Nasal Bone Research Articles

Nasal Bone Fracture (NBF): A Retrospective Study on Epidemiology and Treatment Outcomes in the Omani Population

Nasal Bone Fracture (NBF): A Retrospective Study on Epidemiology and Treatment Outcomes in the Omani Population

Olfactory Neuroblastoma With Divergent Differentiation: Contemporary Management of Unusual Pathology and Literature Review.

Olfactory neuroblastoma (ON; Esthesioneuroblastoma) is a malignant tumor that arises from the olfactory neuroepithelium. Very rarely, ON can histologically display a biphenotypic pattern, with only 7 cases reported in the literature to date. We describe a case of this poorly understood entity and review the patient's histology, pathology, and treatment. An 85-year-old man presented with endoscopy and imaging findings of a sinonasal mass arising from the olfactory cleft. Biopsy and further pathological review established Hyams grade 3 and Kadish stage C tumor. The patient underwent combined endoscopic and open-approach resection due to the involvement of the nasal bone and subsequent adjuvant radiation therapy. Specimen contained Flexner-Wintersteiner rosettes and stained positive for the neuroendocrine marker synaptophysin consistent with ON. A second, epithelial component pattern of goblet cells and mucin was observed suggesting divergent differentiation. We are the first group to report next-generation sequencing of this tumor, which revealed a pathogenic mutation in PIK3CA and a likely pathogenic variant in RUNX1 (AML1). ON with divergent differentiation is very rare, and more robust studies characterizing molecular drivers and pathology may aid in clinical management.

A classification system of Asian noses for rhinoplasty.

While Asian noses are generalised as having smaller bones and softer cartilages, thicker skin and soft tissue envelop (SSTE), there exists a diversity of morphology amongst Asian noses. The over-simplification of Asian noses diminishes the validity or generalizability of rhinoplasty research findings and makes comparison of outcomes challenging. A classification system is proposed that reflects the different structures and SSTEs of the nasal subtypes, the techniques required in the management of each of the subtypes, the challenges the surgeon will face intra- and post-operatively, allows for pre-operative counselling of expected outcomes and facilitate valid and fair comparison of study outcomes by comparing like for like. The classification system stratifies noses into four subtypes based on i. the size and strength of the nasal bone and cartilages, and ii. the thickness of the SSTE. Type I noses have thinner SSTE and stronger structure. Type II noses have thinner SSTE and weaker structure. Type III noses have thicker SSTE and stronger structure. Type IV noses have thicker SSTE and weaker structure. Inter-rater variability in classifying noses amongst rhinoplasty surgeons was found to be very high with a kappa coefficient of 0.933 (95% confidence interval 0.852 to 1.014; variance 0.013).

Ethnic Rhinoplasty in the Brazilian Population: Current Concepts.

The large mixture of races in Brazil gives the nose its distinctive composition, which makes rhinoplasty difficult for these patients. Every patient should have their anatomy thoroughly examined on an individual basis, as there is no unique strategy that works for all situations. This is a narrative overview of the last 10 years' worth of literature that describes the ethnic traits of each nose, with a particular emphasis on the Brazilian nose, and talks about the major surgical approaches that can be applied in these situations. The low dorsum, broad nasal bones, thick skin, and bulbous tip are the primary features of the Brazilian nose. Many times, lateral osteotomies, root grafting, isotretinoin treatment for skin thickness, and neodomus formation are required. The Brazilian nose presents a surgical challenge that calls for the mastery of multiple procedures, not simply structured rhinoplasty. In certain cases, preservation rhinoplasty may even be used. 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 retrospective epidemiological analysis of maxillofacial fractures at a tertiary referral hospital in istanbul: a seven-year study of 1,757 patients

