into zones numbered from 1 to 9 in the macular area and from 1 to 8 in the nasal area. The VD was significantly lower in the nasal peripapillary area (p = 0.0028), and both the VD and VSD were significantly lower in the macular area (p = 0.0131 and p = 0.0132, respectively) in patients with more severe DR. The SD was significantly lower in zones 5 (p = 0.0315) and 6 (p = 0.0324) in the nasal grid in patients with more severe DR. We showed a lower superficial capillary flow in the nasal periphery and peripapillary area in patients with more severe DR.

Ganglion Cell Topography and Retinal Resolution in an Irrawaddy Dolphin (Orcaella brevirostris)

The topographic distribution of retinal ganglion cells was investigated in a retinal wholemount of an Irrawaddy dolphin (Orcaella brevirostris). Two zones of increased concentration of ganglion cells were observed—one in the temporal segment and the other in the nasal segment of the retina. The maximal cell concentration was 250 cell/mm2 in the temporal area and 194 cell/mm2 in the nasal area. Based on the posterior nodal distance of 11 mm, the resolution was evaluated as 19.8 arc min in the temporal retinal area (the frontal visual field) and 22.4 arc min in the nasal retinal area (the temporal visual field). Among retinal ganglion cells, a group of giant cells that ranged from 42 to 52 µm in diameter were observed; these cells represented 8% of the total population. The obtained data allowed us to suggest that the presence of two areas of concentrated ganglion cells is characteristic of many delphinids inhabiting both clear oceanic waters or turbid river waters, whereas low ganglion cell density is associated with optic properties of the media.

Nasal mucoepidermoid carcinoma after radiotherapy: Case report

Abstract Introduction Mucoepidermoid carcinoma (MEC) is a tumor originated from the epithelium of the glandular excretory ducts and has highly variable biological potential. It is the most prevalent cancer of the salivary glands. The present report aims to describe a case of nasal mucoepidermoid carcinoma that developed after adjuvant radiotherapy (RT) treatment of a recurrent pituitary macroadenoma. Case Report Male patient, 62 years old, presented with recurrent nasal epistaxis on the right, associated with intense pulsatile headache, visual analogical scale (VAS) 10/10, with improvement only with the use of opioids and morphine. After undergoing oncological screening and study by imaging exams, the presence of an expansive seal lesion with suprasellar extension was seen, involving the medial wall of the cavernous segment of the right carotid artery and the anterior cerebral artery, as well as the presence of a new expansive lesion in the right nasal cavity, with ethmoid bone invasion superiorly and medial orbit wall invasion laterally, compressing the ipsilateral optic nerve canal. Discussion Sinonasal neoplasms represent a small portion of all malignancies of the upper aerodigestive tract, accounting for < 5% of these neoplasms. The development of MEC involves risk factors such as occupational issues, history of trauma and surgery involving the nasal area, and radiation exposure, as in previous RT. Conclusion Mucoepidermoid carcinoma is an uncommon neoplasia and can be associated with RT treatment, as used in cases of recurrent pituitary macroadenoma. In general, surgical resection to obtain free margins of neoplastic tissue is the aimed treatment, seeking better prognosis.

Effect of Formulation Variables for the Production of WGA-Grafted, Levodopa-Loaded PLGA Nanoparticles

