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Biomedical subjects

Z Smahel

Publications and source records attributed to Z Smahel.

At least 73 records · Page 4Linked to original sources
PubMed1986

Craniofacial changes in hemifacial microsomia.

Cephalometry, X-ray cephalometry, and somatoscopy were used in the studies of 65 adult males with a severe unilateral microtia subdivided into three groups: with marked asymmetry, with slight asymmetry, and without any obvious facial asymmetry. The group with marked asymmetries was designated as hemifacial microsomia. In this group the affected side of the face was depressed on the average from above and from below towards the level of the external auditory canal. The center of the anteroposterior reduction was situated in the region in front of the pterygomaxillar fissure. The anteroposterior and vertical facial dimensions on the affected side were reduced most markedly, while the width dimensions showed the slightest changes. Hypoplasia was most severe within the lower face and increased towards the otocephalic centre. The mandibular joint was displaced in an anteroinferior and medial direction. Hypertelorism did not occur, but the orbit on the affected side was smaller in height and was frequently vertically dislocated. The facial profile was unchanged except for retrusion of the chin and increased frequency of bite disorders. The mobility of the mandible was limited. Hemihypoplasia also exerted an influence on structures that were not of branchiogenic origin, e.g., the cranial base (narrowing, asymmetry, and more pronounced curvature), the neurocranium (depression in mastoid and tympanotemporal regions, posterior rotation of the vault), and the frontonasal component (deviation of the nose and premaxilla). The cranial vault and the bottom of the occipital bone showed on the average no asymmetries. The similar character of deviations in slightly affected groups revealed that in spite of the high variability of changes typical for branchiogenic malformations the development of the face in these defects was subjected to certain rules. Marked facial asymmetry occurred only in every fifth patient with a severe degree of microtia, while definite signs of asymmetry were absent in every third patient.

Adult↗
PubMed1984

Variations in craniofacial morphology with severity of isolated cleft palate.

Cephalometric X-ray studies were carried out in 90 adult males with isolated cleft palate operated upon by the same method. The results were evaluated according to the extent of the clefts (complete, incomplete, or soft palate alone). But for a few exceptions the neurocranium and the cranial base showed no substantial deviations. Similarly, as in cleft lip and palate, a shortening of maxillary depth and a deficient mandibular growth were recorded, with no reduction of the vertical growth of the upper face, retroclination of the dentoalveolar maxillary component or increase of the interocular distance noted. No posterior displacement of the maxilla was found. The two observed deviations resulted in the retrusion of the upper and lower jaws, the flattening of the skeletal profile, impaired maxillomandibular relations and limitation of anterior growth rotation. Soft palate clefts were associated with less retrusion of the maxilla, while the growth deficiency of the mandible was even more marked. The least shortening of the mandible occurred in complete clefts. In general, incomplete clefts were associated with the most marked changes. The flattening of the skeletal profile in complete and incomplete clefts was masked by an increased thickness of the upper lip. Soft palate clefts were associated frequently with a shorter and hard palate. Our results were in agreement with experimental knowledge of the role played by the mandible in the development of isolated cleft palate.

Adult↗
PubMed1984

Craniofacial morphology in adults with bilateral complete cleft lip and palate.

Cephalometric x-ray studies were carried out on 26 adult males with complete bilateral cleft lip and palate (BCLPc) and 50 non-clefts. The configuration of the neurocranium and cranial base showed no substantial differences. Facial differences were similar to those in unilateral clefts (UCLPc). Protrusion and retroinclination of the premaxilla affected the depth and height of the upper jaw and thus the total height and posterior growth rotation of the face. Thus the depth of the maxillary complex was unchanged, while the depth of the posterior maxilla was reduced, as in UCLPc. The increased length of the face, its posterior growth rotation, the dentoalveolar maxillary retroinclination and the displacement of the maxilla backwards were all more marked in bilateral clefts then in unilateral clefts. Changes of mandibular shape, an enlarged interocular distance, retrusion of the upper jaw and the configuration of the soft tissue profile, including the shorter upper lip were identical in both forms of clefts. However the mandible was more retrognathic and posteriorly rotated in bilateral clefts. The skeletal profile was not flattened, but the palatal plane was retroinclined and the depth of the nose was increased. BCLPc was associated with a widening of the nasal cavity and a thinner upper lip. The dimensions of the nasopharyngeal skeletal framework were reduced. The retrocheilia was conspicuous. Premaxillary setback resulted in a reduction of the depth of the upper jaw, of the height of the upper face and of the dentoalveolar retroinclination of the maxilla.

