Zygomatic Region Research Articles

Primary squamous cell carcinoma of the parotid salivary gland: a clinical observation

Introduction. Malignant tumors of the salivary glands account for 3–5 % of all cases of head and neck cancer. Squamous cell carcinoma is the rarest histological variant of this pathology. It accounts for an average of 1.6 %. Among large salivary gland tumors, squamous cell carcinoma most often occurs in the parotid salivary gland.Aim. To present a clinical case of primary disseminated cancer of the parotid salivary gland with squamous cell structure.Clinical observation. A 70-year-old patient was under observation who was diagnosed with a primary squamous cell tumor of the parotid salivary gland with multiple metastases during a complex examination. He was sick for about 6 months when asymmetry of left half of the face appeared due to a painful neoplasm in the parotid salivary gland. Recently, the patient has noted increased tumor growth. Objective examination revealed peripheral paralysis of the facial nerve on the left. In the parotid-masticatory region on the left, with a transition to the zygomatic region, there is a dense painful immobile exophytic tumor with infiltration into soft tissues of the face and skin 6.5 × 5.0 cm in size with an ulcer in the center. Laterally, it reaches the tragus, and at the bottom-the angle of the lower jaw. In the submandibular region on the left, metastatic lymph nodes 2.5 × 2.0 cm in size are palpated. A biopsy was collected. Histological conclusion: non-keratinizing squamous cell carcinoma. Expression of the programmed death receptor ligand (PD-L1) in the tumor is negative. Mutations of genes Her2-neu and BRAF were not detected. According to medical imaging methods, multiple metastases were found in the lungs, liver, zygomatic bone and tumor growth in the maxillary sinus on the left. The diagnosis was established: cancer of the parotid salivary gland, stage IVC, cT4N1M1, with metastases to the liver, lungs and bones. Polychemotherapy was prescribed according to the scheme: 5-fluorouracil + cisplatin + cetuximab + bisphosphonates. After 3 cycles, a partial regression is obtained.Conclusion. The primary squamous cell carcinoma is prone to an aggressive course and has an unfavorable prognosis, especially in patients over 60 years of age with skin and facial nerve damage, as well as the presence of regional and distant metastases. Differential diagnosis is necessary to exclude the secondary nature of the tumor. The presented case is a rare example of primary squamous cell carcinoma of the parotid salivary gland with extensive metastatic lesion and regression of the pathological process after polychemotherapy in combination with targeted therapy.

Primary Epithelioid Sarcoma of Frontotemporal Scalp: a Rare Case Report with Recent Literature Review

Epithelioid sarcoma (ES) is a very rare and aggressive mesenchymal sarcoma subtype which represents less than 1% of soft tissue sarcomas (STS). According to the origin of the site, there are two types of ES: distal-type epithelioid sarcoma and proximal-type epithelioid sarcoma. The clinical diagnosis of ES mainly is confirmed by histopathology examination followed by immunohistochemistry. Radical excisional surgery is the best treatment option for epithelioid sarcoma. According to TNM staging, the treatment option will vary from surgery to surgery accompanied with radiotherapy and chemotherapy. Here in, we presented a 36-year-old man had non-healing ulcer in left frontotemporal scalp extending to involve left orbit. Histopathological confirmed epithelioid sarcoma. Magnetic Resonance Imaging (MRI) of Head and Neck revealed that there was mass in left frontotemporal scalp measuring 6.7 X 5.7 X 2.6 cm extending to zygomatic region and left orbit D/D malignant mass/sarcoma with bilateral (B/L) sinusitis. After that patient undergone for Wide Local excision (WLE) surgery on 11th September 2022. Adjuvant Radiation Therapy (RT) 6000 cGy radiation dose in 30 fractions (#) which was 200 cGy per fraction (#) were given during 22nd September to 10th November 2022 due to local advancement of disease. Patient was asked to follow up after 6 weeks after completion of RT. After 6 weeks of surgery, the patient was undergone for MRI and report revealed normal study.

