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Epilepsy is a frequent chronic and genetic brain disease. In diagnose of genetic and craniofacial disease, the face is one of the gold standard phenotypic features. This study was carried out to determine the angle and linear measurements of face region in Turkish healthy and epilepsy subjects, and to apply a feature selection method to identify the most important attributes that affect epilepsy decision. The retrospective and observational study was conducted with 120 subjects with epilepsy aged between 18 to 60 years (56 males; 64 females) and 60 healthy subjects aged between 18 and 55 years (29 males, 31 females). Pyramidal angle performed from 3 reference points, nasal bone length, the width of piriform aperture, nasofrontal angle, nasolabial angle, distance between glabella and nasion were measured on computed tomography. Also, we used supervised machine learning to learn classification models to detect epilepsy as our dataset has class label where 1 means epilepsy, 2 means healthy. The well-known classification model learning algorithms implemented in Weka (with version 3.8.6) machine learning toolkit were applied. All parameters excluding nasal bone length were higher in epilepsy patients than in healthy subjects. Also, there was a significant difference in nasal pyramidal angle nasal bone, nasal pyramidal angle nasal tip, piriform aperture, and nasal bone lengths between epilepsy and healthy subjects. However, age related changes for healthy subjects were no seen in healthy subjects. In epilepsy subjects there was a significant difference in 6 measurements all nasal pyramidal angles, piriform aperture width, nasofrontal angle, and nasolabial angle. Gender related changes were found in only nasal pyramidal angle nasal root and nasal bone of healthy subjects, in nasal pyramidal angle nasal bone, nasal bone length, nasofrontal angle of epilepsy subjects. We can say epilepsy may affect the some facial parameters and these, although anthropometric measurements are affected by age and gender parameters. Comprehensive knowledge of this region's normal references ranges is essential for planning, proper selection of silicone implants or osteotomy determining the limitations of the surgical field and minimizing the risk of complication and performing aesthetic facial surgery or rhinoplasty in epilepsy patients., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Key Points: A convolutional neural network (CNN)-based model can accurately localize and segment turbinates in images obtained during nasal endoscopy (NE). This model represents a starting point for algorithms that comprehensively interpret NE findings., (© 2024 The Author(s). International Forum of Allergy & Rhinology published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngic Allergy and American Rhinologic Society.)

Introduction: The nasal region plays a pivotal role in both facial esthetics and functionality. The use of volumizing fillers has emerged as a potential means to enhance nasal appearance. Preliminary findings from cadaveric studies have highlighted potential risks associated with deeper needle injection, leading to cartilage damage and lateral migration of filler material. Understanding the subcutaneous tissue depth is crucial to prevent such complications and ensure safe filler placement guided by anatomical knowledge., Methods: This study aimed to employ ultrasonographic assessment to precisely measure the depth of soft tissue in the nasal area. Fifty-two participants without prior nasal surgery or filler injections underwent detailed ultrasonographic evaluation, focusing on seven key anatomical points: Glabellar, Sellion, Rhinion, between Rhinion and Pronasal, Pronasal, between Pronasal and Subnasal, and Subnasal., Results: The ultrasonographic observation revealed varying depths of subcutaneous tissue across these points: Glabellar (4.11 ± 0.79), Sellion (5.21 ± 0.97), Rhinion (2.02 ± 0.74), Rhinion to Pronasal midpoint (6.45 ± 3.1), Pronasal (9.5 ± 2.2), between Pronasal and Subnasal (8.8 ± 0.8), and Subnasal (8.5 ± 0.5)., Discussion: The discussion underscores the significance of understanding subcutaneous tissue depth in guiding needle length and approach angles during filler injections. This knowledge aids in achieving effective filling while ensuring safe placement within the subcutaneous tissue., (© 2024 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Objective: Alar asymmetry in unilateral cleft lip (UCL) nasal deformity is a well-recognized clinical feature. However, there is a lack of comprehensive quantitative analysis of this asymmetry. This study compares the shape, volume, and axis rotation between the cleft and non-cleft ala in skeletally mature patients with UCL., Design: A retrospective comparative study utilizing three-dimensional rendered CT scans., Setting: Tertiary care pediatric institution., Patients, Participants: This study included 18 patients with UCL nasal deformity at skeletal maturity., Main Outcome Measure(s): Cleft and non-cleft side ala volume, surface area, and axis to the midsagittal plane., Results: The cleft-side ala was significantly lesser in volume by 27.3%, significantly lesser in surface area by 17.6%, and significantly greater in surface area to volume ratio by 14.6% than the non-cleft ala. The cleft-side ala was significantly greater by 43.1% horizontal axis to the midsagittal plane. In patients with primary rhinoplasty, the cleft-side ala had 28.0% less volume and 18.7% less surface area. In intermediate rhinoplasty, the cleft-side ala had 39.1% less volume and 23.5% less surface area than the non-cleft ala., Conclusions: Significant asymmetry exists between the cleft-side and non-cleft ala in patients with UCL. The cleft-side ala is significantly smaller in volume and surface area than the non-cleft ala. Additionally, the cleft-side ala demonstrates a significantly greater horizontal axis that contributes considerably to nasal asymmetry, supporting the need to restore a normal vertical axis to the clef-side ala., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