Levodopa is used for the treatment of Parkinson’s disease (PD) for the last few decades. However, adverse reactions such as dyskinesia, somnolence, nausea, itching, rash, as well as the need for frequent dosing and low bioavailability problems affect the success of the treatment. To prevent side effects caused by conventional therapy, a nanoparticular drug delivery system has been developed, in which receptors are constantly stimulated, and the frequency of dosing is reduced. In this study, levodopa was loaded in Poly lactic-co-glycolic acid (PLGA) nanoparticles (NP) which modified with Wheat Germ Agglutinin (WGA) To increase the effectiveness of levodopa, reduce its side effects and apply to the nasal area which is an alternative way for brain targeting with lower doses. To obtain the optimum levodopa loaded PLGA nanoparticles, the effect of some formulation variables such as polyvinyl alcohol (PVA) concentration, homogenization speed, polymer amount and molecular weight, and levodopa content on the entrapment efficiency (EE) and particle size of the nanoparticles were investigated. Besides these variables, the effect of different parameters on the WGA binding constant was also searched. In addition to in vitro release studies, Differential Scanning Calorimetry (DSC) and Fourier Transform Infrared Spectrophotometer (FT-IR), and Transmission electron microscopy (TEM) analysis were used in the characterization of nanoparticles. Among all formulations, A2 and A8a which was produced with different molcular weights of PLGA, different added levodopa amounts and with different homogenization speeds were chosen as optimum formulations due to their sustained release properties and the ability to release 80 % of their drug content.WGA binding constant was found 78.20 % for A8a-1 and 95 % for A2-1. In this study, we aimed to determine the effect of different formulation parameters on the development of levodopa loaded and WGA grafted PLGA nanoparticles and on the quality characteristics of nanoparticle formulations such as particle size, zeta potential, and EE. In this paper, our results are demonstrated for a better understanding of the effect of process parameters on the development of nanoparticle-based drug delivery systems by using the double-emulsion solvent evaporation technique and on WGA binding of drug-loaded PLGA nanoparticles.

Eclipse solaire ou ectopie du cristallin?

Ectopia lentis is defined as an acquired or hereditary malposition of the crystalline lens due to a zonular deficiency. It can be caused by a trauma or secondary to an underlying systemic disease, such as Marfan syndrome, Weill-Marchesani syndrome and homocystinuria. Marfan Syndrome (MFS) is a disease of the connective tissue mainly affecting the ocular, cardiovascular and skeletal system. Up to 80% of patients with Marfan syndrome develop ectopia lentis, 50% of which occurs before the age of 5. Lens displacement is usually bilateral and symmetrical, and frequently occurs superotemporally. We here report the case of a 17-year-old girl born to consanguineous parents. She presented with behavioral disorders and school problems reported by her parents. On general examination, she was tall for her age and had long, thin fingers. Clinical examination showed visual acuity 2/10 and good pupillary light reflex; the examination of the anterior segment objectified clear cornea, with an increase in anterior chamber depth and bilateral ectopia lentis in the nasal area. Fundus examination was normal. Etiological research didn’t uncover causal effects. The patient underwent phacophagia with implantation of an iris-fixated implant and skin biopsy aimed to confirm the diagnosis of Marfan syndrome.

Photographic Assessment of Full Thickness Skin Grafts in the Nasal Area After Skin Cancer Excision– A Regional Hospital Experience

Background: Rates of non-melanoma skin cancer (NMSC) are high in those residing in rural and regional areas of Australia with increased demand for skin cancer excisions. NMSC of the nose are common and are frequently reconstructed with full-thickness skin graft (FTSG). We aimed to evaluate whether post-operative photographic analysis in the outpatient setting is a feasible and efficient way to determine graft take success and presence of complications.

Scleral Necrosis in Porphyria Cutanea Tarda: A Case Report

Scleral necrosis is a rare but well documented ocular manifestation of Porphyria Cutanea Tarda (PCT). The PCT is caused by a deficiency of Uroporphyrinogen Decarboxylase (Uro-D). The typical clinical manifestations of PCT in the form of cutaneous photosensitivity are due to the accumulation of fluorescent polycarboxylated porphyrins. Here, a case of 30-year-old male patient who was referred to the cornea services department for scleral thinning in right eye has been presented. Slit lamp biomicroscopy revealed focal area (5×5 mm2 ) of punched out scleral thinning (>80%) with uveal show in the interpalpebral area, 2 mm temporal to the limbus in right eye and a partial thickness scleral melt in nasal area. The left eye was phthisical. Patient had multiple blisters and pigmented, slightly depressed scars on the skin, especially in the sun-exposed parts such as face, hands and legs. Digital shortening, atrophy and contractures were seen in hands and legs. Based on the clinical, biochemical and dermatological evaluation, the diagnosis of PCT was made. A rare case of scleral necrosis with uveal show in a patient with PCT which was successfully treated with allogenic scleral patch graft has been reported. On follow-up visits scleral patch graft was well taken up.

