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At least 91 records · Page 5Linked to original sources
PubMed2000

Lengthening of the postoperative short nose: combined use of a gull-wing concha composite graft and a rib costochondral dorsal onlay graft.

Several causes of short nose are known: congenital anomaly, developmental problem, trauma, and various types of rhinoplasty-the postoperative short nose being one of the most difficult problems to correct in plastic surgery. Contracted skin envelope, tissue deficiency of cartilage and mucosal lining, and poor circulation make postoperative short nose difficult to lengthen and susceptible to recurrence. Thus, for effective lengthening and long-term maintenance of it, specific grafts should be used to supplement the missing lining and cartilage and a mechanical support also is needed to withstand the skin contraction. The nose consists of three structural layers: the outer skin envelope, middle osteocartilaginous framework, and inner mucosal lining. Many methods have been proposed to correct short nose deformity. Those procedures lengthen the nose slightly, but none of them take into account the unique characteristics of postoperative causes and the structural concept of the nose. The procedures have resulted in only limited success. On the basis of the above clinical findings and the structural concept, we developed a surgical technique to correct postoperative short nose according to the structural layers. Our method consists of three main surgical maneuvers: (1) a gull-wing concha chondrocutaneous composite graft to supplement the deficient middle and inner layers, (2) a rib costochondral onlay graft on the dorsum to reinforce the framework, and (3) wide dissection of the outer skin envelope to cover the lengthened framework without tension. We prefer a closed surgical approach rather than an open approach to avoid too much tension on the columellar incision site and to allay patients' fear of an additional scar. From 1988 to 1998, we performed our lengthening technique on six female patients. All six patients demonstrated a significant lengthening and improved appearance postoperatively. After the lengthening procedure, the average nasolabial angle improved from 116 degrees to 104 degrees. The mean follow-up period was 8.7 months, with a range of 3 to 17 months. Sometimes, epidermal sloughing in the vertical strut of the gull-wing

Adult↗
PubMed2002

Body oxygen stores, aerobic dive limits and diving behaviour of the star-nosed mole (Condylura cristata) and comparisons with non-aquatic talpids.

The dive performance, oxygen storage capacity and partitioning of body oxygen reserves of one of the world's smallest mammalian divers, the star-nosed mole Condylura cristata, were investigated. On the basis of 722 voluntary dives recorded from 18 captive star-nosed moles, the mean dive duration (9.2+/-0.2 s; mean +/- S.E.M.) and maximum recorded dive time (47 s) of this insectivore were comparable with those of several substantially larger semi-aquatic endotherms. Total body O(2) stores of adult star-nosed moles (34.0 ml kg(-1)) were 16.4 % higher than for similarly sized, strictly fossorial coast moles Scapanus orarius (29.2 ml kg(-1)), with the greatest differences observed in lung and muscle O(2) storage capacity. The mean lung volume of C. cristata (8.09 ml 100 g(-1)) was 1.81 times the predicted allometric value and exceeded that of coast moles by 65.4 % (P=0.0001). The overall mean myoglobin (Mb) concentration of skeletal muscles of adult star-nosed moles (13.57+/-0.40 mg g(-1) wet tissue, N=7) was 19.5 % higher than for coast moles (11.36+/-0.34 mg g(-1) wet tissue, N=10; P=0.0008) and 54.2 % higher than for American shrew-moles Neurotrichus gibbsii (8.8 mg g(-1) wet tissue; N=2). The mean skeletal muscle Mb content of adult star-nosed moles was 91.1 % higher than for juveniles of this species (P<0.0001). On the basis of an average diving metabolic rate of 5.38+/-0.35 ml O(2) g(-1) h(-1) (N=11), the calculated aerobic dive limit (ADL) of star-nosed moles was 22.8 s for adults and 20.7 s for juveniles. Only 2.9 % of voluntary dives by adult and juvenile star-nosed moles exceeded their respective calculated ADLs, suggesting that star-nosed moles rarely exploit anaerobic metabolism while diving, a conclusion supported by the low buffering capacity of their skeletal muscles. We suggest that a high mass-specific O(2) storage capacity and relatively low metabolic cost of submergence are key contributors to the impressive dive performance of these diminutive insectivores.