One of the most important indicators of rhinoplasty success is nasal skin thickness. Nasal thickness can lead to irregularities over the osseocartilaginous framework among patients with thin nasal skin and difficulty making tip work changes in patients with thick nasal skin. This study aimed to compare different objective methods. These include computed tomography (CT) and ultrasound (US) techniques, and report the relationship between nasal skin thickness and body mass index (BMI). A prospective cross-sectional study that included all patients at the rhinoplasty clinic (King Abdul-Aziz University Hospital), Riyadh, Saudi Arabia, between December 2022 and March 2023. Age, sex, and Fitzpatrick skin type were collected from the patients' histories and physical examinations. Body mass index was calculated for the subjects. The study sample included 29 patients. The median age of the patients was 25 years (interquartile range: 20-32 y). Most of the included patients were Saudi (89.7%, n = 26). Females represented 62.1% of the study sample. The average BMI was 25.6 ± 4.95 kg/m 2 . The highest correlation was observed between the US and CT tip ( r = 0.544, P < 0.01) and rhinion ( r = 0.525, P < 0.01) measurements. Body mass index was not associated with any US or CT measurements when BMI was used as a continuous or ordinal variable. The correlation between the US and CT measurements was highest for rhinoin and tip measurements, whereas supratip measurements were not correlated ( r = -0.029, P = 0.88). The correlation between mid-dorsum and nasion measurements was low (~0.3). The correlation between nasal skin thickness using CT and US varies depending on the nasal point and location. Body mass index was not associated with nasal skin thickness., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Objective: This study evaluated the reliability of a face scanner in measuring the vertical dimension of occlusion (VDO)., Methods: Fully dentate volunteers (n = 20; mean-age = 30.0 ± 10.7 years) were recruited. Clinical facial measurements were obtained using a digital caliper and a face scanner (Obiscanner, Fifthingenium, Italy). The scans were imported into a mesh-processing software, and the distances were measured digitally. Measurements were obtained for each participant with the jaws positioned in maximal intercuspation (MI) and with increased vertical distances of 2, 4, and 6 mm. Vertical and horizontal measures were obtained using facial anatomical landmarks: Glabella (GL), Pronasale (PrN), Subnasale (SbN), inferior border of the right and left Alare, Labiale superius (Ls), right and left Cheilion (Ch), Soft Pogonion (SPg), right and left Tragus of the ear (Tr), for all selected vertical positions. Data analysis included intra-class correlation coefficient (ICC), pairwise comparison tests, Bland-Altman plots, and Passing-Bablok regression., Results: 120 VDO measurements (clinical=60, digital=60) were recorded by two independent evaluators. Mean differences between digital and clinical measurements ranged from 0.054 ± 0.14 mm to 0.203 ± 0.13 mm. All parameters were strongly correlated (r > 0.93; p < 0.001). ICC estimates revealed excellent reliability, and the measuring procedure yielded the same results on repeated trials irrespective of the raters and measurement methods. Bland-Altman plots revealed a difference, between digital and clinical measurements, of 1.7 % for the vertical measurements. Regression analysis revealed no significant proportional difference between the two methods, so both can be used interchangeably., Conclusions: The findings of this study demonstrate that VDO can be measured accurately from face scans using 3D mesh-processing software and that even small changes in the VDO could be detected using the digital methods., Clinical Significance: Findings provide evidence about the reliability of a digital method for jaw relation registrations and may be applied towards incorporating this method into clinical workflows for computer-aided-design/ computer-assisted-manufacturing (CAD-CAM) dentures., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective(s): It was the first study to apply and compare two CT methods to assess the validity and clinical significance of structural alterations of the nasal valve in patients with cleft lip nose for assessing nasal ventilation disturbance., Methods: The study collected data from the NOSE score, as well as internal nasal valve area, internal nasal valve angle, external nasal valve area, and septal deviation angle, to evaluate the differences and correlations between those factors in patients with cleft lip and nose., Results: There were significant differences among INV transverse and coronal area and INV angle on different axial standardized planes between clefted side and non-clefted side. There were statistically significant negative correlations between NOSE scores and those indicators of standard