Neodymium long-pulse laser as a monotherapy for unaesthetic vessels of various locations: a series of clinical observations

The article presents a series of clinical cases describing the successful use of the long-pulse neodymium laser in removing unaesthetic reticular veins and telangiectasia of various locations. The first two cases demonstrated reticular varicose veins of the lower limbs in female patients with a fear of injections, which were treated without compression garments and ecchymoses with excellent effect. The outcome of treatment was comparable with that of classical sclerotherapy. The third case showed a successful laser removal of large telangiectasias on the hands, which developed following the long-term use of injection narcotic drugs as part of trophovegetoneurosis. Such pathology is rare for medical practice and approaches to its treatment have not been developed. The fourth case showed large telangiectasias of the buccal and zygomatic regions A good effect after the use of a large diameter spot in that area was demonstrated. The fifth case demonstrated the treatment of the veins in the buccal region, including the vein curving over the mandibular angle. The outcome of the treatment allowed to evaluate not only the aesthetic effect of the procedure, but also the severity of side effects in that area. In the sixth case, the periorbital vein, which divides into two branches, was investigated. The treatment was successful despite the different structure of the vein wall and depth of occurrence. The seventh case demonstrated the removal of large temporal veins. The outcome of treatment was presented on the following day, reflecting the degree of visual discomfort in the early post-procedure period. The final outcome a month after treatment was also demonstrated. In conclusion, the eighth case demonstrated the effectiveness of the treatment of scattered small red telangiectasias on the face using a long-pulse neodymium laser.

Nasal Gouty Tophus

A 48-year-old, non-hypertensive, non diabetic man with uncontrolled gouty arthritis presented with a four-day swollen nasal mass. He was assessed to have a nasal abscess at the emergency room and was admitted for urgent management. Paranasal computed tomography (CT) scans showed a heterogeneously enhancing focus with areas of hypodensities in the nasal apex and dorsum extending into the right ala measuring 1.5 x 2.8 x 3.4 cm. with associated erosion of the cartilaginous part of the anterior nasal septum, soft tissue swelling and skin thickening in the nasal dorsum, nasal tip and right zygomatic region that was suspected to relate to an aggressive etiology. Tissue correlation was therefore recommended, and he underwent endoscopic-guided incision and drainage with biopsy and debridement of the nasal mass. The specimen submitted consisted of red to white, irregular, soft tissue fragments with an aggregate measurement of 1.5 x 1.5 x 0.5 cm. Microsections showed deposits of amorphous white to pink material with surrounding fibrosis and acute and chronic inflammatory cell infiltrates and foreign body giant cells. (Figures 1 and 2) Also seen in the background were fragments of sclerotic bone and bacterial colonies. These findings were consistent with gouty tophus with acute and chronic inflammation and bacterial colonization. The culture and sensitivity test of the nasal discharge showed growth of Enterobacter aerogenes (currently named Klebsiella aerogenes) which was identified by an automated mass spectrometry microbial identification system (VITEK® MS). Work-up also included uric acid levels which were within the reference interval at that time (6.57 mg/dL).

The relationship between biological parameters and facial soft tissue thickness measured by ultrasound and its forensic implications.

Facial soft tissue thickness (FSTT) data are currently widely used in forensic and medical science. In the forensic sciences, they form the basis for craniofacial reconstruction and identification methods. Since there are few FSTT data in the Slovak population, this study aims to enrich the data in well-defined age categories, taking into account differences between sexes and body mass index (BMI). The sample consisted of 127 participants aged 17 to 86 years from Slovakia. In addition to biological sex and age information, stature and body weight were recorded to calculate BMI. Subsequently, 17 facial anthropometric landmarks were used to measure FSTT using a noninvasive General Electric LOGIQe R7 ultrasound device. The mean values of FSTT were greater in the mouth region in males and in the zygomatic and eye regions in females. Differences between males and females, regardless of sex and BMI, were significant only at two landmarks. When BMI and age were taken into account, there were differences in 12 of 17 landmarks. Linear regression results showed the strongest correlation of most landmarks with BMI, followed by age and sex. When the FSTT was estimated in association with sex/age/BMI, landmarks in the zygomatic, mandibular, and frontal regions were the best regressors. The results of the present study demonstrate that B-mode ultrasound measurements of FSTT can be used in facial reconstruction as a function of BMI, age, and sex of the subject. Furthermore, the present regression equations can help practitioners in the forensic/medical field to calculate individual tissue thickness.

