Nasal Bone
Amar Bhide, Asma Khalil, Aris T Papageorghiou, Susana Pereira, Shanthi Sairam, Basky Thilaganathan in Problem-Based Obstetric Ultrasound, 2019
The association of nasal bone hypoplasia and trisomy 21 is well established. There are ultrasound studies in low- and high-risk populations, as well as histopathological studies in fetuses with Down syndrome, which have consistently confirmed this association. It is established that 50%–60% of fetuses with Down syndrome will have absent/hypoplastic nasal bones at 11–14 weeks on ultrasound scanning and also on autopsy studies. Advanced maternal age, increased nuchal translucency, abnormal serum biochemistry, and abnormalities or soft markers seen on ultrasound scans are the factors to be considered in determining the a priori risk and would define a “high-risk” population. Absence of nasal bones would significantly increase the chance of underlying trisomy 21, and an invasive test should be considered. On the other hand, prevalence of trisomy 21 in the low-risk population is low. Failure to visualize the fetal nasal bones could easily be a variation of normal.
Death Along the Tracks: The Role of Forensic Anthropology and Social Media in a Homicide Investigation
Heather M. Garvin, Natalie R. Langley in Case Studies in Forensic Anthropology, 2019
Forensic anthropology casework conducted through the California State University, Chico Human Identification Laboratory routinely involves postmortem examination of skeletonized remains from rural outdoor scenes. This chapter highlights the importance of using online searches of antemortem decedent information in the identification process and the role of forensic anthropology in detailing perimortem trauma patterns to corroborate witness statements. All skeletal elements were examined for evidence of perimortem trauma and taphonomic alterations. The facial skeleton showed probable evidence of perimortem trauma, including fractures of the inferior margin of the left and right nasal bones and the medial margin of the frontal process of the left maxilla. One retrospective clinical study found that nearly half of the patients who presented with transverse process fractures of lumbar vertebrae had a significantly higher chance of abdominal organ injuries than patients who presented with fractures to the vertebral body, pedicle, or spinous process.
Postnatal Growth of the Nasomaxillary Complex
D. Dixon Andrew, A.N. Hoyte David, Ronning Olli in Fundamentals of Craniofacial Growth, 2017
Many sites contribute to the multidirectional growth of the nasomaxillary complex, a three-dimensional mosaic of bones and cavities. In these three dimensions of space, however, the nasomaxillary complex grows differentially in both time and rate and is closely correlated with growth of the mandible. Additional sites of growth for the maxillary complex are the maxillary tuberosities and sutures which are found only in the skull. A number of nonsurgical and surgical experiments, conducted primarily on young and some adult animals, were designed to assess growth changes in relation to the nasomaxillary complex. Lateral cephalometric radiographs were taken on the Broadbent-Bolton cephalometer at monthly intervals. The zygomaticotemporal and zygomaticomaxillary sutures were related to anteroinferior movement, and the frontomaxillary and frontozygomatic sutures contributed most to the downward movement of the face. The chapter talks about normal growth and contrasts the gross differential effect of surgical trauma upon postnatal growth with respect to the nasal bones and to the cartilaginous nasal septum.
Clinical factors indicating short nasal bone overlap
Published in Acta Oto-Laryngologica, 2015
Yuri Nomura, Kazuhiro Nomura, Daiki Ozawa, Kazuya Arakawa, Hiroshi Hidaka, Yukio Katori
Conclusion: It is important to take adequate precautions when performing septoplasty for elderly patients. Objective: Septoplasty is the treatment of choice for deviation of the nasal septum. Saddle nose is a rare complication caused by damage to the keystone area. In this area, the nasal bone overlaps the upper lateral cartilages, so careful attention is needed when performing septoplasty to patients with short nasal bone overlap. Therefore, the factors associated with short nasal bone overlap were investigated to allow adequate precautions to be taken during surgery. Method: Computed tomography (CT) including the paranasal sinus region was performed in 177 patients. Data including sex, age, and the primary disease were obtained from their medical records. The degree of septal deviation and the bone overlap distance in the midline were measured using CT. Result: It was found that advancing age was significantly associated with shorter bone overlap distance in the midline. There was no significant association between the degree of septal deviation and nasal bone overlap distance in the midline. Furthermore, there was no significant difference in the overlap distance between nasal sinus diseases and other diseases, and between sexes.
First trimester sonographic diagnosis of orofacial defects. Review of literature
Published in The Journal of Maternal-Fetal & Neonatal Medicine, 2020
Andrea Salazar Trujillo, Cristian Rincón-Guio, Lisseth López Narváez, Juan Cáceres, José D. Charry
Ultrasound has been used since the 1950s as a useful tool for the screening of several pregnancy abnormalities. The National Institute for Excellence in Health and Care (NICE) guidelines for prenatal control recommend its routine use between 12 and 20 weeks of gestational age, given that during the first trimester, a series of very frequent markers that determine a high risk of fetal anomalies can be evaluated. Among these markers, the most frequently studied are: increased nuchal translucency, the absence of nasal bones, increased tricuspid regurgitation, and altered flow in the venous duct. There is also a new ultrasound technique consisting of the evaluation of the retronasal triangle view, which captures the coronal plane of the face in which the primary palate and the frontal process of the maxillary are simultaneously visualized, presenting high sensitivity and specificity for malformations such as oropalatine clefts, malformations of the nasal bones, and micrognathia. The purpose of this article is to make a comprehensive review of first trimester sonographic diagnosis of orofacial defects.
Auditing fetal nasal bone images in the first trimester of pregnancy: results from a peer review program
Published in The Journal of Maternal-Fetal & Neonatal Medicine, 2016
Fernanda Gasparin Palermo, Débora de Paula Soares de Medeiros Albuquerque, Wellington P. Martins, Edward Araujo Júnior, Rafael Frederico Bruns
Objective: To establish a structured review process to facilitate the identification of the fetal nasal bone (NB) in the first trimester ultrasound scan to improve the quality images. Methods: We conducted a retrospective observational study in fetal NB images obtained during ultrasound exams of singleton pregnancies that underwent first trimester screening (crown-rump length 45–84 mm). When the images were obtained the examiner was not aware of the study. Audit was conducted by an examiner according criteria established by the Fetal Medicine Foundation. Fetal NB images were assessed regarding adequate magnification, mid-sagittal view and transducer held parallel to the direction of the nose. The transvaginal and transabdominal as well as anterior and posterior fetal back groups were compared using χ2 test. Results: We considered 874 fetal NB images for auditing. Fetal NB was considered present in 865 images (99%). During the audit process, we identified 72 (8.2%) cases of disagreement between examiner and auditor assessments. Disagreement was higher when image quality was poor (62 cases = 7%). Transvaginal approach performed better in the following criteria: adequate magnification (p