plane and acoustic-axis standardized coronal plane. NOSE score and NSD angle were the indicators of significant differences in the measured data of different complications groups (p = 0.002, p = 0.017). The correlation comparison showed that two standardized CT imaging transverse planes have similar correlations in NOSE score, NSD angle, and complications., Conclusion: The results of the two CT evaluation methods showed that there was a significant difference in nasal valve area on the cleft and non-cleft sides, which was significantly associated with nasal ventilation disturbance. The CT evaluation method based on standard axial 3D reconstruction is more convenient to use in the clinic, can be used for pre-surgical evaluation of nasal repair in patients with secondary nasal deformities of unilateral cleft lip, and is valuable for treatment., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Forensic facial reconstruction is the last recourse to establish the identity of an unknown skull. The facial soft-tissue thickness (FSTT) is required to reconstruct various facial features on a skull. Unlike other facial features, the nose is made of cartilaginous tissue except for a small nasal bone. A large cavity (pyriform aperture) exists on the skull in place of the nose, which makes it a challenging job for reconstruction. The nose is a vital feature for the recognition of a face. Any change in the shape or size of the nose can alter the original aesthetic of the face. The present study proposes angles and regression functions on the bony structure to predict the various parts of the soft nose. A sample of computed tomography (CT) images of 100 males and 100 females aged between 18 and 45 years were included in the study. Apart from measuring fourteen linear parameters with three angles, simple linear regression models were derived for five pairs of parameters. Pearson's correlation coefficients for most of the parameters ranging between 0.221 and 0.872 were found to be significant at p ≤ 0.05 level. FSTT at three anatomical landmarks of the nose was also measured. A morphological observation study was undertaken to find the most frequent direction of the bony anterior nasal spine (ans) and its relation with the position of the pronasale (prn) on the soft nose. The devised parameters proposed in the study may also prove useful for reconstructing the nose in other populations., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Introduction: It is important to generate predictable statistical models by increasing the number of variables on the human skeletal and soft tissue structures on the face to increase the accuracy of human facial reconstructions. The purpose of this study was to determine mouth width 3-dimensionally based on statistical regression model., Material and Methods: Cone-beam computed tomography scan data from 130 individuals were used to measure the horizontal and vertical dimensions of orbital and nasal structures and intercanine width. The correlation between these hard tissue variables and the mouth width was evaluated using the statistical regression model., Results: Orbital width, nasal width, and intercanine width were found to be strong predictors of the mouth width determination and were used to generate the regression formulae to find the most approximate position of the mouth., Conclusion: These specific variables may contribute to improving the accuracy of mouth width determination for oral and maxillofacial reconstructions., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Objectives: Ecogeographic variation in human nasal anatomy has historically been analyzed on skeletal morphology and interpreted in the context of climatic adaptations to respiratory air-conditioning. Only a few studies have analyzed nasal soft tissue morphology, actively involved in air-conditioning physiology., Materials and Methods: We used in vivo computer tomographic scans of (N = 146) adult individuals from Cambodia, Chile, Russia, and Spain. We conducted (N = 438) airflow simulations during inspiration using computational fluid dynamics to analyze the air-conditioning capacities of the nasal soft tissue in the inflow, functional, and outflow tract, under three different environmental conditions: cold-dry; hot-dry; and hot-humid. We performed statistical comparisons between populations and sexes., Results: Subjects from hot-humid regions showed significantly lower air-conditioning capacities than subjects from colder regions in all the three conditions, specifically within the isthmus region in the inflow tract, and the anterior part of the internal functional tract. Posterior to the functional tract, no differences were detected. No differences between sexes were found in any of the tracts and under any of the conditions., Discussion: Our statistical analyses support models of climatic adaptations of anterior nasal soft tissue morphology that fit with, and complement, previous research on dry skulls. However, our results challenge a morpho-functional model that attributes air-conditioning capacities exclusively to the functional tract located within the nasal cavity. Instead, our findings support studies that have suggested that both, the external nose and the intra-facial soft tissue airways contribute to efficiently warming and humidifying air during inspiration. This supports functional interpretations in modern midfacial variation and evolution., (© 2024 The Authors. American Journal of Biological Anthropology published by Wiley Periodicals LLC.)

