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Upper airway bronchoscopic approach and diagnostic procedures
Published in Don Hayes, Kara D. Meister, Pediatric Bronchoscopy for Clinicians, 2023
The examination begins with inspection of the patient. The patient should be in a sleep-like state, preferably snoring as a result of obstructions (if obstructions are included in the clinical history), with natural positioning. The patient's overall habitus, jaw position, neck anatomy and hyoid position, chest wall anatomy, and chest movement should be examined. It may be helpful to obtain photo documentation of pertinent findings, such as retrognathia or an abnormal bite.
Pre-Assessment For Rhinoplasty
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Catherine Rennie, Hesham Saleh
Lip–chin relationship: The horizontal distance from the surface of the upper lip to that of lower lip is normally around 2 mm. The anterior surfaces of the upper and lower lips rest on the nasomental line in an aesthetic face (Figure 46.2B). When the chin lies posterior to this line, it is described as retrognathic; when it lies anterior it is prognathic. A retrognathic chin can give the illusion of an over projected nose, and the reverse applies to a prognathic chin. Genioplasty or chin implant procedures are therefore often used in conjunction with rhinoplasty.
The lower third of the face
Published in Jani van Loghem, Calcium Hydroxylapatite Soft Tissue Fillers, 2020
Facial harmony can be defined as balance between the elements of the face. Augmentation of the chin is a powerful way of improving facial harmony, especially in patients who have a retruded chin. Retrognathia is a condition where the mandible is set further back than the maxilla, making it look like the person has severe overbite. Surgically, this can be corrected with cutting the mandible and moving it forward. This is quite an invasive procedure with considerable risks and downtime. CaHA can be used with minimal risk, discomfort, and downtime for the patient, and can produce a significant improvement in facial harmony.
A novel treatment of pediatric bilateral condylar fractures with lateral dislocation of the temporomandibular joint (TMJ) using transfacial pinning
Published in Case Reports in Plastic Surgery and Hand Surgery, 2023
Kerry A. Morrison, Roberto L. Flores
The patient was a healthy 3-year-old male, who was an unrestrained passenger in a golf cart accident. Physical examination was notable for panfacial edema with no soft tissue injuries, very limited oral excursion, and an intact facial nerve bilaterally. Computed tomographic (CT) craniomaxillofacial findings revealed a tripartite mandibular fracture, including bilateral condylar fractures with lateral dislocation of the left condyle and a symphyseal fracture (Figure 1). There was a complete right condylar neck fracture with lateral apex angulation as well as medial and inferior dislocation of the right mandibular condyle. The symphyseal fracture was associated with lateral displacement of the mandibular angle, bilaterally. Physical exam included bilateral lateral crossbite, retrognathia and an open bite deformity. The remainder of the patient’s facial architecture was intact, the patient’s cervical spine was cleared both clinically and radiographically, and there were no other physical injuries noted.
The orofacial, oromotor, speech, and voice characteristics of adolescents in youth detention: a comparison of groups with and without prenatal alcohol exposure
Published in Speech, Language and Hearing, 2022
Natalie R. Kippin, Suze Leitão, Rochelle Watkins, Raewyn Mutch, Amy Finlay-Jones
Orofacial structures and functions were examined using a standard checklist and record form (Supplementary material). The checklist incorporated items used in orofacial and oromotor assessment protocols of standard SLP practice (for example, Paul & Norbury, 2012); it included items related to the face, lips, jaw, tongue, oral cavity, and related cranial nerves. Each item was explained to the adolescent using a standard set of simple instructions and modelling. The record sheet included checkboxes and space to write qualitative comments, and took less than five minutes to complete. Features consistent with malocclusions (i.e., underbite: prognathia; overbite: retrognathia) were recorded by the speech-language pathologist on the standard record form (Supplementary material) and by the paediatrician within the medical assessment. Findings were discussed by the clinicians in team meetings, and final descriptions were agreed for all adolescents.
Biomechanical evaluation of a novel mandibular distraction osteogenesis protocol: an in-vitro validation and the practical use of the method
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
A. T. Şensoy, I. Kaymaz, Ü. Ertaş
This section covers the planning of Optimum Mandibular Surgery (OMS) explained in detail in the previous sections, manufacturing patient-specific surgery guide and application of the proposed method to a real MDO case, respectively. For surgery planning, the CT images of a patient suffering from severe mandibular retrognathia were imported to MIMICS software. After the segmentation process, the intact mandible model was obtained. With the help of the developed method for OMS, the optimum osteotomy level and the optimum screw positions were determined for the operation. Considering the MDO parameters, a patient-specific surgery guide (Figure 5(a)) was modeled, and virtual surgery (Figure 5(b)) was performed for surgery planning. The following step was the clinical use of the manufactured osteotomy guides for MDO operation (Figure 5(c)).