Aerobiosis↗
PubMedDate not supplied

Outcome of surgery for crooked nose: an objective method of evaluation.

OBJECTIVES: The aim of this study was to report the authors' surgical results, and to present their method of angle measurement using the Scion Image computer program to evaluate surgical results for crooked noses. METHODS: The study included 27 patients with crooked noses: classified as C-type and 14 classified as I-type. Deviation angles were measured by using the Scion Image computer program on frontal views before and at least 3 months after the operation. Correction of the crooked nose was performed through an open approach with the patients under general anesthesia. RESULTS: Significant correction was achieved for both types of crooked noses (p <0.05). The results for the I-type crooked noses were closer to the ideal angles than those for the C-type, but the difference was not significant. The findings showed that 66.7% of the patients with crooked noses, had good or excellent results after surgery: 53.8% of those with the C-Type and 78.6% of those with the I-type. CONCLUSION: It is difficult to achieve satisfactory results in the correction of crooked noses. The angle measurement method using the Scion Image computer program may be helpful in evaluating the effectiveness of different surgical techniques.

Adolescent↗
PubMed2005

Investigations of the influence of external nose deformities on nasal airflow.

BACKGROUND: Abnormalities of the external shape of the nose are often felt as cosmetically disturbing. In many cases an additional hampering of the respiratory function of the nose is seen and causes pathological nasal airflow patterns. For the functional outcome of aesthetic-surgery of the nose, knowledge of nasal flow is essential. In the medical literature there are some discrepancies between the relationship of nasal shape and nasal flow. We investigated typical airflow patterns in different abnormalities of the external nose. METHODS: We performed fluid dynamic experiments on exact, anatomical nasal models and functional nasal models (so-called modified Mink boxes). We investigated the inspiratory flow pattern in nose-models with typical variations of the shape of the external nose. RESULTS AND CONCLUSIONS: There were typical airflow patterns for every external nasal abnormalities. The normal nose shows a disturbance of the streamlines over the entire nasal cavum. Under physiological flow velocities we find laminar and turbulent flow. The pathological variations of the nasal shape show mostly different airflow patterns and characteristics. The main reason for that is a deformed or anatomically false configurated inflow area (vestibulum, isthmus and anterior cavum). During rhinoplasty the reconstruction of the nasal inflow area has to be taken into account.

Humans↗
PubMedDate not supplied

Management of the long nose: review of techniques for nasal tip supporting structures.

The long nose with a "plunging" tip is a deformity that involves an inferiorly rotated nasal tip, leading to an increase in the length of the nose. The anatomic basis of the long nose with a plunging tip may be divided into two types. Type 1 presents a normal alar-cartilage complex inferiorly displaced by a long nasal septum and long upper lateral cartilages. Type 2 is caused by a dislocation of the alar cartilages downward from the aponeurotic attachments to the septal angle. During the study period, the authors identified 60 patients with long noses and plunging tips. For 22 patients with type 1 long noses, the high septal incision technique was used in 12 cases and the step technique in 10 cases. The invagination procedure alone was used for 22 of 38 patients with type 2 plunging noses. Also, an extension graft with the invagination procedure was used for 6 patients, and a columellar strut graft was used for 10 patients. A high septal incision increased tip rotation without significantly changing the amount of tip projection. However, the step procedure, the invagination technique alone, septal extension graft with the invagination technique, and columellar strut grafts increased nasal tip rotation and projection. During the study period, 38 patients were identified as having a smiling deformity, which was improved using the authors' modification procedure. On the basis of the results, the authors recommend that the appropriate treatment for each patient with a long nose and a plunging tip must be determined by preoperative and intraoperative examination findings with the patient at rest and while smiling.

Adult↗
PubMed1995

A lateral cephalometric analysis of the adult nose.