BackgroundThe aim of the study was to evaluate the etiology, incidence, demographics, and characteristics of maxillofacial fractures treated at a university hospital over a seven-year period.MethodsWe performed a retrospective analysis of 1,757 patients with maxillofacial fractures who were referred to our department between May 2012 and March 2019. The patients’ demographic and clinical characteristics were noted, as well as the fracture type, location, and etiology. The treatment modalities were also analyzed.ResultsA total of 2,173 maxillofacial fractures were seen in 1,757 patients. The male to female ratio was 3.9:1, and the mean patient age was 31.89 ± 17.70 years (range: 0–95 years). Maxillofacial injuries were most prevalent in the 19–28 years age group (23.9% of cases), with a general increase in injuries observed between 2013 and 2018 across all age groups. The most common etiological factor was assault (29.1%), followed by falls (26%). In male patients, assault was reported as the main cause, while in female patients, falls were identified as the main cause. The nasal bone was the most common site of fracture, followed by the maxilla. The average time from admission to surgery was 2.8 days, with local anesthesia being the most frequent surgical intervention. The average time from admission to surgery was 2.8 ± 2.5 days (range: 0–20 days), with surgeries performed under local anesthesia being more frequent than those carried out under general anesthesia. Among the surgical interventions, the most common general anesthesia technique for fracture reduction was open reduction and internal fixation with plates and screws. Plate exposure, wound-site infection, and temporomandibular joint ankylosis were the major complications encountered in the study population.ConclusionThe study reveals significant variability in maxillofacial fractures based on gender, age, and etiology. Assault emerged as the leading cause of these fractures, followed by falls and road traffic accidents. Men were affected by maxillofacial trauma four times more often than women, with the highest incidence occurring in the 19–28 years age group. Nasal fractures were the most frequently observed (78.7%), while condylar-subcondylar process fractures were the most common type of mandibular fracture. Given these findings, a targeted, lifelong prevention strategy focused on high-risk groups could significantly reduce the burden of maxillofacial trauma.

Clinical effects of two kinds of nasal bone reductors used for shortened and displaced overlapping external nasal fracture reduction under nasal endoscopy and the impact on ventilation function

Objective:To explore the clinical effects of two kinds of nasal bone reductors used for shortened and displaced overlapping external nasal fracture reduction under nasal endoscopy and the impact on ventilation function. Methods:From January 2020 to February 2022, 82 patients with shortened and displaced overlapping external nasal fractures diagnosed and treated in the Department of Otolaryngology, the Second People's Hospital of Hefei were collected as the study subjects. The patients were divided into control group（41 cases） and observation group（41 cases） by random number table method. Both groups underwent closed reduction under nasal endoscopy. The control group was treated with traditional straight nasal bone reductor, and the observation group was treated with gun-shaped hook type nasal bone reductor. The success rate of reduction, follow-up rate, clinical effect, and complications were compared between the two groups. The visual analogue scale（VAS） was used to evaluate the aesthetic effect and functional recovery. Rhinomanometry and acoustic rhinometry were used to evaluate nasal ventilation function. Results:The success rate of one-time reduction in the observation group was significantly higher than that in the control group, and the nasal reduction adaptation time was shorter than that in the control group（P<0.05）. There was no significant difference in the follow-up rate of 95.12% and 92.68% between the two groups. The success rate of one-time reduction in observation group was significantly higher than that in the control group, and the adaptation time for nasal reduction in observation group was shorter than that in the control group（P<0.05）. There was no significant difference in the follow-up rate of 95.12% and 92.68% between the two groups in six months after surgery. the total clinical effective rate in observation group was higher than that in the control group（94.87% vs 76.32%, P<0.05）. After surgery, the scores of nasal aesthetics, nasal congestion and olfactory function in both groups were significantly lower compared with the preoperative scores. All the scores in the observed group were lower than that in the control group（P<0.05）. After surgery, there were significant increases in the minimum cross-sectional area of nasal cavity, volume of nasal cavity and total nasal expiratory volume in both groups. Above indicators in observation group were significantly greater than that in control group. The nasal exhalation and inhalation resistance was significantly lower than that before operation, and the resistance in observation group was significantly lower than that in control group（P<0.05）. The total incidence of complications was lower than that in observation group（P<0.05）. Conclusion:The application of gun-shaped hook-type nasal bone reductor in patients with shortened and displaced overlapping external nasal fractures has better success rate of one-time reduction, adaptation time of nasal reduction and treatment outcome. Moreover, it has more advantages in aesthetic effect of nasal appearance, nasal ventilation function and reduction of complications.