IMPACT OF THE NASAL VALVE SHAPE ON THE OLFACTORY FUNCTION AND SUBJECTIVE PERCEPTION OF THE NASAL BREATHING.

The aim: To study the impact of the internal nasal valve shape on respiratory and olfactory nose function as well as on quality of life. Materials and methods: The study involved 17 volunteers who noted satisfaction of nasal breathing in the absence of changes during endorhinoscopy. The study was con¬ducted in two stages: stage 1 involved assessing initial indicators of quality of life by the SNOT-22 questionnaire, performing active anterior rhinomanometry, and estimating the olfactory function (Sniffin' Sticks); stage 2 consisted in re-assessing the mentioned indicators after changing the shape and lumen of the internal nasal valve. The sodium alginate self-hardening gel was used for simulating the narrowing of the nasal valve. It was applied to the mucous in the upper part of the nasal valve area, obturating the diffuser above the level of attachment of the middle nasal turbinate to a depth of 3-4 mm from nasal vestibule. Results: Air resistance did not change significantly after partial blockage of the internal nasal valve, although, 16 out of 17 patients showed signs of hyposmia with an average Sniffin' Sticks test score 8.68 ± 0.15. Conclusions: The simulated partial blockage of the internal nasal valve lumen in its upper part in the area of the diffuser does not significantly affect the resistance of the air passing through the nasal passages, but the olfactory function is impaired, which is reflected the quality of life.

An Extremely Rare Case of Granular Cell Tumour of Right Nasal Vestibule

Granular Cell Tumour (GCT) of nasal and paranasal area is an extremely rare entity, while the most common site is the tongue in oral cavity. GCT was first time described by Abrikossoff in 1926, which occurs in 3rd to 5th decades of life and most frequently involving the head and neck region. Abrikossoff in 1926, first time described GCT, to be derived from smooth muscle and gave the term myoblastomas, also known as Abrikossoff’s tumours. Schwann cell origin of GCT was demonstrated on immunohistochemistry through positive S100 protein identification. Herein, the authors report a case of GCT arising from right nasal vestibule in a 28- year-old female who presented with swelling since three months. On gross examination, the specimen revealed firm red and white pieces of tissue measuring 0.8x0.8x0.5cm. Diagnosis was made by histopathological examination which was confirmed by PAS special stain and S100 immunohistochemistry. Author also abridge the clinical information, microscopic features, treatment and patient status after follow-up. This case is believed to be the 7th reported case of GCT as primary lesion at this location.

Assessment of the Asymmetry of the Lower Jaw, Face, and Palate in Patients with Unilateral Cleft Lip and Palate.

Background: This study aimed to assess the asymmetry of the lower jaw, face, and palate in patients with unilateral cleft lip and palate (UCLP) using photography, cone-beam computed tomography (CBCT), and digitized three-dimensional casts.Methods: This case–control study was conducted on photographic, CBCT, and digital cast records of 14 UCLP patients and 24 healthy controls between 10 and 16 years. Totally, 65 variables were measured on photographs, CBCT scans, and on digitized casts. Measurements were compared between the two groups and within each group between the two sides. For easier measurement, in patients who had right side CLP, the cleft was transferred to the left side and in subjects without cleft, mild chin deviation was transferred to the left side.Results: The anteroposterior dimensions of the two condyles in the UCLP group were greater than those in the control group, while the mediolateral dimensions of the left condyle and ramus height, mandibular body length, and total length of the mandible in the control group were greater than those in the UCLP group. Right ocular, nasal, and angular variables were greater in the UCLP group. Other variables except for the palatal width from the right canine to midline were greater in the control group.Conclusion: Our findings highlighted the presence of asymmetry in the nasal and palatal areas in patients with UCLP while these patients had no significant difference with healthy controls in the relationship of condyles with the temporomandibular fossa.

