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PubMed1985

Growth movements during prenatal development of human facial morphology.

After formation of the primary palate, human facial morphology develops rapidly and by 10-12 weeks pc the face has characteristics that appear typically human. The objective of this study was to review major growth movements and developmental changes in craniofacial tissues between 7 and 12 weeks pc. During this period (20 - 80 mm CR length), the upper and lower facial regions grow forward rapidly to achieve relationships to the cranial base that are similar to those present later prenatally and postnatally. Initial ossification of facial bones is present but the primary cartilages form the continuous craniofacial skeleton through the entire period. Rapid directional growth of the cartilaginous components between 7 and 10 weeks appears to be important to development of the typically human facial appearance prior to the formation of the continuous bony skeleton. The effects of altered primary cartilage growth on bony skeletal patterns were examined in experimental animal studies in which embryonic rats were exposed to teratogens. Reduction in the length of Meckel's cartilage or alteration in the shape of the cartilage was found to affect the size and shape of the bony mandible that developed later. Therefore, growth movements of the chondrocranium and Meckel's cartilage appear to play an important role in spatial relocation of developing facial bones during formation of craniofacial morphology. The results suggest that significant alterations in growth during this period when the primary cartilages form the continuous skeleton may produce significant irreversible effects on later prenatal and postnatal craniofacial morphology.

Animals↗
PubMed2002

Traumatic injuries: imaging of facial injuries.

Facial injuries are common and require radiologic evaluation to plan treatment. The role of imaging is to detect fractures, describe their morphology and topography, and evaluate adjacent soft tissue damage. Computed tomography is the imaging method of choice for an accurate diagnosis and for depicting the complex anatomic structures of the maxillo-facial region. Magnetic resonance imaging plays a limited role, mainly in the assessment of lesions of orbital soft tissues. This paper reviews the most common traumatic injuries of facial bones, paranasal sinuses, orbits and mandible.

Facial Bones↗
PubMed2006

Bilateral visual loss in craniodiaphysial dysplasia.

PURPOSE: To report a rare case of craniodiaphysial dysplasia (CDD) that resulted in a profound loss of vision in both eyes. DESIGN: Observational case report. METHODS: A 2-year-old girl presented with midfacial anomaly. Marked thickening and sclerosis in the calvaria and facial bones were detected on the plain x-rays, which were compatible with CDD. Two years later, she visited our clinic because of visual loss in both eyes. RESULTS: The visual acuity was light perception in both eyes. The optic disk swelling with temporal pallor was observed in her both eyes. Orbital computed tomography scan revealed near-total obliteration of the optic canal in both eyes. CONCLUSIONS: CDD is a severe bone disorder characterized by massive generalized hyperostosis and sclerosis, especially involving the facial bones. Bony encroachment on the cranial foramina causes optic nerve compression, and this may lead to progressive visual impairment and ultimately to blindness.

Blindness↗
PubMed2000

Sutural expansion osteogenesis for management of the bony-tissue defect in cleft palate repair: experimental studies in dogs.

A series of experimental studies on sutural expansion osteogenesis for management of the bony-tissue defect in cleft palate repair was performed between 1995 and 1997. Forty-five young dogs in weaning were used in four experiments that were divided into two parts. Part I probed the possibility of closing the surgically constructed hard palate cleft not only with mucoperiosteum but also with bony tissue by the technique of sutural expansion of lateral palatine sutures. Part II explored the possibility of pushing the palatine bone posteriorly and advancing the maxillary segment anteriorly by transverse palatine suture expansion. In Part I, a ring-shaped suture expander made of nickel-titanium shape memory alloy was used to expand the lateral suture of palatine bones. Expansion forces of 200 G, 360 G, and 480 G were used for the first experiment. A force of 360 G was chosen for two other experiments; this force is equivalent to the distraction rate of 0.5 mm per day of a jackscrew device. The ring-shaped suture expander was opened and its two feet were fixed in the medial sides of residual horizontal plates of the palatine bones immediately after a hard palate cleft was constructed surgically under endotracheal general anesthesia. At the eighth postoperative day, under the traction of 360 G, the two sides of the 8-mm-wide hard palate cleft were brought into contact with each other, and 8 or 9 days later the closed palatal cleft had healed completely with mucosal tissue. This experiment was repeated twice and yielded the same results. Sutural expansion osteogenesis was evaluated physically, fluorescently, histologically, and ultrastructurally to examine the deposition of the regenerated bone in the suture areas. Additionally, the influence of sutural expansion osteogenesis of the palatal bones on other facial bones was also studied cephalometrically. In Part II, a bow-shaped suture expander made of nickel-titanium shape memory alloy was applied to expand either the left or the right side of the transverse palatal suture of each of the experimental dogs. At the postoperative week 4 to 6, the maxillary segment was moved forward 5 to 6 mm on the expanded side, and the palatal bone was pushed backward 5 mm. The changes of bone position were assessed radiographically and cephalometrically. Tissue response of circum-maxillary sutures was examined histologically. These experiments led to the following conclusions: (1) Bony closure of the surgically constructed hard palate cleft with a ring-shaped suture expander made of nickel-titanium shape memory alloy is possible. (2) Anterior advancement of the maxillary segment and posterior lengthening of the hard palate using a bow-shaped suture expander made of nickel-titanium shape memory alloy applied at the palatomaxillary suture (transverse palatal suture) of the hard palate are also possible. Thus, in humans, a new approach for cleft palate repair may be a worthwhile investigation.