Psychopathologic Evaluation in Patients With Nasal Bone Fractures.

Background: Nasal bone fractures are pretty common. The most common causes include interpersonal violence, traffic accidents, sports injuries, and falls. This study aimed to assess patients presenting with nasal bone fractures not only for nasal trauma but also for personality disorders, impulsivity, and attention-deficit/hyperactivity disorder (ADHD) using psychiatric questionnaires. Methods: The study included 41 patients, and the control group consisted of 43 volunteers without nasal bone fracture; neither the patients nor the volunteers had previously been diagnosed with or treated for psychiatric disorders. The psychiatric questionnaires administered were the Eysenck Personality Questionnaire Revised-Short Form (EPQR-S), the Barratt Impulsivity Scale-Short Form (BIS-11-SF), and Turgay's Adult ADD/ADHD DSM-IV-based Scale. Results: The most common cause of nasal bone fractures in our study was violence (41.5%), followed by traffic accidents (29.3%), falls (17%), and sports injuries (12.2%). In the EPQR-S assessment, the nasal bone fracture (NBF) group had significantly-higher total scores than the control group (CG) (P < .001). In the subscales of the questionnaire, extroversion, psychoticism, and lie subscale scores were higher in the NBF group than in the CG. In the BIS-11-SF assessment, the NBF group had higher total scores than the CG (P < .001). Assessment using Turgay's adult ADD/ADHD DSM IV-based diagnostic screening and rating scale revealed no statistically-significant difference between the NBF group and the CG in terms of attention deficit and hyperactivity. Conclusion: We found that psychoticism patterns and impulsivity were more prevalent in the patient group, whereas ADD/ADHD was not. The results of our study suggest that performing a psychiatric assessment may be the right decision in patients presenting with NBFs caused by violence, whether they are the aggressor or the victim.

Comparative Histopathological Analysis of Nasal Osteotomy Techniques in a Rabbit Model.

Objective: Nasal osteotomy is a crucial step in rhinoplasty, explicitly addressing the open roof deformity in nasal bones. This study aimed to assess and compare the recovery patterns associated with 4 distinct osteotomy techniques in a rabbit model. Materials and Methods: Twenty white New Zealand rabbits weighing 2.5 to 3.0 kg were included in the study. Median osteotomies were performed on the left side using piezosurgery and on the right side using an oscillating micro-saw. Additionally, internal osteotomy was executed on the right side and external osteotomy on the left side, both performed with a chisel across all rabbits. Ten rabbits were sacrificed on the 7th day, while the remaining 10 were sacrificed on the 15th day for subsequent histological examination. The granulation tissue formation (GTF), vascularization, inflammation, collagen fibril content, osteotomy gap width, and new bone formation were evaluated in hematoxylin and eosin and Masson's trichrome-stained sections. Results: On the 7th day, piezosurgery demonstrated statistically-significant advantages in terms of GTF, neovascularization, and collagen fibril quantity when compared to the oscillating micro-saw (P < .05). Furthermore, a statistically-significant difference was observed among the groups concerning the distribution of connective tissue organization between the 7th and 15th days (P < .05). Conclusions: This study's findings unequivocally establish that bone healing after osteotomy with piezosurgery surpasses that achieved with an oscillating micro-saw in this rabbit model.