This retrospective cross-sectional study reviewed adult patients with operated cleft lip and/or palate (CL/P) and normal control, and performed comprehensive craniofacial and nasal morphological analyses based on lateral cephalometric radiographs. Pearson or Spearman correlation coefficient assessed intraclass correlation. Seven hundred fifty-seven operated patients with CL/P, and 165 noncleft normal controls were enrolled. Among the normal and CL/P groups, S-N-A angle registered positive correlations with nasal base prominence (S-N'-Sn, degrees). Upper facial height (N-ANS, mm) had positive correlations with nasal dorsum length (N'-Prn, mm) and nasal bone length (N-Na, mm). Although in patients with bilateral cleft lip and palate, there were moderate negative correlations ( r =-0.541, P <0.05) with soft tissue facial profile angle (FH-N'Pog', degree) and nasolabial angle (Cm-Sn-ULA, degree). Correlation exists between the morphology of jaw bones and external nose among patients with CL/P. Maxillary sagittal insufficiency is associated with concave nasal profile, and maxilla height is associated with nasal length., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Background: To quantify the accuracy of Dolphin Imaging software in predicting soft tissue changes of Class II Division 1 incisor relationship treated by all first premolar extraction compared with actual changes., Methods: Pretreatment and post-treatment lateral cephalograms of 30 young adult subjects (25 females and 5 males; age range of 16 to 21 years) were imported and traced in Dolphin Imaging software (version 11.95). Tracings of actual treatment results and the Dolphin predicted treatment outcome were superimposed to calculate the prediction errors. The mean difference for the Holdaway soft tissue analysis and at each landmark was measured in both the X and Y axes. Paired t test was used to compare the statistical differences in Holdaway soft tissue analysis parameters., Results: There were significant differences between the predicted and actual values in three parameters of the Holdaway soft tissue analysis (P < 0.05). The overall accuracy of estimation was better in vertical direction than horizontal. Prediction of upper and lower lip landmarks was overestimated horizontally and underestimated vertically, whereas that belonging to chin was underestimated horizontally and overestimated vertically. Soft tissue nasion and soft tissue A-point were most accurately predicted, whereas the least accuracy was found in soft tissue chin region., Conclusions: Dolphin Imaging Software (version 11.95) can be accurate enough for use in patient communication and education but should be used with caution. It is most accurate in predicting soft tissue changes in the nasion and A-point regions, but least accurate in chin region., (Copyright © 2024 World Federation of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Aim: To investigate the differences of the nasal soft and hard tissue asymmetry in postoperative patients with unilateral cleft lip and palate (UCLP) between adolescence and adulthood, and to explore the correlation of nasal soft and hard tissue asymmetry., Methods: CT data from 47 repaired UCLP patients were included and divided into two groups:1. adolescent group: 23 patients (15 males, 8 females; age: 10-12 years old). 2. adult group: 24 patients (16 males, 8 females; age:18-32 years old). The three-dimensional asymmetry in nasal soft and hard tissues was analyzed. Additionally, the correlation between nasal soft and hard tissue asymmetry was also analyzed., Results: Both the adolescent group and adult group showed asymmetries in nasal soft and hard tissues. Compared to the adolescent group, the adult group had a significantly increased horizontal asymmetry of nasal soft tissues Sbal (P < 0.05). Furthermore, the sagittal asymmetry of soft tissue Glat (P < 0.05), Sbal (P < 0.001), Sni (P < 0.001) and hard tissue LPA (P < 0.05) also increased significantly. In the adult group, there were more landmarks with a correlation between the asymmetry of nasal hard tissue and soft tissue compared to the adolescent group. There were moderate to strong correlations between nasal hard and soft tissue symmetries in the horizontal and sagittal directions (0.444 < r < 764), but no correlation in the vertical direction in the adult group (P > 0.05)., Conclusions: The asymmetry of nasal soft and hard tissues in patients with repaired UCLP becomes more apparent in the horizontal and sagittal dimensions from adolescence to adulthood. The correlation between the asymmetry of nasal hard tissue and soft tissue becomes stronger in the horizontal and sagittal dimensions. These factors should be taken into account when performing treatment for repaired UCLP patients in adolescence and adulthood., (© 2023. The Author(s), under exclusive licence to The Society of The Nippon Dental University.)