A rare case of herpes zoster in a child involving dermatomes V1 and V2

Herpes zoster (HZ) is rarely found in healthy children but may be attributed to immunocompromised children. Latent varicella-zoster virus (VZV) might have source from intrauterine exposure, chicken pox vaccination, or exposure to wild VZV. A 2 ½-year-old healthy boy presented with a painful red vesicular rashes with blisters on the right upper cheek, periorbital area, temporal and nasal area extending over the dermatomes V1 and V2 of 3 days' duration. There was an involvement of the right eye causing conjunctivitis. He had persistent frontal and temporal headache on the day 10 of the disease. Computed tomography scan of the brain reveals no abnormality. The child responded well to symptomatic management and routine skin care. Medications such as cetrizine, sup acyclovir, and local acyclovir ointment and emollients were given. Acyclovir was used orally in a dose of 20 mg/kg body weight every 6 hourly for 7 days. The patient recovered well in 10 days of treatment. HZ is a rare presentation in healthy children and needs a high index of suspicion to diagnose in cases with vesicular eruptions. In our case, the intrauterine infection is the source of latent VZV. HZ may not indicate that the child is immunocompromised.

A Recalcitrant Case of Eosinophilic Pustular Folliculitis

Eosinophilic Pustular Folliculitis (EPF) or papulooerythroderma of Ofuji (PEO) is a rare dermatosis that presents with recurrent pruritic follicular papules and pustules that can involve the entire skin surface sparing the skin folds. This can be accompanied with elevated IgE levels and eosinophils. Diagnosis has been challenging due to its ability to mimic several common dermatologic disorders, such as acne and contact dermatitis. Literature has described the first line of therapy to be oral and topical indomethacin, however, success has been variable, and reports have been anecdotal. Until this day, there is yet to be standard guidelines for approach to diagnosis and management of this condition. In this article, we report a case of a 29 year-old female of Chinese descent who presented with papules on bilateral malar and nasal areas recalcitrant to topical corticosteroids. She demonstrated success with the use of a monthly regimen of isotretinoin after a perplexing diagnostic dilemma.

Direct nose to the brain nanomedicine delivery presents a formidable challenge.

This advanced review describes the anatomical and physiological barriers and mechanisms impacting nanomedicine translocation from the nasal cavity directly to the brain. There are significant physiological and anatomical differences in the nasal cavity, olfactory area, and airflow reaching the olfactory epithelium between humans and experimentally studied species that should be considered when extrapolating experimental results to humans. Mucus, transporters, and tight junction proteins present barriers to material translocation across the olfactory epithelium. Uptake of nanoparticles through the olfactory mucosa and translocation to the brain can be intracellular via cranial nerves (intraneuronal) or other cells of the olfactory epithelium, or extracellular along cranial nerve pathways (perineural) and surrounding blood vessels (perivascular, the glymphatic system). Transport rates vary greatly among the nose to brain pathways. Nanomedicine physicochemical properties (size, surface charge, surface coating, and particle stability) can affect uptake efficiency, which is usually less than 5%. Incorporation of therapeutic agents in nanoparticles has been shown to produce pharmacokinetic and pharmacodynamic benefits. Assessment of adverse effects has included olfactory mucosa toxicity, ciliotoxicity, and olfactory bulb and brain neurotoxicity. The results have generally suggested the investigated nanomedicines do not present significant toxicity. Research needs to advance the understanding of nanomedicine translocation and its drug cargo after intranasal administration is presented. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Neurological Disease Therapeutic Approaches and Drug Discovery > Emerging Technologies Toxicology and Regulatory Issues in Nanomedicine > Toxicology of Nanomaterials.

