Nasal Profiles Research Articles

A new method to quantify subtle morphological deformities in nasal profile curvatures and its application for analysis of unilateral cleft lip noses

The authors conducted the present study to elucidate what elements characterize the nasal profiles of patients with unilateral cleft lips (CLs). A total of 40 Japanese unilateral CL patients were studied. For each patient, the nasal profile curve was traced on three-dimensional computer tomography image. Then four points were marked on the contour. The points were NAS (Nasion), MAP (the Most Anterior Point on the nasal profile curve), GPRN (the Genuine Pronasale: the point on the nasal curve at which the curve protrudes most), and SBN (Subnasale: the point at the columellar base). Using specially designed software, the distances between these marking points were measured along the nasal profile curve. In CL patients, the distance between the MAP and GPRN is longer, and the GPRN is located more inferiorly than in non-cleft persons. The nasal tip tends to become round and to droop in unilateral CL patients. In order to avoid this deformity pattern, the nasal tip should be reshaped to present a sharper curvature and corrected superiorly.

Similar Cytokine Profiles in Response to Infection with Respiratory Syncytial Virus Type A and Type B in the Upper Respiratory Tract in Infants

Human respiratory syncytial virus (RSV) is the leading viral cause of severe respiratory illness in infants and young children worldwide. RSV isolates can be divided into 2 subgroups, type A and type B. Here, we compare for the first time the nasal profiles of 27 immune mediators in response to both viral subtypes in 14 children infected with RSV/A, 8 children infected with RSV/B, 11 children coinfected with RSV/A plus other respiratory viruses, and finally, 27 control children, all <2 years old. Our results evidence that children’s infection with both RSV subtypes induces very similar profiles of immune mediators in the upper respiratory tract, characterized by the elevation of Th1 and Th2 cytokines, chemokines and growth factors. Interestingly, no major differences in the profiles of the immune mediators were found between the children infected exclusively with RSV/A and those infected with RSV/A plus other respiratory viruses.

Peripheral retinal shape measurements, using the IOLMaster, in myopia and hyperopia

Purpose: When measuring peripheral retinal shape using the IOLMaster, measurements have been taken with the instrument in a fixed position and the subjects rotating their eye to measure peripherally. However, eye rotation could affect the peripheral ocular shape measures. The aim of this experiment is to determine the effect of eye rotation upon the measurement of peripheral retinal shape in myopic and hyperopic subjects using the IOLMaster.Methods: 20 subjects participated with informed consent in the experiment [10 myopes (MYO) and 10 hyperopes (HYP)]. All subjects were visually normal with visual acuity of 0.0 logMAR or better. The mean age of the subjects was 21.4 ± 2.2 years, and all were students in the University. Cycloplegia and mydriasis were induced using 1.0% cyclopentolate and the measurements were taken 30 min after instillation of the eyedrops. Peripheral retinal dimensions were measured with the IOLMaster (Carl Zeiss Ltd., Welwyn Garden City, UK) which measures axial length using partial coherence interferometry. 5 measures of axial length were taken at 10 degree intervals from 0–40 degree nasally and temporally using two different experimental paradigms. Experiment 1: Subjects rotated their eye to view an LED target array, attached to the front of the instrument. Experiment 2: Subjects maintained fixation upon a stationary target in the primary position while the IOL‐Master was rotated about the centre of rotation of the eye. The data was fitted with second order polynomials with separate curves being fitted to the temporal and nasal profiles to take into account any retinal asymmetry.Results: A significant difference (p &lt; 0.01) was found in the mean second order coefficients for the temporal and nasal retinal profiles in the MYO subjects, with the temporal retina having the lower coefficient. There was no significant difference between temporal and nasal second order coefficients in the HYP subjects. Eye rotation produced a significant shift in the second order coefficients for both temporal (p &lt; 0.01) and nasal (p &lt; 0.01) retinal profiles in the MYO group, with the coefficients becoming smaller with ocular rotation. No significant effect of eye rotation was found in the HYP group.Conclusions: Asymmetry between the temporal and nasal retinal profiles is more pronounced in the myopic eye. Ocular rotation has a substantial and measurable effect on the shape of the myopic eye, but no measurable effect is found in the hyperopic eye. These results are indicative of substantial structural differences between the eyes of subjects with myopia and hyperopia. When measuring peripheral retinal shape these factors should be taken into account.

Knowledge-Dependent Pattern Classification of Human Nasal Profiles

(1) To determine feature vector representations (geometric pattern parameters) that are effective in describing human nasal profiles, (2) to determine the number of code vectors (typical nasal patterns) that are mathematically optimized by applying the vector quantization method to each feature vector extracted for each subject, and (3) to determine the morphological traits of each code. Lateral facial photographs of 200 Japanese women recorded for orthodontic diagnosis were selected. Five anatomic landmarks were identified on each image together with a set of data points that constituted the contour of the facial profile. An eight-dimensional feature vector effective in distinguishing differences in nasal profile patterns was extracted from the data set using experts' knowledge of the anatomic traits of the nose. The vector quantization technique was applied to the feature vectors to provide the optimum number of nasal profile patterns. The number of code vectors mathematically optimized was six, and the differences between vectors were maximized by morphological traits of the root, dorsum, tip, and base of the nose. Proportions of the number of image records classified into each code were 25.5%, 24.5%, 21.5%, 15.0%, 10.0%, and 3.5% from code 1 to code 6, respectively. Classifying nasal profile patterns based on knowledge from a linguistic description was found to be more effective than a method based on uniform sectioning. The differences between vectors were maximized by morphological traits of the root, the dorsum, the tip, and the base of the nose.