Aim: This study aimed to describe gender-specific three-dimensional morphology of the soft-tissue nose in Lebanese young adults and to explore the associations between nasal morphology with age and body mass index (BMI)., Materials and Methods: Three-dimensional photographs were captured for 176 young healthy Lebanese adults (75 males and 101 females) aged 18.1-37.68 years. Linear and angular nasal measurements were computed and compared between genders, in addition to other established norms. Associations with age and BMI were also assessed., Results: All linear measurements were greater in males than in females, and only the nasolabial angle was significantly larger in females by 2.97 degrees on average. Most of the measurements were found to be larger than the Caucasian norms. A few significant correlations were found between the measurements and age or BMI., Conclusion: This study is the first to present the sex-specific norms for nasal morphology in the Lebanese population and highlights the presence of gender dimorphism in the majority of measurements. Additional studies are needed to validate our data and expand the associations with age and BMI., Clinical Significance: The data offered in this study could help enhance the accuracy of facial reconstructive surgery and aid in personalized treatment planning for both medical and cosmetic nasal interventions. How to cite this article: Saadeh M, Shamseddine L, Fayyad-Kazan H, et al . Nasal Morphology in a Young Adult Middle-Eastern Population: A Stereophotogrammetric Analysis. J Contemp Dent Pract 2024;25(3):199-206.

Background: With the increasing use of dermal injectable fillers in aesthetic medicine, the popularity of non-surgical filler-based rhinoplasty (NSR) is also growing. While performing this procedure might result in certain vascular complications, injecting deep into the midline of the nose is commonly considered the safest method for blind primary NSR., Aims: In this study, we challenged the common NSR method with a Doppler ultrasound study of the nose., Patients/methods: The vascular pattern of the common zones of the NSR procedure (radix and nasal tip) of 21 Iranian women were investigated by using a 14 MHz Doppler handheld ultrasound device (Silarious L14PS). Participants had never undergone any procedure on their nose. We focused on the depth of midline vessels in the radix and nasal tip. The radix was studied sagittally and horizontally, and the nasal tip was examined axially by ultrasound., Results: In the radix of eight cases (38%), at least one vessel was observed at midline, and all were superficial. In the nose tip of 18 cases (86%), at least one vessel was observed at midline, and 9 out of these 18 vessels (50%) were deep. As a result, conducting NSR by the common method in our study population was relatively safe in the radix, but there was an increased likelihood of vascular events in the tip., Conclusion: Our research results show that while the common method of the NSR may carry a high risk of vascular events, the safety of this procedure could be enhanced by using ultrasound for planning and conducting a tailored treatment., (© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Background: As people pay more attention to their skin health and the demand of developing skin care products for facial blackheads grows, the value of objective and efficient image recognition methods for blackheads is becoming more evident. Inspired by this current situation, this study attempted to analyze the number of blackheads of different severity automatically on the nose using an object recognition method on photographs of the nasal blackheads of subjects., Method: This study collected 350 subjects' facial photos in the laboratory environment, who aged 18-60, with blackhead symptoms in the nasal region. And expert assessment was used as a reference for machine learning to verify the performance of the nasal blackhead image recognition model through consistency and correlation analysis., Results: The study concluded that the algorithm accuracy reached above 0.9, the model itself was effective, and the consistency between the model and the expert assessor assessment results was good, with the number of nasal blackheads, the count of blackheads of different severity, and the intra-group correlation coefficient ICC of blackhead severity all above 0.9, indicating that the deep learning-based assessment model had high overall performance and the evaluation results were comparable to those of the expert assessor., Conclusion: The recognition and analyzing model of nasal blackhead images provides a scientifically objective and accurate method for identifying the number and evaluating the severity of nasal blackheads. By using this model, the efficiency of evaluating nasal blackhead images in the cosmetics clinical trial will be improved. The assessment result of nasal blackheads will be objective and stable, and not only rely on the professional knowledge and clinical experience of assessors. The model can try to be applied in cosmetics efficacy testing and continuously optimized., (© 2024 The Authors. Skin Research and Technology published by John Wiley & Sons Ltd.)