코의 크기 및 형태와 자가건강, 미병과의 상관성

Mibyeong (sub-health) is a concept that represents the sub-health in traditional East Asian medicine. Assuming that the nose sizes and shapes are related to respiratory function, in this study, we hypothesized that the nose size and shape features are related to the self-rated health (SRH) level and self-rated Mibyeong severity, and aimed to assess this relationship using a fully automated image analysis system. The nose size features were evaluated from the frontal and profile face images of 810 participants. The nose size features consisted of five length features, one area feature, and one volume feature. The level of SRH and the Mibyeong severity were determined using a questionnaire. The normalized nasal height was negatively associated with the self-rated health score (SRHS) (partial ρ = -0.125, p = 3.53E-04) and the Mibyeong score (MBS) (partial ρ = -.172, p = 9.38E-07), even after adjustment for sex, age, and body mass index. The normalized nasal volume (ρ = -.105, p = 0.003), the normalized nasal tip protrusion length (ρ = -.087, p = 0.014), and the normalized nares width (ρ = -.086, p = .015) showed significant correlation with the SRHS. The normalized nasal area (ρ = -.118, p = 0.001), the normalized nasal volume (ρ = -.107, p = .002) showed significant correlation with the MBS. The wider, longer, and larger the nose, the lower the SRHS and MBS, indicating that health status can be estimated based on the size and shape features of the nose.

Endoscopic Trans-Turbinal Medial Maxillectomy: A Modified Endoscopic Medial Maxillectomy Technique to Preserve the Inferior Turbinate

Endoscopic medial maxillectomy (EMM) and its modifications are surgical techniques are used to treat recalcitrant maxillary sinusitis as well as maxillary sinus tumors. In this report, we propose a simple and efficient modification of EMM, called endoscopic trans-turbinal medial maxillectomy (ETTMM), by which the inferior turbinate (IT), nasolacrimal duct, and anatomical integrity of the nasal valve area are preserved. A total of 10 patients (five tumorous and five nontumorous maxillary diseases) underwent ETTMM. Briefly, a turbinate mucosal flap on the superior aspect of the IT was elevated after middle meatal antrostomy. Then a trans-turbinal window was developed to expose the inferior meatus, after which an extended maxillary antrostomy was generated. Finally, the turbinate mucosal flap was repositioned after complete removal of the antral lesions. All lesions were successfully treated using ETTMM. Our modification was easy to perform, and we achieved good endoscopic visualization and accessibility throughout the whole antrum by creating a trans-turbinal window and extended maxillary antrostomy. We could perform postoperative surveillance easily through the wide antrostomy using rigid endoscopes of various angles. ETTMM is a simple and useful modification of EMM that provides clear visualization and great accessibility to most aspects of the maxillary antrum while preserving the nasal functional units, including the IT and nasal valve area.

Volumetric Measurement of Peripapillary Hyperreflective Ovoid Masslike Structures in Patients with Optic Disc Drusen.