The Role of Nasal Feminization Rhinoplasty in Male-to-Female Gender Reassignment

To objectively assess the results of rhinoplasty in feminizing the facial profiles of male-to-female transsexual patients undergoing gender reassignment. Twelve patients underwent nasal feminization as part of male-to-female gender reassignment. Global assessments of facial profile were performed, and nasofrontal, nasolabial, and supratip angles and the Goode ratio were objectively measured. Postoperative and long-term patient satisfaction was assessed. The surgical procedures created more feminine nasal profiles in all patients. The mean +/- SD nasofrontal angle changed from 141.6 degrees +/- 6.0 degrees to 150.5 degrees +/- 5.5 degrees (P < .001). The nasolabial angle changed from 107.4 degrees +/- 14.3 degrees to 115.2 degrees +/- 11.7 degrees (P < .001), and the supratip angle from 1.7 degrees +/- 4.9 degrees to 12.8 degrees +/- 5.8 degrees (P < .001). The Goode ratio did not change significantly, remaining on average around 1.64 +/- 0.15. In 4 cases, spreader grafts were used to reconstruct the nasal valve, and no cases of valve insufficiency occurred. Rhinoplasty is effective in achieving feminine facial profiles in patients undergoing male-to-female gender reassignment. This requires reducing the overall nasal size and changing nasal angles to those more reminiscent of the female form. Because of the extensive resections often required to modify the nasal form, it is important to pay particular attention to preserving function, which may require concomitant nasal valve reconstruction.

The ideal nasal profile: rhinoplasty patients vs the general public.

To evaluate whether patients seeking reduction rhinoplasty hold a different concept of the ideal nose than does the general public, and to determine what features characterize the ideal nasal profile. Twenty-seven patients seeking reduction rhinoplasty and 15 randomly selected members of the public evaluated a series of computer-manipulated photographic profiles using a pictorial visual analogue scale to rate their preferences for several variables. Center-scale images were created from mesh-warped ("morphed") computer averaging of 12 white women. Differences between the rhinoplasty group and the public group were then compared, as was each group's deviation from the center of the scale. Both groups preferred narrowly distributed differences from the "average" profile to a high degree of significance. No statistically significant difference was found between the ideal nasal profiles selected by the rhinoplasty group and the public group. Reduction rhinoplasty patients do not appear to have a different concept of the ideal nose than does the public at large. The ideal nose, as it pertains to the ideal white female profile, has characteristics that differ from a mathematically averaged nasal profile.

COMPUTATIONAL FLUID DYNAMICS SIMULATIONS OF INSPIRATORY AIRFLOW IN THE HUMAN NOSE AND NASOPHARYNX

Extrapolation of the regional dose of an inhaled xenobiotic from laboratory animals to humans for purposes of assessing human health risk is problematic because of large interspecies differences in nasal respiratory physiology and airway anatomy. There is a need for dosimetry models that can adjust for these differences in the upper respiratory tract. The present work extends previous efforts in this laboratory and elsewhere to simulate nasal airflow profiles numerically in laboratory animals and humans. A three-dimensional, anatomically accurate representation of an adult human nasal cavity and nasopharynx was constructed. The Navier-Stokes and continuity equations for airflow were solved using the finite-element method under steady-state, inspiratory conditions simulating rest and light exercise (steady-state inspiratory flow rates: 15 L/min and 26 L/min, respectively) with the fluid dynamics software package FIDAP. Simulated airflow was streamlined in the main nasal passages and complex in the vestibule and nasopharynx. Swirling air currents and recirculating flow were predicted in the nasal vestibule, and the expansion at the nasopharynx gave rise to two downward, countercurrent, spiraling vortices. Significant lateral flow was observed mainly in the middle lateral meatus. Flow apportionment among different regions of the nose remained almost unchanged between the two inspiratory rates simulated. Fastest flow occurred in the posterior nasal valve region. In the main nasal airway, the highest airspeeds occurred through the ventral and middle medial regions. Simulated velocity fields and pressure drops across the nasal cavity generally agreed with experimental results from the literature. It is proposed that this model can be used to reduce uncertainty in human health risk assessment for inhaled materials and to assess changes in airflow and nasal resistance due to common surgical procedures and medical conditions.

Quantitative analysis of nasal tip projection.

Previously described methods for quantifying nasal tip projection were evaluated. Fifty-one nasal profiles were analyzed and scored by expert rhinoplastic surgeons. The noses and faces were then evaluated quantitatively using several methods. The methods were found to vary widely in their correlation with the experts' subjective analyses. Several helpful relationships and guides were obtained: 1. Aesthetic tip projection does not correlate well with upper lip length. 2. A new method described in this paper showed the best correlation with the experts' opinions (regression, r value = 0.8132). This method related tip projection to total nasal length (including upper lip length). 3. The second new method tested in this report yielded helpful data by comparing tip projection with overall facial length. 4. After slight modification the method previously described by Goode proved useful as nasal length and desired tip projection formed a 3:4:5 right triangle.

Nasal tip projection changes related to cheeks and lip.

Nasal profiles are altered in almost every rhinoplasty operation. Often neglected in diagnosis and surgery are alterations in profiles of the cheeks and upper lip that should be made at the same time. We show aesthetic effects produced by alterations in these structures and describe how we measure and record the adjustment. A few examples of results are presented to indicate the techniques used and the importance of including changes in profiles of the cheeks and upper lip in cosmetic rhinoplastic diagnosis and treatment.