Purpose: This study was designed to investigate the changes in nasal soft tissue following maxillary Lefort I advancement with and without impaction in subjects presenting a skeletal class III malocclusion, using a 3D photogrammetry scanner., Materials and Methods: Patients with class III malocclusion undergoing Lefort I advancement with and without impaction and bilateral sagittal split osteotomy with the standard technique were included in this study. Patients were divided into two groups: maxillary Lefort I advancement alone (group 1) and combined with impaction (group 2). Facial soft tissue landmarks of the nose including nasal height (NH), nasal length (NL), nasal tip projection (NTP), alar width (AW), alar base width (ABW), subalar width (Sbal), nasolabial angle (NLA), nasofrontal angle (NFA), and columella inclination (CI) before and at least 4 months after surgery were obtained by a 3D scanner., Results: Twenty-one patients were included in this study (Group 1: 11 and Group 2: 10). NH, NTP, and NL decreased significantly in both groups following surgery. In addition, Sbal decreased only in group 2. On the other hand, NLA and CI increased significantly in group 2. The inter-group comparison revealed a statistically significant difference in the alterations in NH, NL, and CI between the two groups., Conclusion: Changes in the nose soft tissue occurred after both surgeries, but their type and extent were different. Actions taken to reduce unwanted changes need to be further investigated. To evaluate the changes, 3D photogrammetry scan is a feasible imaging technique that can be used, providing numerous benefits., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The nose is a prominent feature for facial recognition and reconstruction. To investigate the relationship of the nasal shape with the piriform aperture in Korean adults and juveniles, we performed regression analysis. By regression analysis, prediction equations for nasal shape were obtained in relation to the shape of the piriform aperture considering sex and age groups. Three-dimensional skull and face models, rendered from computed tomography images, were assessed (331 males and 334 females). Juveniles (<20 years) were divided into three age groups according to the development of the dentition. Adults were divided into three age groups of two decades each, according to their age. To measure the nasal area, nine landmarks and nine measurements were chosen, while seven landmarks and five measurements were selected to measure the piriform aperture area. Four measurements were defined to explain the direct relationship between the nasal aperture and nasal shape. First, descriptive statistical analyses were performed according to sex and age groups. Subsequently, the correlation of nasal soft tissue measurements with piriform measurements was analyzed. Last, we performed a linear regression analysis of the measurements with higher correlations, considering sex and age groups as variables. Prediction equations were used to estimate the nasal bridge length, height, protrusion, and width. Equations considering sex and age groups showed better explanation ability. Measurements related to the height of the nasal bridge presented improvement. This study may assist in the more accurate approximation of nasal shape in facial reconstruction., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: New 3D technologies for superficial soft tissue changes, especially in plastic and reconstructive surgical procedures, can improve the planning and documentation of facial surgeries. The purpose of this study was to compare and determine the applicability and feasibility of three different 3D-photography systems in clinical practice imaging the nose., Methods: A total of 16 healthy non-operated noses were included in this prospective study. A plaster model of each nose was produced, digitized, and converted to a .stl mesh (= ground truth model). Three-dimensional images of each nose were then taken using Artec Space Spider (gold standard), Planmeca ProFace®, and the Bellus3D Dental Pro application. All resulting .stl files were aligned to the ground truth model using MeshLab software, and the root mean square error (RMSE), mean surface distance (MSD), and Hausdorff distance (HD) were calculated., Results: The Artec Space Spider 3D-photography system showed significantly better results compared to the two other systems in regard to RMSE, MSD, and HD (each p < 0.001). There was no significant difference between Planmeca ProFace® and Bellus3D Dental Pro in terms of RMSE, MSD, and HD. Overall, all three camera systems showed a clinically acceptable deviation to the reference model (range: -1.23-1.57 mm)., Conclusions: The three evaluated 3D-photography systems were suitable for nose imaging in the clinical routine. While Artec Space Spider showed the highest accuracy, the Bellus3D Dental Pro app may be the most feasible option for everyday clinical use due to its portability, ease of use, and low cost. This study presents three different systems, allowing readers to extrapolate to other systems when planning to introduce 3D photography in the clinical routine., (© 2024. The Author(s).)

The emergency of esophageal button batteries is recognized. Foreign bodies in the ear or nose are treated as comparatively nonemergent. We present the case of a child who presented with suspected pen-nib in the nostril to highlight the importance of investigation and intervention in unwitnessed nasal foreign body and review the literature regarding X-rays in these cases. Fifteen papers were identified as per search parameters; 3 papers recommend the use of plain radiographs for nasal foreign bodies. We propose that in unwitnessed pediatric nasal foreign body insertion, a facial X-ray should be considered, especially if suspecting a metallic foreign body., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: The nasal cavity effectively captures the particles present in inhaled air, thereby preventing harmful and toxic pollutants from reaching the lungs. This filtering ability of the nasal cavity can be effectively utilized for targeted nasal drug delivery applications. This study aims to understand the particle deposition patterns in three age groups: neonate, infant, and adult. Materials and methods: The CT scans are built using MIMICS 21.0, followed by CATIA V6 to generate a patient-specific airway model. Fluid flow is simulated using ANSYS FLUENT 2021 R2. Spherical monodisperse microparticles ranging from 2 to 60 µm and a density of 1100 kg/m 3 are simulated at steady-state and sedentary inspiration conditions. Results: The highest nasal valve depositions for the neonate are 25% for 20 µm, for infants, 10% for 50 µm, 15% for adults, and 15% for 15 µm. At mid nasal region, deposition of 15% for 20 µm is observed for infant and 8% for neonate and adult nasal cavities at a particle size of 10 and 20 µm, respectively. The highest particle deposition at the olfactory region is about 2.7% for the adult nasal cavity for 20 µm, and it is <1% for neonate and infant nasal cavities. Discussion and conclusions: The study of preferred nasal depositions during natural sedentary breathing conditions is utilized to determine the size that allows medication particles to be targeted to specific nose regions.