Affinities of the Sargat Population in the Baraba Forest-Steppe

Within-group, between-group, and comparative analysis of craniometric data relating to local and chronological samples of the Sargat population (5th century BC to late 3rd / 4th century AD) was carried out. The study focuses on sample from the Baraba forest-steppe. Comparative analysis, performed with the principal component method, included Early Iron Age samples from adjacent territories. No discontinuity was found in the spatio-temporal cranial variation among the Sargat groups. Despite differences between the three Sargat samples (Baraba, Irtysh, and Trans-Ural), they all represent one and the same Caucasoid physical type, characterized by meso-brachycrany, medium-high braincase, wide low, and somewhat flattened face, moderately inclined frontal bone, and protruding nasal bones. The Baraba group differs from two others by a wider face, larger pyriform aperture, and largest dacryal width. Comparative statistical analysis indicates affinities of the male part of Sargat groups with nomads of the Urals and Kazakhstan—Saka, Sauromatians, and Sarmats. Possibly, military campaigns by the Achaemenid state against the nomadic tribal unions of Central Asia in the second half of the 6th century BC triggered the migration process. Initially, migrants moved to the Irtysh basin, and thence to the western (Trans-Ural) and eastern (Baraba) peripheries of the emerging Sargat culture. The female part of the population was less affected by migratory processes. Female samples of the Sargat reveal an autochthonous cranial complex.

Head, face and neck injury patterns for electric scooter accidents identified on computed tomography scanning: Does legislative change enforcing safer riding practices have an impact on morbidity for significant head, face and neck trauma?

The purpose of this study is to review whether legislative change enforcing safer riding conditions for Electric Scooters (E-Scooter), regardless of other factors, had an impact on reducing significant head, facial and neck trauma. Additionally, to identify the radiological injury patterns for head, face and neck injuries identified on CT imaging for a patient's initial presentation to the emergency department (ED) resulting from an E-Scooter accident. A retrospective single-centre observational study at a metropolitan tertiary ED of patients presenting after an E-Scooter accident comparing 6 months before and after legislative change. Four hundred and forty-three patients presented following an E-Scooter accident: 191 patients 6 months before and 252 patients 6 months after legislative change. One hundred and sixty-two patients pre- and 217 patients post-legislative change had negative CT studies. Twenty-nine patients pre- and 35 patients post-legislative change had CT studies demonstrating significant head, face or neck trauma. The most common type of intracranial bleeding was subarachnoid haemorrhage followed by subdural haemorrhage with a significant proportion (41%) presenting with multi-factorial intracranial bleeding. There was no specific injury pattern involving the cranial vault or cervical spine. Of the patients presenting with a significant injury, facial bones were the most common injury site (84% (n = 54)). The most common site of facial fractures was the nasal bones followed by dental trauma and maxillary fractures. This single-centre, retrospective observational study has shown no reduction in serious head, neck and facial injuries. Large-scale, multicentre studies will need to be undertaken to understand the true impact of legislative change.

Nasal bone modification compared to normal growth after rapid maxillary expansion anchored onto deciduous teeth: a CBCT retrospective study.

The present study was designed to evaluate the enlargement of the nasal bone as side effect when a treatment with a Haas rapid maxillary expander is performed in early mixed dentition. The CBCT imaging of 36 children (mean age 8,4; SD,1,5) were retrospectively selected and then traced in order to evaluate the change in the nasal bone (primary outcome) and in the maxilla (secondary outcome). Five distances and one angle were measured: upper and lower nasal bone width (UNBw and LNBw) as well as its inclination (NBi), and the maxillary bone at the level of infraorbital foramen (IOFw), the nasolacrimal duct (NLDd), and greater palatine foramina (PFd). The sample was divided in a treatment group (26 subjects; 14 males; 12 females; mean age 8,0; SD 0,9), comprising children who underwent to a rapid maxillary expansion, and a control group (10 subjects; 7 males; 3 females; mean age 9,3; SD 2,3) including untreated children homogeneous for dental age to the treated subjects. Measurements were performed at baseline or before the treatment (T0), and after 2 years (T1). The transversal modification induced with a rapid maxillary expansion was limited to the maxilla without involving the nasal bones when the treatment was performed in early mixed dentition. The changes recorded in the nasal bones seem to be the same of what happens during normal growth.