Alloys↗
PubMedDate not supplied

Aneurysmal bone cyst: report of a case mimicking orbital tumor.

Aneurysmal bone cysts are rare bone tumors which normally affect the vertebral region or long bones. Involvement of facial bones is uncommon. Although nonneoplastic, these lesions are expansile and may cause local destruction of bone and soft tissues. When making the diagnosis, it is imperative to consider the clinical, radiologic, and histologic features of the entity to avoid confusion with other possibly malignant giant cell tumors. We report an unusual case involving the orbit in a 2 1/2-year-old girl.

Bone Cysts↗
PubMed1989

[Oral respiration. Diagnosis and physiopathology].

The oral breathing can change the functional connections during the development of the facial bones of the children. All this causes an abnormal growth of the facial bones and of the dental structures. This work developed a new discipline to remove this problem.

Child↗
PubMed1981

[Fundamentals of echographic diagnosis of acute and chronic sinusitis (author's transl)].

Changes of sound permeability in facial bones are caused by inflammatory or tumorous reaction in the mucosa of the sinuses; echo-orbitography (8-10 MHz) shows in this case extraorbital echo signals if bony walls are thin enough (e.g. Lamina papyracea, anterior and upper wall of the antrum). Further examinations of facial bones show early inflammatory changes of bony tissue in sinusitis without influencing the echographic pattern; the amount of hydroxylapatite remains unchanged.

Durapatite↗
PubMed2005

Management of neck and head injuries.

The horse, a flight animal that is used extensively by man, frequently receives injuries to its neck or head that result mostly from its management and handling. Better facilities, training of the horse, and horsemanship skills of the handler could prevent many of these injuries. Because many body systems can be involved, with potentially major consequences regarding health, performance, and appearance, early recognition of trauma and competent treatment are crucial. Progress has been made in the treatment of some tracheal and esophageal injuries. Severe tracheal trauma and rupture of the esophagus still represent major challenges for the attending veterinarian, however. Lacerations of the head generally heal well, likely because of an abundant blood supply. Thorough yet conservative debridement is necessary, as is accurate reconstruction of the tissues to maintain normal function and an acceptable cosmetic appearance. Fractures of the facial bones can result in complications, such as sequestrum formation, sinusitis, nasolacrimal duct injury,facial deformity, and injury to or entrapment of the globe. An awareness of the treatment methods available can help to diminish the complication rate and to restore a normal or acceptable appearance.

Animals↗
PubMed1997

Relationship between bone and muscles of mastication in hemifacial microsomia.

The relationship between the bone and muscles of mastication in hemifacial microsomia was studied using three-dimensional volumetric computed tomography scans and image processing techniques. High resolution head computed tomography scans were obtained from 31 patients with unilateral hemifacial microsomia and eight normal patients. Using three-dimensional volume renderings of bone, mandibular deformities in patients with hemifacial microsomia were classified using the Pruzansky system. For each patient, specific craniofacial bones (temporal bone, maxilla mandible) and the muscles of mastication (masseter, temporalis and lateral and medial pterygoid) were segmented bilaterally from the image volume for independent display and volume measurement. Volumes were expressed as the ratio of the affected: unaffected sides. For the masseter and temporalis, the relationship between muscular hypoplasia and osseous hypoplasia in its origin and insertion was studied by plotting affected:unaffected bone volume as a function of affected:unaffected muscle volume for each muscle, bone of origin, bone of insertion triplet. The volumes of the pterygoid muscles were compared with hemimandibular volumes. The precision of object segmentations was examined by repetitive definition tasks, whereas the accuracy of volume measurement was tested by scanning custom-made phantom objects and comparing digital to physical object volume measurements. Volume measurements performed using these techniques were both accurate and precise. In hemifacial microsomia, the extent of hypoplasia of specific muscles of mastication predicted the extent of dysplasia in their osseous origin and insertion. However, the reverse was not true. The extent of hypoplasia of the facial bones did not necessarily predict the extent of hypoplasia in the attached muscles of mastication. Pruzansky grade of the mandible described the degree of mandibular hypoplasia on the affected side, but was inconsistent in its prediction of volume decrease of the other facial bones.