A prospective study utilizing image analysis to assess nostril openings in post-operative patients with cleft lip and cleft lip nose deformities. This preliminary study seeks to employ two-dimensional (2D) images to fabricate a custom-made nostril retainer. This study was performed at Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand. This study included 30 healthy volunteers and 15 patients with cleft lip and cleft lip nose deformities. The nostril opening width and height for all participants were measured, and photographs were taken. An image analysis application was used to fabricate a three-dimensional (3D) custom-made nostril retainer. The mean differences between the direct measurements of the nostril aperture and the measurements obtained through the program did not exceed 2 mm in terms of nostril height, width, or columella. Two-dimensional photographs can be used to create a custom-made, three-dimensional nostril retainer. This retainer allows post-operative patients to maintain their nares without needing to visit the hospital, thereby reducing the cost of care., (© 2023. The Author(s).)

The present study used microdissection, histology, and microcomputed tomography (micro-CT) with the aims of determining the prevalence and patterns of the depressor septi nasi (DSN) and orbicularis oris (OOr) muscles attached to the footplate of the medial crus (fMC) of the major alar cartilage, focusing on their crossing fibers. The DSN and OOr attached to the fMC of the major alar cartilage were investigated in 76 samples from 38 embalmed Korean adult cadavers (20 males, 18 females; mean age 70 years). The DSN, OOr, or both were attached to the fMC. When the DSN ran unilaterally or was absent, some OOr fibers ascended to attach to the fMC instead of the DSN in 20.6% of the samples. Crossing fibers of the DSN or OOr attached to the fMC were found in 82.4% of the samples. Bilateral and unilateral crossing fibers were found in 32.4% and 50.0%, respectively, and no crossing fibers were found in 17.6%. The DSN and OOr that attached to the fMC could be categorized into six types according to presence of the DSN and the crossing patterns of the DSN and OOr. Anatomical findings of the DSN and OOr that attached to the fMC were confirmed in histology and micro-CT images. These findings offer insights on anatomical mechanisms that may underlie the dynamic pulling forces generated by muscles that attach to the fMCs and on evolutionary variation observed in human facial expressions. They can also provide useful information for guiding rhinoplasty of the nasal tip., (© 2023. The Author(s).)

Objective: To determine the correlation of nasal morphology with maxillary and mandibular patterns., Study Design: Descriptive cross-sectional study. Place and Duration of the Study: Department of Orthodontics, Liaquat College of Medicine and Dentistry and Qamar Dental Hospital, Karachi, Pakistan, , Liaquat College of Medicine & Dentistry and Darul Sehat Hospital Karachi, Pakistan from January to June, 2022., Methodology: The pre-treatment lateral cephalograms of 120 patients, aged 18-35 years were included in the study. Eleven nasal parameters were traced on lateral cephalograms and correlated with four maxillary and mandibular skeletal parameters by Pearson correlation coefficient test using SPSS version 26.0., Results: Nasal bone length and nasal base angle showed a negative correlation with maxillary and mandibular position. Nasal upward tip angle was correlated positively with maxillary position whereas nasal tip angle was found to be negatively correlated with maxillary length. A negative correlation was observed between nasolabial angle and mandibular position. Nasal bone angle depicted a positive correlation with maxillary position and a negative correlation with jaw lengths and mandibular inclination., Conclusion: Nasal morphology has a strong correlation with maxillary as well as mandibular base lengths and position but not with inclination of the jaws. The acquaintance of the relationship of different nasal parameters with jaw parameters might be helpful in diagnosis and treatment planning and to attain the favourable treatment outcomes in patients undergoing orthodontic treatment, orthopedic interventions, orthognathic, genioplasty, rhinoplasty, profiloplasty and other procedures., Key Words: Nasal morphology, Maxillomandibular skeletal pattern, Jaw length, Jaw position, Jaw inclination.