RHABDOMYOSARCOMA WITH EPITHELIOID AND SPINDLE CELL MORPHOLOGY IN THE HEAD AND NECK REGION: REPORT OF THREE CASES.

Rhabdomyosarcoma with TFCP2 rearrangement has recently been described as an aggressive tumor with a predilection for the craniofacial bones. We report three new cases with detailed clinicopathologic, immunohistochemical, and molecular descriptions. Case 1 is a 58-year-old male with a three-month history of painful swelling in the anterior maxilla. Case 2 is a 22-year-old male presenting with right facial swelling and proptosis. Case 3 is a 43-year-old female with a rapidly growing tumor located in the zygomatic region. Imaging exams revealed highly destructive intraosseous masses in cases 1-2 and a soft tissue tumor without bone involvement in case 3. Microscopically, all cases showed a hybrid spindle and epithelioid phenotype that were positive for desmin, myogenin and/or Myo-D1, cytokeratin, and ALK. FISH confirmed molecular alterations related to EWSR1/FUS-TFCP2 gene fusions in Cases 1-2. There was no available material for molecular study in case 3. The patients were subsequently referred to oncologic treatment. Rhabdomyosarcoma with TFCP2 rearrangement has recently been described as an aggressive tumor with a predilection for the craniofacial bones. We report three new cases with detailed clinicopathologic, immunohistochemical, and molecular descriptions. Case 1 is a 58-year-old male with a three-month history of painful swelling in the anterior maxilla. Case 2 is a 22-year-old male presenting with right facial swelling and proptosis. Case 3 is a 43-year-old female with a rapidly growing tumor located in the zygomatic region. Imaging exams revealed highly destructive intraosseous masses in cases 1-2 and a soft tissue tumor without bone involvement in case 3. Microscopically, all cases showed a hybrid spindle and epithelioid phenotype that were positive for desmin, myogenin and/or Myo-D1, cytokeratin, and ALK. FISH confirmed molecular alterations related to EWSR1/FUS-TFCP2 gene fusions in Cases 1-2. There was no available material for molecular study in case 3. The patients were subsequently referred to oncologic treatment.

TREATMENT OF SEVERE BUCOSINUSAL FISTULA DUE TO MYIASIS WITH PEDICULATED FLAP OF THE BUCAL FAT PAD

This work aimed to report a surgical rehabilitation of a bucosinusal fistula resulting from myiasis from closure with a Bichat's fat pad. An 81-year-old female patient came to our dental office with sequelae due to myiasis. During the clinical examination, bucosinusal communication was observed, and with the help of cone-beam computed tomography, we observed a loss of bone structures of the middle third in the right face hemi, reaching the zygoma and zygomatic pillar region. Immediate treatment was the rehabilitation of the oroantral fistula region with pediculated flap of the buccal fat pad, which is highly vascularized. Adipose tissue exposed by blunt dissection and without major tensions, suffers metaplasia serving as a bed for epithelium growth from 2 to 3 weeks without the need for coating with skin grafts. In conclusion, the use of Bichat´s ball was a successful alternative to rehabilitation of the oroantral defect. This work aimed to report a surgical rehabilitation of a bucosinusal fistula resulting from myiasis from closure with a Bichat's fat pad. An 81-year-old female patient came to our dental office with sequelae due to myiasis. During the clinical examination, bucosinusal communication was observed, and with the help of cone-beam computed tomography, we observed a loss of bone structures of the middle third in the right face hemi, reaching the zygoma and zygomatic pillar region. Immediate treatment was the rehabilitation of the oroantral fistula region with pediculated flap of the buccal fat pad, which is highly vascularized. Adipose tissue exposed by blunt dissection and without major tensions, suffers metaplasia serving as a bed for epithelium growth from 2 to 3 weeks without the need for coating with skin grafts. In conclusion, the use of Bichat´s ball was a successful alternative to rehabilitation of the oroantral defect.