Management of Acute Nasal Bone Fractures in Adults: Systematic Review and Meta-Analysis

Management of Acute Nasal Bone Fractures in Adults: Systematic Review and Meta-Analysis

Clinical application of submandibular endotracheal intubation in craniomaxillofacial fracture

ObjectiveTo explore the clinical application of submandibular endotracheal intubation in craniomaxillofacial fractures. MethodsThe submandibular endotracheal intubation was used to treat 10 patients with cranio-maxillofacial fractures and contraindications to nasal intubation.Ventilator monitoring data including SPO2(oxygen saturation of blood), Freq,VT,MV,PEEP, PLAT and PEAK were monitored before and after the operation of submandibular endotracheal intubation. The technique of submandibular intubation was assessed intraoperatively and in the postoperative period. The outcomes and complications are presented. ResultsThe study included 10 patients aged between 18 and 63 years(6 males and 4 females). All patients had mandibular fractures, with 6 midface fractures (60 %), 5 nasal bone fractures (50 %), 6 zygomatic bone fractures (60 %). The procedure time ranged from 6 to 10 min (mean, 7.9 min). NO delayed extubation was performed in 10 cases. The technique has proved to be straightforward and satisfactory. A postoperative superficial infection occurred in 1 patients, whereas hypertrophic scars occurred in another 1 patients. ConclusionSubmandibular endotracheal intubation is a safe procedure for intraoperative airway control in maxillofacial trauma patients who present contraindication to nasotracheal intubation.

Anatomical Variations in Keystone Area in Nepalese Noses: A Descriptive Cross-sectional Study

Introduction: The keystone area, a crucial part of the nasal dorsum that maintains its structural stability, is known to have anatomical variations. This study aimed to evaluate these anatomical variations in Nepalese noses. Methods: This was an observational, analytical study done at a tertiary center after taking ethical approval {208(6-11)E2-077/078}. Thirty-one cadaveric noses consisting of 26 males and five females aged 24 to 70 years were dissected. The shape of the caudal margin and the overlap pattern of the nasal bone over upper lateral cartilage were assessed. The proportion of overlap was calculated. The lengths of the lateral and dorsal keystone and dorsal quadrangular cartilage were measured. Results: The most common shape of the nasal bone caudal margin was curvilinear 15 (48.39%) followed by paramedian retractions 8 (25.81%). Elongated midline was the least commonly seen in 1 (3.23%) female only. The length of the dorsal keystone ranged from 1-12 mm (mean 6.97 ± 2.57) whilst the lateral keystone measured 1-4 mm (mean 2.22± 1.20). The dorsal quadrangular cartilage measured 21 – 39 mm ( mean 29.77± 4.6). The mean overlap proportion was 23.82± 7.33 (11 – 40) %.Conclusions: Anatomical variations in the structural components of the keystone area in Nepalese was seen in this study.

Surgical management of a lateral sphenoid sinus encephalocele: 2-Dimensional operative video

Encephaloceles are considered rare with an approximate incidence of 1 in 35,000, and sphenoid encephaloceles are even more uncommon.2 Two types of sphenoid encephaloceles exist: medial perisellar encephaloceles, and lateral sphenoidal encephaloceles. Surgical correction of the lateral sphenoid recess encephalocele is achieved via one of two endoscopic approaches: extended sphenoidotomy or transpterygopalatine. Extended sphenoidotomy is preferred if the angle between the access door and lateral extension of bone defect is greater than 35°1. Otherwise, the transpterygopalatine approach is used. Intraoperative video demonstrating an extended sphenoidotomy approach to correcting a lateral recess sphenoidal encephalocele has not previously been published.Here we present a case of a 41-year-old female who presented with meningitis, a cerebrospinal fluid leak, and an incidental sphenoid mass. Brain MRI redemonstrated the mass in the sphenoid sinus consistent with an encephalocele occupying Sternberg's Canal. The patient consented to the procedure. The video demonstrates the skull base approach, encephalocele extraction, collagen inlay, and nasal septal bone and vascularized pedicled nasoseptal flap placement. Postoperative imaging confirmed the placement of the collagen inlay and nasal septal bone autograft. The patient recovered from surgery and was discharged on post-operative day 3 with no cerebrospinal fluid (CSF) leak recurrence. Postoperative follow up demonstrated viable nasoseptal graft without evidence of CSF leak.For patients with favorable anatomy, an extended sphenoidotomy approach to lateral sphenoid sinus encephalocele resection is a preferred alternative to the transpterygoid approach. This surgical video demonstrates the technique for managing lateral sphenoid sinus encephaloceles occupying Sternberg's canal, including endonasal approach, encephalocele resection and posterior sphenoid wall repair.