PURPOSE: The purpose of this study was to establish a set of standard values for the form of the nose and its relationship to other craniofacial structures in young adult caucasians. SUBJECTS AND METHODS: The subjects were 50 (25 male, 25 female) caucasian dental students who gave no history of orthodontic treatment, facial surgery, or facial fractures. Lateral cephalometric radiographs were used to determine the form of the nose and its position relative to other craniofacial structures. RESULTS: The men had significantly longer and straighter noses than the women, and their noses also projected further from the face. The dorsum of the nose was straight in most subjects. The vertical distances from the tip of the nose to the most prominent part of the upper lip, to the incisal edge of the maxillary central incisor, and to soft tissue pogonion were significantly greater in the men. There were no gender differences in the horizontal distances between the same points and the tip of the nose. Subnasale was significantly more prominent in the men. CONCLUSIONS: In general, the findings of nasal form and position are in agreement with previous studies. Several gender differences in nasal form and position were found. The standards reported should prove to be a useful yardstick for clinicians engaged in procedures likely to alter the form of the adult human face.

Adolescent↗
PubMed2005

Analysis of 109 Japanese children's lip and nose shapes using 3-dimensional digitizer.

We assessed lip and nose shapes, which played an important role in performance evaluations, before and after cleft lip and nose surgery. We used a noncontact-type semiconductor laser 3-dimensional measurement system on normal Japanese children to obtain 3-dimensional images of noses and lips, which were accurate enough to measure facial shapes. We could rotate these images on the computer, therefore we measured the following points: the distance between the peaks of the Cupid's bow and the width of the labial fissure (frontal view), and the width of the nose and the nasal tip protrusion (basal view). Lip and nose shapes were evaluated for each gender. Additionally, nasolabial angles (NLA) were measured on the lateral views of faces. We classified the morphology of the philtral columns into four types; (1) triangular type, (2) parallel type, (3) concave type, and (4) flat type. We also classified nostril shapes into four types: (1) teardrop type, (2) heart shaped type, (3) round type, and (4) triangular type. We calculated the average of the 3-dimensional coordinate values for each landmark, and created standard facial models of normal Japanese children. Moreover, we invented a new morphological evaluation method before and after cleft lip and nose surgery, using the 3-dimensional data converting and editing software. The method was more feasible to evaluate the assessment cleft lip and nose surgery, by quantifying the surface areas of right and left nostrils and the surface areas of upper and lower vermilions, even now by measuring with the eyes and comparing them.

Anthropometry↗
PubMed2006

A comparison of aesthetic proportions between the healthy Caucasian nose and the aesthetic ideal.

BACKGROUND AND OBJECTIVE: The aim of septorhinoplasty is to create a nose that is aesthetically pleasing to the patient and to maintain nasal function. Although a small number of population cohort studies have been performed on the ethnic nose, little is known of the aesthetics standards of nasal proportions in the general Caucasian population. The aim of this study was to establish parameters of the average nose in the healthy population and to compare them with those of the aesthetic ideals. MATERIAL AND METHODS: Ethical approval was obtained to recruit a cohort of staff and students from the medical school. Two photographs were taken: anterior and right lateral. The following measurements were made: intercanthal width, alar width, length of the nose (nasion-pronasion length), naso-labial angle, nasal tip projection, naso-facial angle and naso-frontal angle. These parameters were compared with published aesthetic ideals. RESULTS AND CONCLUSION: Aesthetic nasal proportions of 50 healthy Caucasians were examined from a cohort of 57 volunteers. Results showed that the average nose did not conform to neo-classical facial canons. The alar width (average 3.6 cm) was significantly wider than the intercanthal width (average 3.0 cm, p<0.05). The nasal width-length ratio was also greater suggesting that the cohort average was shorter and wider than the aesthetic ideal. The Baum ratio was 2.5:1, indicating that the average nasal tip was more projected that the aesthetic ideal (2.8:1). The naso-frontal and naso-facial angles are both more obtuse, and in profile the average nose overall appeared more prominent, as a result of the reduced forehead projection. The only parameter where there appeared to be consistency between the average and the ideal nose was the naso-labial angle. This study shows that many aesthetic parameters from a cohort of healthy subjects differ from the widely used aesthetic standards. Rhinoplasty surgeons should, therefore, give thought to the frame of reference used when discussing aesthetic objectives with their patients.