Facial Asymmetry↗
PubMed1977

[Bone grafting in facial malformations].

The possibilities of bone graft to the face are multiple. After reviewing the anatomy and physiology of bone grafting, the authors present different types of cases illustrating some of these possibilities. Each case of malformation of the face presents problems in which bone grafting is often an elegant solution with or without osteotomies. After describing the principles and techniques used in these cases, the authors comment upon 26 personal cases using mostly the intraoral approach for laying bone around the face. Three out of 26 have developed postoperative infections but only one case has needed removal of part of the bone grafts. Their youngest patient was 12 years old.

Adolescent↗
PubMed2002

Familial Axenfeld-Rieger anomaly, cardiac malformations, and sensorineural hearing loss: a provisionally unique genetic syndrome?

Axenfeld-Rieger anomaly (ARA) is an autosomal dominant disorder of the anterior chamber of the eye that includes a prominent and anteriorly displaced Schwalbe line and an iridocorneal synechiae, and is associated with iris hypoplasia, corectopia, and hole formation. Extraocular developmental abnormalities, especially of the teeth, facial bones, and periumbilical skin, have also been reported with ARA, in the context of the so-called Axenfeld-Rieger syndrome (ARS). Genetic heterogeneity exists, as ARA maps to chromosome 6p25, whereas ARS can be linked to both chromosome 4q25 and chromosome 13q14. Here we describe a new family in which ARA is associated with cardiac malformations and sensorineural hearing loss. No abnormalities of the teeth, facial bone, or periumbilical skin, which are considered of paramount importance in the diagnosis of ARS, were observed in our patients. Genetic studies will clarify if these patients represent a unique phenotypic expression of ARS or constitute the clinical presentation of a new genetic syndrome.

Adolescent↗
PubMed1979

Experimental and postexperimental response to anteriorly directed extraoral force in young Macaca nemestrina.

An anteriorly directed extraoral force was applied to the maxillas of four healthy young M. nemestrina monkeys. Experimental, retention, and postretention alterations were evaluated through a combination of cephalometric, histologic, and gross techniques. In view of the results of the present study, the following conclusions can be made: 1. Skeletal remodeling occurs in all circummaxillary sutures following the application of an anteriorly directed extraoral force to the maxilla. The amount of remodeling appears to be proportional to a suture's distance from and orientation to the applied force system. 2. The maxillary complex exhibited a marked anterior positioning with a small amount of counterclockwise rotation during the experimental period. 3. The application of an extraoral force to the maxilia produces compensatory deposition and resorption of bone, not only at the sutural margins but also at the external surface of the bones themselves. 4. It is possible that the experimental appliance transmits its effect to the facial bones adjacent to the maxilla through an alteration in the skull's periosteal envelope. 5. A substantial reorientation of the maxillary complex occurs following the termination of active force, and the degree of relapse or reorientation is directly proportional to the length of stabilization. 6. The dentition, through the periodontal ligament, undergoes approximately four times as much relapse as do the facial bones through their sutural articulations, following a minimal period of stabilization. 7. Extraoral forces applied to the craniofacial complex are transmitted through the maxilla and related midfacial bones, resulting in changes in such deep cranial structures as the cartilaginous synchondroses of the sphenoid bone. 8. Anterior displacement of the maxilla by extraoral traction appears to have a minimal effect on the mandible and the temporomandibular joint. 9. The number of sinusoidal vessels in the sutural ligament tends to increase in those sutures subjected to a tensional force.

Animals↗
PubMed1983

Developmental deficiencies of the upper facial skeleton due to partial elimination of mesencephalic neural crest cells in the chick embryo.

With the aim to test the hypothesis that cells derived from the mesencephalic portion of the neural crest, are involved in the process of differentiation of various upper facial bones, in 41 chick embryos of the 6-somite stage (approx. 26 hours of incubation) the anterior and middle thirds of this part of the neural crest were partially eliminated by micro-laser irradiation, either unilaterally or bilaterally. Of the 14 embryos sacrificed at the age of 12 days, a number of 6 proved to have developed harelip and/or cleft palate conditions. In these embryos, in addition a reduction or absence of the maxillary, palatal, jugale and quadrato-jugale was observed. On the contrary, other facial bones as well as the first and second branchial arch cartilages proved to have developed normally. From these results the conclusion may be drawn that (a sufficient number of) cells from the anterior and middle thirds of the mesencephalic neural crest are indispensable for a normal differentiation of the maxillary, palatal, jugale and quadrato-jugale.

Animals↗