PurposeTo develop a method to determine the volume of peripapillary hyperreflective ovoid masslike structures (PHOMS) and to examine the correlation between PHOMS and anatomic optic nerve head characteristics in a large cohort of patients with optic disc drusen (ODD).DesignRetrospective, observational study of patients with ODD.ParticipantsPatients with ODD seen in a 3-year period.MethodsWe determined the prevalence of PHOMS. We then developed a method to calculate the volume of PHOMS and measured this in all patients where radial scans on OCT were available. We analyzed the correlation between PHOMS volume and patient age, size of Bruch’s membrane opening (BMO), ODD visibility, and anatomic location of ODD in the optic nerve.Main Outcome MeasuresPrevalence and characteristics of PHOMS in patients with ODD.ResultsIn 247 (77%) eyes with ODD, PHOMS were found. Among these, 80% were in the first decade of life, 87% were in the second decade, 89% were in the third decade, 85% were in the fourth decade, 74% were in the fifth decade, 73% were in the sixth decade, 58% were in the seventh decade, 40% were in the eighth decade, and 0% were in the ninth decade. The ophthalmoscopic visibility of ODD increased with age. The volume of PHOMS decreased with age, but with no correlation to the size of BMO. The median volume of PHOMS was 0.27 mm3 (interquartile range [IQR], 0.13–0.49 mm3). Predominantly, PHOMS were observed in the nasal peripapillary area (87.5% nasal, 78.5% superior, 67% inferior, and 63.5% temporal).ConclusionsIn patients with ODD, PHOMS are seen frequently, with the highest prevalence in younger individuals. The volume of PHOMS decreases with age, and PHOMS are seen more frequently in patients with superficial ODD.

The role of normal nasal morphological variations from race and gender differences on respiratory physiology

This study identifies anatomical and airflow-induced relationships based on nasal morphological variations due to inter- and intra-racial differences and gender. Subject-specific nasal airway reconstruction was created from computed tomography images in 16 subjects: 4 subjects from each ethnic group (Black, East Asian, Caucasian, and Latino) comprising of 2 males and 2 females. Volume, surface area and nasal index were calculated, as well as airflow rate and nasal resistance after computational fluid dynamics simulations in the nasal airway. Results showed that nasal airspace surface area (p = 0.0499) and volume (p = 0.0281) were significantly greater in males than in females. Nasal volume was greatest in East Asians (Median = 20.38cm3, Interquartile Range [IQR] = 4.58 cm3), Latinos had the greatest surface area (Median = 219.70cm2, IQR = 29.56cm2). On average, East Asian and Black females had larger nasal index than their male counterparts. Caucasians had the highest median nasal resistance (0.050 Pa.s/mL, IQR = 0.025 Pa.s/mL). Results indicate that there exist anatomical variabilities based on race and gender. However, these variabilities may not significantly influence nasal function.

Study on changes of nasal resistance based on 3D printing transparent nasal cavity models

Objective:To investigate the causal relationship between the minimum cross-sectional area of nasal cavity and nasal resistance. Methods:Thirty transparent detachable 3D printing nasal cavity models were made. The airway was completely blocked with sealing material at different anatomical sections. Then ventilatable nasal drainage tubes with different cross-sectional areas were used to pass through the nasal cavity. Nasal resistance was measured. SPSS was used for statistical analysis. Results:①The postoperative nasal resistances of patients and 3D printing nasal cavity models were （0.38±0.15）Pa· s/mL and （0.39±0.02）Pa· s/mL respectively. There was no statistical difference between the two groups.The preoperative nasal resistance of patients was （0.56±0.09）Pa· s/mL, and the postoperative nasal resistance of the models was significantly descreased by 31% compared with preoperative nasal resistance of the patients, with statistically significant difference（P<0.05）. ②When the ventilatable nasal drainage tubes with a cross-sectional area of 3.14 square millimeters was located in the the upper part of common meatus and the nasal valve area, the nasal cavity is moderately blocked, and the nasal resistances were （1.80±0.30） times and （2.02±0.36） times of that before the obstruction respectively. When the ventilatable nasal drainage tube was located in the lower part of common meatus,the nasal resistance was （1.68±0.28） times of that before the obstruction. ③When the ventilatable nasal drainage tubes with a cross-sectional area of 6.28 square millimeters and were located in the lower part of common meatus, the upper part of common meatus and nasal valve area, the nasal resistances were （1.44±0.23） times, （1.50±0.25） times and （1.60±0.27） times of those before obstruction, respectively. ④When the ventilatable nasal drainage tubes with a cross-sectional area of 9.42 square millimeters were located in the above areas, nasal ventilation was nearly normal without obvious nasal obstruction. The nasal resistances were （1.17±0.18） times, （1.26±0.21） times and （1.33±0.24） times of those before obstruction, respectively. ⑤The nasal resistance was statistically significant correlated with the cross-sectional area of the ventilation tubes and the obstruction sites. The correlation coefficients were -0.895 and 0.339, respectively （P<0.05）. Conclusion:①3D printing can quickly and accurately replicate anatomical structure of the nasal cavity, and can be used as a research method for quantifitative measurement of nasal resistance. ②The minimum cross-sectional area of nasal cavitiy is the main determinant of nasal resistance. ③The obstruction site is the secondary determinant of nasal resistance. When the degree of nasal obstruction is the same , the nasal resistance in the nasal valve area is sightly higher than that in the common meatus.