Adolescent↗
PubMed1997

Anatomy of a rhinoplasty: emphasis on the middle third of the nose.

The nose is an organ that serves many functions. These functions are intimately involved in an organ that occupies a very aesthetically prominent position on the face. A thorough knowledge of the anatomy is of the utmost importance for surgeons attempting to preserve or improve the functional capability and the aesthetic appearance of the nose. Nasal anatomy is extremely complex with a myriad of different three-dimensional variances. The middle third of the nose has largely been overlooked in its importance. The components of this portions of the nose consist of the paired upper lateral cartilages, the dorsal aspect of the septum, and the scroll of the upper lateral cartilages upon the lower lateral cartilages. This area is of key importance to the nasal valve area and can have a major impact on the functional capabilities of the nose. A description of the confluence of the flare of the septum to the upper lateral cartilages is necessary for an understanding of changes that may occur during rhinoplastic operations. A knowledge of the anatomy of the middle third of the nose may prevent nasal valve collapse, a pinched appearance of this portion of the nose, or an aesthetically unappealing appearance.

Cartilage↗
PubMed1994

[The large nose--an esthetic, but also a functional problem].

The term "Big Nose" describes many deformities caused by hypertrophy of the bone or the cartilagenous framework of the nose or both. This leads to disharmony of the face, which discomforts the patients. By diminution of the naso-labial angle as for example in a "Pinocchio nose" or by the reduced angle of the inner valve like in a tension nose, a "Big Nose" presents not only an aesthetic problem but a functional one too. An exact analysis of the deformity is necessary to choose the adequate operative procedure. The reduction of the nose should lead to an improvement in "looks" as well as in breathing. The most challenging factor in nose reduction is the diminution of the tip projection. Two different methods are mainly available: the technique according to Goldman and to Lipsett. The pros and cons of both are compared and a few refinements suggested.

Cartilage↗
PubMed1993

Simultaneous construction of an internal and external nose in an infant with arhinia.

We report on the simultaneous construction of an internal and external nose in an infant born with arhinia. The indication for this very early reconstruction was due to respiratory distress and the associated feeding problems. It was possible to create two nasal cavities separated by a septum and to form an external nose from pre-expanded skin and a secondary arm flap for the tip supported by a frontal bone flap with intrinsic growth potential and auricular cartilage grafts for the tip. The 4-year-old child has excellent function of the nose with an acceptable appearance. Her psychological development is normal. Respiratory distress and associated feeding problems necessitated the use of oropharyngeal and orogastric tubes in a female infant born without a nose (arhinia). Over a period of many weeks, with attempts to remove the tube resulting in aspiration, we decided to create a functional nasal airway and an external nose simultaneously at this early stage. At the age of 20 weeks, two nasal cavities were created by using a buccal sulcus incision and connected to the existing nasopharynx and partially lined with split skin grafts. An external nose was created using the expanded midfacial skin and supporting it, an osteoperiosteal flap from the frontal bone. Later, a Tagliacozzi flap had to be added for the nasal tip. The newly constructed nose functions well and appears to aid favorably in the normal psychosocial development of the now 4-year-old girl.

Female↗
PubMed1998

Bone grafts to the nose in Binder's syndrome (maxillonasal dysplasia): a follow-up of eleven patients with the use of profile roentgenograms.

Bone grafts are used to lengthen the dorsum and elevate the tip of the nose in patients with Binder's syndrome. Disappointing long-term results in some patients generally have been assumed to be a result of resorption and/or displacement of the grafts. Treatment outcome was studied in 11 patients with the use of serial profile roentgenograms. At 40 months, the mean values after surgery were reduction of the initial transplant length by 28 percent and reduction of the transplant angle by 4 degrees. The initial nose length was increased by 1 mm, and nose tip projection was increased by 2 mm. Although the mean changes of nose length and nose tip projection seemed small, treatment outcome varied considerably between patients. In contrast with earlier assumptions, no correlation could be found between the degree of transplant resorption and/or displacement and the effect of surgery on nose length and nose tip projection.