A common ecogeographic trend in the internal nasal cavity variation across Mesolithic to Bronze Age Eastern European and Caucasian populations

AbstractThe ecogeographic trends in the shape of the internal nasal cavity and external facial skeleton were explored in a sample of Mesolithic, Neolithic, and Bronze Age skulls from Northeastern Europe and the Caucasus and tested against a background of the variation in recent populations from the same area. The volume, surface area, and several linear dimensions of the internal nasal cavity as well as a set of 3D landmarks of the external mid‐face were collected in a sample of computed tomography (CT) scans of 121 adult male skulls from six modern human populations of Eastern Europe, Anatolia, and Caucasus (74 individuals) and seven ancient burial sites (47 individuals). Various measures of the association between nasal cavity morphology and climate revealed moderate to high levels of correlation. The modern populations from colder climates and all but one ancient group display a substantial decrease in the nasal cavity heights and widths, volume and nasal protrusion, a relative narrowing of the nasal cavity, and a substantial increment in length of the maxillary part of the cavity. These groups also exhibit a less protruding external nose, smaller orbits, and a vertically taller zygomatic region. Our results show that the suite of morphological features associated with living in a cold climate is more strongly pronounced in ancient Europeans compared with the Medieval or modern groups of the same continent.

Is Convolutional Neural Network Accurate for Automatic Detection of Zygomatic Fractures on Computed Tomography?

Zygomatic fractures involve complex anatomical structures of the mid-face and the diagnosis can be challenging and labor-consuming. This research is aimed to evaluate the performance of an automatic algorithm for the detection of zygomatic fractures based on convolutional neural network (CNN) on spiral computed tomography (CT). We designed a cross-sectional retrospective diagnostic trial study. Clinical records and CT scans of patients with zygomatic fractures were reviewed. The sample consisted of two types of patients with different zygomatic fractures statuses (positive or negative) in Peking University School of Stomatology from 2013 to 2019. All CT samples were randomly divided into three groups at a ratio of 6:2:2 as training set, validation set, and test set, respectively. All CT scans were viewed and annotated by three experienced maxillofacial surgeons, serving as the gold standard. The algorithm consisted of two modules as follows: (1) segmentation of the zygomatic region of CT based on U-Net, a type of CNN model; (2) detection of fractures based on Deep Residual Network 34(ResNet34). The region segmentation model was used first to detect and extract the zygomatic region, then the detection model was used to detect the fracture status. The Dice coefficient was used to evaluate the performance of the segmentation algorithm. The sensitivity and specificity were used to assess the performance of the detection model. The covariates included age, gender, duration of injury, and the etiology of fractures. A total of 379 patients with an average age of 35.43±12.74years were included in the study. There were 203 nonfracture patients and 176 fracture patients with 220 sites of zygomatic fractures (44 patients underwent bilateral fractures). The Dice coefficientof zygomatic region detection model and gold standard verified by manual labeling were 0.9337 (coronal plane) and 0.9269 (sagittal plane), respectively. The sensitivity and specificity of the fracture detection model were 100% (p＞.05). The performance of the algorithm based on CNNs was not statistically different from the gold standard (manual diagnosis) for zygomatic fracture detection in order for the algorithm to be applied clinically.

Correction of postoperative temporal hollowing using a combination of thread-lift and autologous fat graft: a case report

Postoperative temporal hollowing is a complication that can occur after craniectomy or cranioplasty. It is caused by the disinsertion or displacement of the temporalis muscle and atrophy of the superficial temporal fat pad. We introduce a case of temporal hollowing correction using polydioxanone thread-lifting and fat grafts. A 28-year-old man presented with right temporal hollowing and asymmetric bulging of the zygomatic region. The patient wanted an aesthetically favorable correction with a short recovery period, without using a permanent implant. We performed a two-stage procedure. In the first stage, 21 mL of centrifuged fat was obtained, of which 7 mL was injected into the temporal region. A month later, another 4 mL of the stored fat was injected, and thread-lifting was performed through the temporal region after identifying the deep temporal fascia. Four threads were inserted, pulled toward the entry point, and tied. The anchoring of the thread-lifted tissue remained stable, and the volume of grafted fat was well preserved at the 4-month follow-up. The patient was satisfied with the cosmetic results. In this case, temporal hollowing was effectively managed with fat grafting and thread lifting. We recommend this method as an option for reconstruction of temporal hollowing with a short recovery period and high patient satisfaction.