Long-Term Three-Dimensional Morphometric Outcome Study of Nasal Bone in Cleft Patients.

Cleft lip nose deformities are characterized by underlying features in the bony skeleton as well as the soft tissues; however, no previous study has focused on the evaluation of the nasal bone. The aim of this study was to compare nasal bone features among adult patients with unilateral cleft lip with or without cleft palate, those with bilateral cleft lip and palate, and controls. Included in this retrospective study were patients aged ≥16 years with nonsyndromic cleft who underwent long-term orthodontic treatment and controls aged 18-45 years who underwent surgery for jaw deformities at Keio University Hospital. Piriform width, nasal width, and nasomaxillary angle values measured on CT were compared among the groups using the Wilcoxon rank sum test. Nine patients had unilateral cleft lip and alveolar cleft, 19 had unilateral cleft lip and cleft palate, and 14 had bilateral cleft lip and palate (BCLCP). There were 18 controls. Mean piriform width and mean nasomaxillary angle were significantly greater in the BCLCP group than the control group (20.1±2.54mm versus 18.8±1.35mm, P<0.05; and 105.8±8.13 degrees versus 100.4±7.95 degrees, P<0.05, respectively). There was no significant difference in mean nasal width among the groups. Nasal bone morphology was not affected by initial cleft lip alone or by the presence or absence of cleft palate. Patients with bilateral cleft lip and palate have a wider and lower nose than those without cleft deformity and might benefit more from reduction of the bony nasal width than from treatment of the soft tissues.

Dorsal roof flap rhinoplasty: Updated results and a new classification of nasal dorsal deformity

BackgroundThe dorsal roof flap (DRF) technique was developed as a modification of the retractable roof method (1), which is a variant of dorsal preservation (DP). ObjectiveThe paper aims to present new results of the DRF technique and dorsal deformity analysis created for the technique. MethodsA total of 57 primary rhinoplasty patients treated with DRF technique between 2022-2023 years were included in the study. A dorsal deformity classification based on the anticipated amount of dorsal reduction, nasal bone shape, and hump content was used. According to the classification, the noses were categorized into 3 types. All data were obtained from patient records, computed tomography views, and pre-and postoperative photographs. Aesthetic and functional results were assessed pre-and postoperatively using a visual analog scale (VAS) (0-10, 0 points means very poor). ResultsThe mean follow-up period was 10.1±3.9 months. 23 cases were type 1, 14 were type 2, and 20 were type 3. The anticipated amount of dorsal reduction in type 1 was 2-4mm, 5-7mm in type 2, and 8-10mm in type 3 deformity. Of the total, 27 cases had a V-shaped nasal bone and 30 had an S-shaped. The hump composition was cartilaginous in 13 cases and bone and cartilage in 44 cases. Pre- and postoperative aesthetic and functional VAS scores were significantly different (p ≤0.001). No complications and therefore no revisions were observed during the follow-up period. ConclusionIt is a versatile method to reshape the nasal dorsum and minimize the revisions associated with dorsal preservation when used in appropriate cases.

Big Data Analysis of Facial Fracture Epidemiology in South Korea From 2015 to 2020: Impacts of Aging and Personal Mobility.