Adolescent↗
PubMed2006

Concurrent analysis of nose and groin swab specimens by the IDI-MRSA PCR assay is comparable to analysis by individual-specimen PCR and routine culture assays for detection of colonization by methicillin-resistant Staphylococcus aureus.

The IDI-MRSA assay (Infectio Diagnostic, Inc., Sainte-Foy, Quebec, Canada) with the Smart Cycler II rapid DNA amplification system (Cepheid, Sunnyvale, CA) appears to be sensitive and specific for the rapid detection of nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA). We assessed the sensitivity and specificity of this assay under conditions in which both the nose and cutaneous groin specimens were analyzed together and compared the accuracy of this PCR approach to that when these specimens were tested separately and by culture assays in an inpatient population with known high rates (12 to 15%) of MRSA colonization. Of 211 patients screened, 192 had results assessable by all three methods (agar-broth culture, separate nose and groin IDI-MRSA assay, and combined nose-groin IDI-MRSA assay), with MRSA carriage noted in 31/192 (16.1%), 41/192 (21.4%), and 36/192 (18.8%) patients by each method, respectively. Compared to agar culture results, the sensitivity and specificity of the combined nose-groin IDI-MRSA assay were 88.0% and 91.6%, respectively, whereas when each specimen was processed separately, the sensitivities were 90.0% (nose) and 83.3% (groin) and the specificities were 91.7% (nose) and 90.2% (groin). IDI-MRSA assay of a combined nose-groin specimen appears to have an accuracy similar to that of the current recommended PCR protocol, providing results in a clinically useful time frame, and may represent a more cost-effective approach to using this assay for screening for MRSA colonization.

Groin↗
PubMed1994

Response of the nose to exercise in healthy subjects and in patients with rhinitis and asthma.

BACKGROUND: Although the nose and the bronchi are both involved in the process of regulating respiratory heat exchange, thermal changes may precipitate airway obstruction during exercise but rarely cause nasal obstruction in patients with rhinitis. The cause of the different response of the nose and bronchial tree has hardly been investigated. This study was performed to assess the response of the nose during exercise in the presence of rhinitis, asthma, and in normal controls. METHODS: Ten healthy subjects (group 1), 15 patients with asthma and rhinitis (group 2), 10 with rhinitis only (group 3), and 11 with asthma only (group 4) were included in the study. Exercise was performed on a bicycle ergometer for six minutes, reaching a heart rate of 80% of predicted. Bronchial and nasal responses were measured by forced expiratory volume in one second (FEV1) and posterior rhinomanometry, respectively. A drop in the FEV1 of 20% or more was considered a positive exercise induced asthma challenge test. RESULTS: Heart rate and ventilation increased by a similar proportion in the four groups. The FEV1 significantly decreased in asthmatic patients (groups 2 and 4) but it did not change in healthy subjects (group 1) or in those with rhinitis (group 3). Thirteen asthmatic patients developed exercise induced asthma. Nasal patency increased with exercise by a similar proportion in all groups, and no differences were detected between those with rhinitis (groups 2 and 3) and those without (groups 1 and 4). Nasal patency had returned to basal values at 25 minutes after completion of exercise in the four groups. The nose of patients with exercise induced asthma, however, remained significantly more patent than in patients without exercise induced asthma between 10 and 30 minutes after exercise. CONCLUSIONS: These results suggest that the nose responds differently from the bronchi during exercise induced airway obstruction: whereas the bronchial tree responds by becoming narrowed, the nose becomes more patent. These findings suggest that the mechanisms regulating the response of the nose to exercise are different from those involved in the response of the bronchial tree.

Adult↗
PubMed1986

Respiratory volume perception through the nose and mouth determined noninvasively.