Three-dimensional analysis of zygomatic change after L-shaped reduction malarplasty with bone setback or resection

Reduction malarplasty is one of the most popular procedures for esthetic facial contouring in East Asians. The retrospective observational study aimed to analyze the association between the zygomatic change and bone setback or resection to propose quantitative guidance for L-shaped reduction malarplasty based on computed tomographic (CT) images. A retrospective observational study was conducted on patients who underwent L-shaped reduction malarplasty with bone resection (Group I) or without bone resection (Group II). The amount of bone setback and resection was calculated. The unilateral width changes of the anterior, middle, and posterior zygomatic regions as well as zygomatic protrusion change were also evaluated. Pearson correlation analysis and linear regression analysis were used to analyze the relationship between the bone setback or resection and the zygomatic changes. Eighty patients who underwent L-shaped reduction malarplasty were included in this study. Significant correlation was observed between the bone setback or resection and the change of anterior, and middle zygomatic width as well as protrusion in both the two groups (P < .001). The correlation between bone setback or resection and the posterior zygomatic width change was not significant (P ＞.05). The bone setback or resection of L-shaped reduction malarplasty lead to the anterior and middle zygomatic width and zygomatic protrusion changes. Furthermore, the linear regression equation can be referenced as a guidance for a preoperative surgical plan.

Functional reorganisation of the cranial skeleton during the cynodont–mammaliaform transition

Skeletal simplification occurred in multiple vertebrate clades over the last 500 million years, including the evolution from premammalian cynodonts to mammals. This transition is characterised by the loss and reduction of cranial bones, the emergence of a novel jaw joint, and the rearrangement of the jaw musculature. These modifications have long been hypothesised to increase skull strength and efficiency during feeding. Here, we combine digital reconstruction and biomechanical modelling to show that there is no evidence for an increase in cranial strength and biomechanical performance. Our analyses demonstrate the selective functional reorganisation of the cranial skeleton, leading to reduced stresses in the braincase and the skull roof but increased stresses in the zygomatic region through this transition. This cranial functional reorganisation, reduction in mechanical advantage, and overall miniaturisation in body size are linked with a dietary specialisation to insectivory, permitting the subsequent morphological and ecological diversification of the mammalian lineage.

Practical application of the facial fat compartments and the line of ligaments concept in achieving the lifting effect in the lower face region in female patients.

Practical application of the facial fat compartments and the line of ligaments concept in achieving the lifting effect in the lower face region in female patients.

The sagittal evaluation and classification of midfacial morphology in Chinese Han Youth: A cross-sectional study

Midface is located in the central area of the facial region and plays a crucial role in the aesthetic evaluation of one's appearance. The East Asian, especially the Chinese, has wide and flat midfacial bone structure, low piriform aperture area compared with the prominent zygomatic and oral region, which results in an unpleasant appearance. 1 Jin H.R. Won T.B. Rhinoplasty in the Asian Patient. Clin Plast Surg. 2016; 43: 265-279 Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar In contrast to the patients' surging demand of midface filling surgery, there is a lack of evaluation standard for midfacial depression, nor quantitative and objective grading system for midface morphology. In the current study, we collected the three-dimensional (3D) facial information of Chinese Han Youth and summarized the morphological characteristics of their midface, focusing on the concavity and convexity from the sagittal plane.

A Case of Impacted Foreign Body in Zygomatic Region- A Missed Diagnosis

Foreign body impaction in the soft tissues is not uncommon following maxillofacial trauma. Traumatic injuries in this region often cause penetrative injury of the soft tissues. Immediate closure of the soft tissue wound becomes the primary management strategy for control of haemorrhage. Foreign bodies may sometimes remain unnoticed in these wounds. Here, the authors present a case of retained metallic foreign body in the left zygomatic region in a 21-year-old male patient with history of simple slip and fall from staircase at home. Clinical evaluation and primary management of the facial wounds were done in a nearby healthcare centre by a general physician where the facial wounds were closed primarily using cyanoacrylate tissue glue to control the bleeding. Further, on clinical and radiographic examination by an oral maxillofacial surgeon, a 2×1 cm metallic foreign body was noted in the left zygomatic region. Immediate surgical removal under local anaesthesia was planned and performed. The purpose of reporting this case is to highlight the importance of thorough clinical and radiographic assessment as well as the need for an oral maxillofacial surgeon for prompt assessment, diagnosis, and management of these facial injuries.