Adult↗
PubMed1984

Craniofacial changes in unilateral microtia: II. An X-ray study.

Roentgenocephalometry was used for studies into the extent and character of craniofacial changes in 45 adult males with unilateral (right-sided) microtia. Out of the whole complex of changes associated with this malformation the mandibular ramus showed the most marked involvement and represented the main cause of the accompanying deviations and asymmetries. On the average, the affected half of the face was compressed toward the level of the external auditory meatus both from above and below, but there was a marked variability in individual patients examined. No signs of asymmetry were disclosed in one third of the patients while severe asymmetry was present in one fifth of the patients. Facial hemihypoplasia exerted no substantial influence on the facial profile (when no retrusion of the lower jaw was present) on the sagittal maxillomandibular relations or on the occlusion of incisors, while in transverse direction a laterosuperior deviation of the mandible towards the affected side was clearly visible. A branchiogenic malformation affected the neighboring structures, the cranial base (a more marked curving), frontonasal segment (septum and premaxillar deviation), and the neurocranium (posterior rotation of the cranial vault). The inner ear structures (semicircular canals) were affected only rarely (in 4% of patients). These findings complemented the results obtained in the first part of our study and confirmed the complex character of this inborn anomaly.

Abnormalities, Multiple↗
PubMed1984

Craniofacial changes in unilateral microtia: I. An anthropometric study.

Anthropological studies were carried out in 100 adult males with microtia. Craniofacial changes were assessed in 45 selected males ranging in age from 20 to 42 years and affected by right-sided microtia of the third degree. The results showed the extent of facial involvement in unilateral severe microtia, as well as the type of the changes. They were expressed quantitatively in terms of metrical values. The defect was a typically lateral anomaly with decreased height-depth dimensions of the affected side of the face, while the facial width dimensions and the height dimensions in the median plane were unchanged. The hemihypoplasia was most marked in the distal part of the face and increased towards the otocephalic center. The dimensions of the reconstructed earlobe corresponded on the average to the contralateral lobe, though there were some individual differences and the lobe was inclined anteriorly. Anomalies of the normal earlobe occurred in 27% of individuals examined, and consisted most frequently of lobe protrusion (16%). Associated anomalies of cervical vertebrae were recorded in 13% and a familial occurrence of microtia in 4%. The body growth was not affected in our patients.

Abnormalities, Multiple↗
PubMed1983

Differences in craniofacial morphology between complete and incomplete unilateral cleft lip and palate in adults.

Differences in craniofacial morphology between complete and incomplete unilateral cleft lip and palate were studied in adult males by roentgenocephalometry. Incomplete clefts did not have the widening of the nasal cavity, reduction of the upper face height, or reduced thickness of the upper lip found in complete clefts. The shortening of maxillary depth was half that noted in complete clefts. The mandibular deviations and interorbital widening did not differ. The same held true for the retroinclination of upper incisors and alveolar process and backward shift of the maxilla. These changes accounted for differences in sagittal maxillo-mandibular relations, facial profile, occlusion of incisors and total facial height between complete and incomplete clefts. Limitation of anterior growth rotation of the face was identical. The independence of mandibular variations on the extent of the cleft and on maxillary malformation suggests the possibility of an underlying primary impairment of growth of the lower jaw, at least in some cases.

Adult↗