The relative importance of the nose vs. the mouth in the perception of respiratory volumes has never been assessed, nor have previous respiratory perception studies been performed noninvasively. Using respiratory inductive plethysmography, we monitored 12 normal subjects noninvasively when breathing either exclusively through the nose or mouth. The sensation of inspired volume mouth breathing was compared with that of nose breathing over a wide range of the inspiratory capacity. The psychophysical techniques of tidal volume duplication, tidal volume doubling, and magnitude estimation were utilized. A just noticeable difference was calculated from the constant error of the tidal volume duplication trials. The exponents for magnitude estimation were 1.06 and 1.07 for nose and mouth breathing, respectively. The other psychophysical techniques also revealed no differences in nose and mouth volume perception. These results suggest that tidal volume changes are perceived equally well through the nose and mouth. Furthermore, the location of the receptors, important in volume perception, is probably at a distal point common to the nose and mouth.

Adult↗
PubMed1991

Dimensions and resistances of the human nose: racial differences.

Dimensions of the external nose and nostrils and nasal airflow resistances were determined in healthy, young Caucasian, Oriental, and Negro adults. Statistically significant variation between racial groups was found in nasal width and the differential between dorsi-ventral and transverse nostril diameters. Corresponding differences were found also in nasal airflow resistances of combined and separate nasal cavities in both the untreated and decongested state. Caucasian noses were leptorrhine, Negro noses were platyrrhine, and Oriental noses were of intermediate dimension. Mean nasal resistances of untreated noses were 0.129 Pa/cm3/sec in Negroes (N = 17), 0.146 in Orientals (N = 20), and 0.184 in Caucasians (N = 24), and differences were more marked when noses were decongested (P less than 0.05 in all cases). Ratios between resistances of untreated and decongested noses showed no statistical differences between racial groups, suggesting a similarity in the mucovascular component of resistances.

Adolescent↗
PubMed2000

Volatiles for mycological quality grading of barley grains: determinations using gas chromatography-mass spectrometry and electronic nose.

The possibility of using an electronic nose or gas chromatography combined with mass spectrometry (GC-MS) to quantify ergosterol and colony forming units (CFU) of naturally contaminated barley samples was investigated. Each sample was split into three parts for (i) ergosterol and CFU analysis, (ii) measurements with the electronic nose and (iii) identification of volatiles collected on an adsorbent with a GC-MS system. Forty samples were selected after sensory analysis to obtain 10 samples with normal odour and 30 with some degree of off-odour. The data set of volatile compounds and the data collected from the electronic nose were evaluated by multivariate analyse techniques. SIMCA classification (soft independent modelling of class analogy) was used for objective evaluation of the usefulness of the data from the GC-MS or electronic nose measurements for classification of grain samples as normal or with off-odour. The main volatile compounds of grain with normal odour were 2-hexenal, benzaldehyde and nonanal, while 3-octanone, methylheptanone and trimethylbenzene were the main volatile compounds of grain with off-odours. Using data from the electronic nose three samples of 40 were misclassified, while data analysis of the volatile compounds detected with the GC-MS, led to six misclassified samples. Regression models (partial least-squares, PLS) were built to predict ergosterol- and CFU-levels with data from the GC-MS or electronic nose measurements. PLS models based on both GC-MS and electronic nose data could be used to predict the ergosterol levels with high accuracy and with low root mean square error of prediction (RMSEP). CFU values from naturally infected grain could not be predicted with the same degree of confidence.

Ergosterol↗
PubMed1987

Haemostatic disorders in habitual nose-bleeders.

Ninety-one habitual nose-bleeders were screened for haemostatic disorders. 46 screening results in 38 nose-bleeders were outside the normal range. After extended investigation, it was found that 25 (27 per cent) habitual nose-bleeders had haemostatic disorders, all except one in the primary haemostasis. The disorders found could be classified as mild bleeding disorders (MBD) and compared to the estimated frequency of MBD in the population there was an increased incidence of haemostatic disorders in the habitual nose-bleeders. Abnormal vessels in the nasal mucosa were present in 85 per cent of the investigated nose-bleeders, equally distributed between nose-bleeders with and without haemostatic disorders. This indicates that abnormal vessels and haemostatic disorders in habitual nose-bleeders, it is possible to detect previously unknown but clinically important disorders.

Adolescent↗