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Dorsum Surgery
Published in Suleyman Tas, Rhinoplasty in Practice, 2022
The examination of the relationship between both maxillas is crucial to diagnose maxillary hypoplasia. Asymmetries in this plane can affect the frontal appearance as alar base retractions or rim asymmetries [51–52].
Oculocutaneous tyrosinemia/tyrosine aminotransferase deficiency
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
Maternal tyrosinemia has been documented to have adverse effects on the fetus [41]. An untreated 28-year-old woman whose disease was untreated, had two pregnancies with tyrosine levels at around 1302 μmol/L. Both infants had microcephaly and delayed development. One had maxillary hypoplasia. Two other infants of untreated women had microphthalmia and impaired mental development [40].
Anatomy of the Nose and Paranasal Sinuses
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Dustin M. Dalgorf, Richard J. Harvey
Any disruption or abnormality in the development of the maxillary sinus may result in maxillary sinus aplasia or hypoplasia. Maxillary sinus hypoplasia is present in up to 10% of CT scans.1 Radiographic diagnostic criteria for maxillary hypoplasia include: (1) enlargement of the vertical orbit, (2) lateral position of the infraorbital neurovascular canal, (3) elevated canine fossa, (4) enlargement of superior orbital fissure and (5) enlargement of pterygopalatine fissure (Figure 87.5).2
Is the “Habsburg jaw” related to inbreeding?
Published in Annals of Human Biology, 2019
Román Vilas, Francisco C. Ceballos, Laila Al-Soufi, Raúl González-García, Carlos Moreno, Manuel Moreno, Laura Villanueva, Luis Ruiz, Jesús Mateos, David González, Jennifer Ruiz, Aitor Cinza, Florencio Monje, Gonzalo Álvarez
Diagnosis of MD and MP from portraits was performed from the detection of 11 dysmorphic features for MD and 7 for MP as previously described (Peacock et al. 2014). The features of maxillary hypoplasia were as follows: scleral show (MD1), exorbitism (MD2), peri-alar hollowing (MD3), prominent nasolabial folds (MD4), narrow nasal base (MD5), convex nasal ridge (MD6), overhanging nasal tip (MD7), obtuse nasolabial angle (MD8), thin upper lip vermilion (MD9), overclosed mandible (MD10), and everted or prominent lower lip (MD11); the features of mandibular hyperplasia were as follows: increased thyromental distance (MP1), taut submental soft tissue (MP2), obtuse gonial angle (MP3), shallow labiomental fold (MP4), acute chin-throat angle (MP5), increased depth of lower facial third (MP6), and soft tissue pogonion >5 mm anterior to zero meridian of González-Ulloa (MP7). These features can be observed in portraits of members of different families of the Habsburg lineage and some of them have been popularly identified as “Habsburg nose” (particularly, MD6 and MD7) and “Habsburg lip” (MD11).
Anterosuperior protraction of maxillae using the extraoral device, RAMPA; finite element method
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Yasushi Mitani, Bumkyoo Choi, Jaehyuk Choi
Maxillary hypoplasia affects the functioning as well as the appearance of people. In order to treat maxillary hypoplasia, maxillary expansion devices have been developed. Methods for nonsurgical correction have been developed with intraoral and extraoral devices. Among them, there are rapid maxillary expansion (RME), slow maxillary expansion (SME), and semi-rapid maxillary expansion (sRME), which have been most commonly used for intraoral devices. The first commonly cited report was published by E. C. Angell in Dental Cosmos in 1860 (Angell 1860). In the 1950s, Derichsweiler (Derichsweiler 1953) and Gerlach (Gerlach 1956) renewed interest in RME when they reported improvement of nasal respiration, as well as an increase in the width of the maxillary apical base due to expansion. Haas proposed an early Haas-type model in 1961 (Haas 1961), and Biedermann proposed an initial Hyrax-type model in 1973 (Biederman 1973). In general, RME therapy aims to treat young patients with maxillary deficiency and/or skeletal Class III malocclusion by applying a strong lateral force on the maxillary alveolar dentition to increase the dental arch width. Slow maxillary expansion (SME) is a treatment that attempts to solve the side effects of RME treatment by gradually expanding the maxilla by applying less force than RME therapy (Hicks 1978). It has been reported that fewer side effects and similar results can be obtained for the same treatment subjects as RME therapy (Cotton 1978; Hicks 1978), but there is still no consensus on the extent to which SME therapy can be effective for older patients or for younger patients (Bell 1982; Akkaya et al. 1999). In 1977, Mew announced semi-rapid maxillary expansion (sRME) as a remedy for the disadvantages of the aforementioned RME and SME therapies (Mew 1977). In addition, Işeri applied sRME treatment to adolescent patients for 3 years and showed that the changes in teeth and skeleton were stable (Işeri and Ozsoy 2004). Although sRME treatment has several advantages compared with other maxillary expansion treatments, research on sRME has not been extensively conducted. In particular, there are few studies that evaluate the treatment with the finite element method (FEM).
Long-term patient-reported outcomes after anterior distraction osteogenesis of the maxilla in patients with cleft
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Lina Yasin, Magnus Becker, Henry Svensson, Anna-Paulina Wiedel
Either conventional orthognathic surgery (CO) or distraction osteogenesis (DO) is used for the advancement of the maxilla in cases of maxillary hypoplasia, typically in patients with cleft lip and palate (CLP) and cleft palate (CP). These surgical interventions are often performed in the late teens to allow fully developed bone growth, thus achieving a lasting result [1]. Both methods are based on a Le Fort I osteotomy, which makes the teeth bearing part of the lower maxilla freely movable in the forward direction. CO is the traditionally used method. In CO the lower maxilla is moved forward in one step by means of autologous bone transplantation and rigid fixation [2]. The technique has its limitations. Firstly, just a short advancement is achievable, around 5 mm on average, which constitutes a limitation in the treatment of severe forms of maxillary hypoplasia. Second, the technique is linked to a high relapse risk [3]. DO, on the other hand, is a mechanical bone lengthening procedure that generates new bone by gradual distraction [4]. The method was used for the first time on the human cranium in 1992 [5,6]. DO encompasses the Le Fort I osteotomy supplemented with the application of a rigid external distractor (RED). The device is semi-circular and surrounds the head like a halo. It is fastened to the temporal bones on either side as shown in Figure 1. The loosened lower maxilla is connected to the device via a dental appliance, wires, and a vertical bar. By adjusting the device step by step, 0.5–1.0 mm a day, dragging the loosened lower maxilla forwards, more bone regeneration can be achieved compared with CO. Immediately postoperatively a latency phase up to a week is allowed during which callus is formed around the osteotomies enabling bone regeneration. The distraction itself, referred to as the active phase, begins once callus has formed and can last up to 15 days or more depending on the severity of the maxillary hypoplasia. The fixation phase begins once the desired advancement is achieved to allow the regenerated bone to become consolidated. This process normally takes about three months and then the DO device can be removed [2,3,7]. Considering the long procedure and restrictions involved, DO certainly has an impact on daily life and presumably the quality of life of the patients during the treatment period [3].