Studying Dynamics of Mid-face Lifting During Hyaluronic Acid Filler Injection Using Ultrasound Imaging.

The ageing in the mid-face involves volume deficiency in multiple anatomical units, including the zygomatic arch, infraorbital region, medial and lateral cheek and nasolabial fold (NLF). Hyaluronic acid (HA) is extensively used in the minimally invasive procedures of mid-face rejuvenation. MD CodesTM is proposed to perform combined treatment of multiple sites to reduce treatment variability and increase clinician success rates. Although the detailed procedure of this technique, aesthetic effects and complications have been disclosed, its anatomical information has yet to be discussed. This paper elaborated on the static and dynamic anatomical characteristics of MD CodesTM through cadaveric dissection and ultrasound imaging. Anatomical dissection and ultrasound imaging help us look back on the injection methods and anatomical principles of MD CodesTM. The treatment is threefold: (1) the bolus injections, for lifting purposes, are performed at the most depressing point along the zygomatic arch, zygomatic eminence, the prominent optimal point in the zygomatic region, the most depressed point of upper NLF with 0.2-0.3ml HA. (2) The linear injections, featuring facial contouring refinement, are performed at the deep fat pad of the medial cheek and infraorbital region with 0.4ml HA. (3) The linear injections, featuring volume replacement, are performed at the subcutaneous fat layer of lateral cheek and NLF with 0.8 and 0.4ml HA. MD CodeTM is led by the principle of "less dosage and better effect", and a special injection sequence is formulated based on the anatomical characteristics. Ultrasound is a useful tool to make for a dynamic anatomical understanding of MD CodeTM and visualize the anatomical information such as layers and thicknesses. 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 .

Local hardware hypothermia influence on the physiological processes

Relevance. Cold vasodilation is a response to a decrease in local and general temperature. Dose-controlled hypothermia is a therapeutic method for treating various pathological processes. Materials and Methods. In our study, we analyzed various indicators of the general condition of the human body under the influence of local controlled hypothermia. The study involved 25 healthy volunteers from the age of 21 to 34, including 14 males and 11 females. The study was carried out at a constant temperature of 25 ºС, relative humidity of 30 ± 5%, and an atmospheric pressure of 765mm Hg in silence and moderate illumination. The instruments of these indicators were bio-impedancemetry, angioscanning, as well as general thermometry. We also performed local thermometry of the buccal mucosa to identify temperature correlations between local hypothermia and buccal mucosa temperature. Local сontrolled hypothermia of the face was carried out by applying an elastic mask to the subject’s face. The mask had a system of irrigation tubes connected to the «ViTherm» device, which cooled the liquid and maintained its circulation. Due to the circulation of the cooled liquid in the mask the face was cooled. The mask covered the parotid-chewing, buccal, zygomatic, and infraorbital regions on the right and left. LCG lasted 50 minutes, and the circulating fluid temperature was 18 ºС. Results and Discussion. The effect of local controlled hypothermia at 18-20 °C did not affect vital signs in healthy adults: active cell mass, electrical reactance, extracellular fluid, oxygen saturation, the duration of systole. pulse. general temperature. At the same time, a decrease in tissue hydration was recorded. The revealed physiological effect of local hypothermia justifies using this temperature regime to reduce postoperative edema. Conclusion. Due to the absence of negative effects of local controlled hypothermia on the vital signs of the human body, the development and application of this tool in clinical practice, including the dental surgeon. is relevant.

Facial Defects With Infraorbital and Zygomatic Area Reconstruction Using an Expanded Flap Based on the Orbicularis Oculi Muscle: A Long-Term Follow-up.