The epidemiology of facial fractures is continuously evolving due to various influencing factors, including social, economic, and technological advancements. Thus, an updated analysis of facial bone fractures is necessary. This study aimed to provide an updated epidemiological analysis of facial bone fractures and assess severity using multiple factors. We retrospectively reviewed patients who underwent facial bone fracture surgery at 3 teaching hospitals in South Korea between January 2015 and December 2020. Data collected included patient demographics (sex and age), trauma mechanism, alcohol intoxication status, and fracture types. Trauma mechanisms were categorized into 7 groups: assault, fall, sports, occupational injury, motor vehicle crash, bicycle, and personal mobility. Severity was assessed using the modified facial injury severity scale. A total of 5953 patients (4437 males and 1516 females) were included, with ages ranging from 1 to 92 years (mean age: 36.37±18.61y). A steady decline in the number of patients was observed from 2015 to 2020. Falls were the most common cause of facial fractures (2300 cases, 39%), and nasal bone fractures were the most frequent type (3683 cases, 46%). The number of elderly patients (> 60y) and injuries caused by personal mobility devices increased steadily. Male sex and alcohol intoxication were associated with higher severity scores. Motor vehicle crashes had the highest severity scores (2.246). While the incidence of facial bone fractures has decreased in recent years, the proportion of elderly patients and injuries caused by personal mobility devices is increasing, posing a significant burden on the health care system.

Primary Open Reduction and Internal Fixation of Isolated Compound Depressed Nasal Fractures.

The aim of this study was to assess the efficacy of primary open reduction and internal fixation (ORIF) utilizing the existing dorsal wound for the management of isolated nasal fractures characterized by significant depression and to determine its effectiveness in preventing the need for subsequent nasal revisions. A retrospective review was conducted on patients who underwent ORIF of nasal bone for isolated compound depressed nasal fractures from January 2018 to January 2024. The primary outcomes included the assessment of clinical and radiographic results postoperatively, focusing on nasal symmetry, projection, airway patency, and the incidence of secondary surgical interventions. The study included 15 patients, predominantly males (60%), with an average age of 39.33 years. The mechanisms of injury included motor vehicle accidents (40%), falls (26.7%), interpersonal violence (20%), and occupational injuries (13.3%). All patients were treated on the first (73.3%) or second day (26.7%) after the injury. All patients had satisfactory esthetic and functional outcomes and did not require secondary rhinoplasty. The hardware was removed in 4 patients (26.7%). Primary ORIF through an existing dorsal wound for significantly depressed isolated nasal fractures was effective in obviating the necessity for subsequent nasal revisions.

Defining of the nasal anthropometry on facial computed tomography in subjects with epilepsy and healthy subjects.

Epilepsy is a frequent chronic and genetic brain disease. In diagnose of genetic and craniofacial disease, the face is one of the gold standard phenotypic features. This study was carried out to determine the angle and linear measurements of face region in Turkish healthy and epilepsy subjects, and to apply a feature selection method to identify the most important attributes that affect epilepsy decision. The retrospective and observational study was conducted with 120 subjects with epilepsy aged between 18 to 60 years (56 males; 64 females) and 60 healthy subjects aged between 18 and 55 years (29 males, 31 females). Pyramidal angle performed from 3 reference points, nasal bone length, the width of piriform aperture, nasofrontal angle, nasolabial angle, distance between glabella and nasion were measured on computed tomography. Also, we used supervised machine learning to learn classification models to detect epilepsy as our dataset has class label where 1 means epilepsy, 2 means healthy. The well-known classification model learning algorithms implemented in Weka (with version 3.8.6) machine learning toolkit were applied. All parameters excluding nasal bone length were higher in epilepsy patients than in healthy subjects. Also, there was a significant difference in nasal pyramidal angle nasal bone, nasal pyramidal angle nasal tip, piriform aperture, and nasal bone lengths between epilepsy and healthy subjects. However, age related changes for healthy subjects were no seen in healthy subjects. In epilepsy subjects there was a significant difference in 6 measurements all nasal pyramidal angles, piriform aperture width, nasofrontal angle, and nasolabial angle. Gender related changes were found in only nasal pyramidal angle nasal root and nasal bone of healthy subjects, in nasal pyramidal angle nasal bone, nasal bone length, nasofrontal angle of epilepsy subjects. We can say epilepsy may affect the some facial parameters and these, although anthropometric measurements are affected by age and gender parameters. Comprehensive knowledge of this region's normal references ranges is essential for planning, proper selection of silicone implants or osteotomy determining the limitations of the surgical field and minimizing the risk of complication and performing aesthetic facial surgery or rhinoplasty in epilepsy patients.