The Influence of Three Root Canal Irrigation Methods on PostThe Influence of Three Root Canal Irrigation Methods on PostOperative Pain “Randomized Clinical Trial”

Introduction: Facial soft tissue changes in relation to hard tissue movements after orthognathic surgery cases is always of concern to patients , surgical and orthodontics teams. The aim of the present study was to assess facial soft tissue changes and stability using 3D facial laser scanner after orthognathic surgery Le Forte I maxillary impaction in excessive gingival display patients. Methods: The subjects consisted of 12 patients with skeletal vertical maxillary excess (VME) causing an aesthetic concern to the patients in the form of “Gummy smile”, who underwent LeFort I osteotomy with maxillary impaction, Three-dimensional images of the patients were acquired with a 3D laser scanner preoperatively and postoperatively. The changes in facial soft tissue were detected using a colour coded map for analysis. Results: Significant change was recorded in the upper lip, alar base, nasolabial fold and nasal tip areas, without specification of this change in direction. Conclusions: The 3D images captured using the laser scanner in this study can be a useful tool for communication with both patients and professionals but cannot be relied upon solely for accurate analysis of the facial soft tissue changes. The colour coded map analysis cannot be relied upon solely as a method of analysis as it lacks an important aspect of the change which is the direction.

Comparing the symmetry of upper eyelid following unilateral ptosis correction

BackgroundMargin Reflex Distance 1(MRD 1) only describes the central height of upper eyelid and relies on the examiner’s experience and disregards eyelid contour abnormalities. Therefore MRD 1 may not be sufficient for an acceptable result to evaluate the outcomes of ptosis surgery. The primary purpose of this study was to assess outcomes of unilateral ptosis correction based on parameters including degree of symmetry, MRD 1, peak height of the upper lid, temporal and nasal ocular surface area, and temporal/nasal area ratio with an objective, quantitative, and repeatable method.MethodsThis study was designed as a retrospective non-randomized case-control study. Medical records of the patients with unilateral ptosis between October 2015 and December 2020 were reviewed. Patients with unilateral ptosis who underwent surgical correction and levator function of 5 mm or greater were included in the study. Two groups were defined; ptotic eye was case group and contralateral eye was control group. Data analysis was performed Image J and Matlab softwares.ResultsThirty-four patients were included in the study. Mean age of patients was 58.8 ± 12.7 years (range 15–75 years). Mean follow-up time was 19.5 ± 7.3 months (range 8–40 months). Four patients were diagnosed with congenital ptosis and 30 patients aponeurotic ptosis. Mean preoperative degree of symmetry for overall eyelid contour was 36.6 ± 27.5% (range 1–92%). Mean postoperative degree of symmetry for overall eyelid contour was 72.4 ± 16.5% (range 55–92%). Temporal/Nasal (T/N) area ratios for contralateral normal eye was 1.19 pre-postoperative, and it was 1.11 preoperatively, 1.15 postoperatively for operated ptotic eye.ConclusionsThis study primarily demonstrated a quantitative, objective, and repeatable method to investigate the degree of symmetry after eyelid surgeries. Secondly, this study suggested that T/N ratio may not be a reliable parameter to evaluate the eyelid symmetry.