Reconstruction of facial soft-tissue defects may pose a dilemma for plastic surgeons, as the flaps must be reliable to obtain a natural appearance while minimizing donor site morbidities. This clinical study describes a reconstructive method for infraorbital and zygomatic defects using a pre-expanded rotation flap based on the orbicularis oculi muscle (OOM). The surgeries were subdivided into 2 stages. In the first stage of the operation, a 100 to 200mL expander was placed underneath the temporal area through a hairline incision. In the second stage, after adequate inflation of the expander, the pre-expanded rotation flap based on the OOM of the lower eyelid was raised from lateral to medial to cover the facial defects. In this single-center study from February 2010 to February 2017, 16 patients underwent facial defect reconstruction using the pre-expanded flap based on the OOM. All of the defects were located at the infraorbital and zygomatic regions, and their sizes ranged from 3.0 4.0 to 7.0 14.0cm. The causes of these defects included postburn scars (37.5%), melanocytic nevus (50%), and hemangiomas (12.5%). In all cases, good coverage was provided for the defects that were in the medial cheek or lower eyelids. There were no flap losses of any kind. There were no major complications, and all minor incidences were treated by minimal procedures. The patients were followed up after surgery, with the follow up ranging from 6 months to 108 months. The follow-up data included postoperative consultations, the defect size, the need for further procedures and the degree of satisfaction. The pre-expanded rotation flaps in the lateral facial area based on the OOM can ideally and safely be applied for facial defect reconstruction owing to their reliable blood supply and excellent texture match.

A Geometric Morphometric Study on Sexual Dimorphism in Viscerocranium.

Simple SummarySex estimation is a crucial step in the identification of unknown bone remains. The accuracy of sex estimation methods depends on the level of sexual dimorphism manifested by the human bones. Therefore, the evaluation of sex differences of particular bones of the skeleton is an important preceding stage. We have used geometric morphometric techniques to investigate the sexual dimorphism in the size and shape of the facial part of the skull and its subregions. Our results show that the facial skeleton in males and females differs more in size than in shape, so its overall size is a more useful sex indicator than its shape. The same result is observed for all facial subregions studied here. However, the best discrimination between the male and female skulls is achieved when both size and shape are considered together.The level of sexual dimorphism manifested by human bones is an important factor for development of effective sex estimation methods. The aim of the study was to investigate the sexual dimorphism in the size and shape of the viscerocranium using geometric morphometric techniques. It also aimed to explore the sex differences in distinct viscerocranial regions and to establish the most dimorphic region with regard to size and shape. Computed tomography images of 156 males and 184 females were used in the study. Three-dimensional coordinates of 31 landmarks were acquired. Five landmark configurations were constructed from the viscerocranium and its orbital, nasal, maxillary, and zygomatic region. Generalized Procrustes superimposition, principal component analysis, and discriminant analysis were applied to each configuration. The significance of the sex differences in size and shape was assessed and significant differences were found in all configurations. The highest accuracy was obtained from both shape and size of the whole viscerocranium. Based on size only, the highest accuracy was achieved by the nasal region. The accuracy based on shape was generally low for all configurations, but the highest result was attained by the orbital region. Hence, size is a better sex discriminator than shape.

Epidemiological survey of the quantity and anatomical position of facial pigmented spots in relation to age in 454 Japanese women.

Facial pigmented spots are one of the phenotypes of skin aging, but no quantitative analysis of spot features such as color intensity, size, anatomical position, and number on the cheek has yet been performed. In the current study, we conducted an epidemiological survey of 454 Japanese women in their 20s to 70s and analyzed age-related changes and site differences of facial pigmented spots. Using image analysis of high-resolution digital facial photographs, 4912 individual pigmented spots were quantified according to color, size, anatomical position, and total number on the cheek. As a result of color analysis, the color intensity of individual pigmented spots increased with aging, significantly so between ages 30s and 50s. The age-related increase in melanin index of facial spots was confirmed in all sites but did not significantly differ between facial subregions. Regarding the size of pigmented spots, the frequency of large spots increased with age, and large spots were detected in all facial sites. The total number of pigmented spots on the entire cheek increased with aging, significantly so between the 20s and 40s. The number of pigmented spots tended to increase from the region near the canthi to the lower cheeks. The number of spots was markedly increased in the buccal regions compared with the infraorbital and zygomatic regions. The data and methodology presented in the current study can link the state of facial pigmentation with the various factors involved in the histological development of pigmented spots, opening new possibilities in the fields of skin pharmacology and dermatology.