Introduction: One of the primary objectives of orthodontic treatment has been the enhancement of facial aesthetics. To obtain the perfect facial profile with aesthetic balance, knowledge of facial anatomy is essential. The diagnosis and treatment planning of orthodontic patients depend greatly on the examination of the soft tissue profile. Since the nasolabial angle is significantly affected by the inclination of the upper incisors, it is a frequently employed soft tissue parameter in orthodontic diagnosis., Aim: The study aimed to find out the correlation between the nasolabial angles with maxillary incisor inclination., Materials and Methods: In this retrospective study, 120 lateral cephalograms of orthodontic patients including males and females were traced. Their nasolabial angle and maxillary incisor inclination were calculated before and after orthodontic treatment., Result: The mean of pre- and post-treatment nasolabial angle was found to be 91.43° ± 14.008 and 97.93° ± 14.194, respectively. The mean of pre- and post-treatment incisor inclination was found to be 32.59° ± 7.290 and 23.98° ± 6.851, respectively. The gender-wise Pearson's correlation (r) of nasolabial angle with incisor inclination for male and female was found to be -0.464 with a P value of 0.164 and -0.305 with a P value of 0.118, respectively. Overall Pearson's correlation of nasolabial angle with incisor inclination was found to be -0.040 with a P value of 0.384., Conclusion: There is an insignificant negative correlation between nasolabial angle and incisor inclination in the Chhattisgarh population as well as among the two genders., (Copyright © 2023 Copyright: © 2023 Indian Journal of Dental Research.)

Background: There is a lack of standardized surgery for cleft rhinoplasty. We felt that the technique described by Dr Louise Caouette Laberge is an ideal way to approach this problem, thus we tried to quantify the outcome of surgery by volumetric assessment., Material and Method: We recorded 3D images using an Artec scanner and performed volume calculations of the cleft side and noncleft side of the nose. These readings were taken once in the preoperative and then 2 weeks postoperative. Another scan of the face was performed 2 years after the surgery to compare the volumes of the cleft and noncleft side nostril., Results: Of the 31 patients with unilateral cleft lip operated on (mean age 3-8 months), we found a significant increase in the cleft side volume at 3 weeks postoperative from 3.95 mm 3 to 5.65 mm 3 (p < 0.001 on paired t-test). A repeat scan done on the study population at 2 years postoperative found that the mean volume of the cleft side was 30.43 mm 3 (standard deviation [SD], 2.49) and that of the normal side was 30.82 mm 3 (SD, 2.51). An independent t-test found that there was no significant difference between the two volumes (p > 0.05) CONCLUSION: The use of volumetric data in the evaluation of postoperative outcomes provides an objective criterion for assessing the aesthetics as well as the growth. Our study concludes that the Laberge technique provides a good aesthetic outcome with minimal scarring for the management of cleft nose and lip with the anterior palate., Competing Interests: Declaration of Competing Interest The authors do not have any conflict of interest., (Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Proboscis lateralis is a rare craniofacial anomaly in which a rudimentary nasal appendage arises at the medial canthal area. The severity depends on organ involvement, including eyes, nose, cleft lip/palate, and/or concomitant intracranial anomalies. Here, we present a child with proboscis lateralis and associated trans-ethmoidal encephalocele. We suggest doing the preoperative CT and/or MRI to rule out associated intracranial anomalies and reliably preoperative planning tools. Moreover, we proposed an alternative nasal reconstructive technique using a composite graft from the proboscis mass at the same time as encephalocele repair with promising results.

Objectives: To evaluate the midfacial soft tissue changes of the face in patients treated with miniscrew-assisted rapid palatal expansion (MARPE)., Materials and Methods: 3D facial images and intra-oral scans (IOS) were obtained before expansion (T0), immediately after completion of expansion (T1), and 1 year after expansion (T2). The 3D images were superimposed and two 3D distance maps were generated to measure the midfacial soft tissue changes: immediate effects between timepoints T0 and T1 and overall effects between T0 and T2. Changes of the alar width were also measured and dental expansion was measured as the interpremolar width (IPW) on IOS., Results: Twenty-nine patients (22 women, 7 men, mean age 25.9 years) were enrolled. The soft tissue in the regions of the nose, left of philtrum, right of philtrum, and upper lip tubercle demonstrated a statistically significant anterior movement of 0.30 mm, 0.93 mm, 0.74 mm, and 0.81 mm, respectively (p < 0.01) immediately after expansion (T0-T1). These changes persisted as an overall effect (T0-T2). The alar width initially increased by 1.59 mm, and then decreased by 0.08 mm after 1 year, but this effect was not significant. The IPW increased by 4.58 mm and remained stable 1 year later. There was no significant correlation between the increase in IPW and alar width (r = 0.35, p = 0.06)., Conclusions: Our findings indicate that MARPE results in significant but small changes of the soft tissue in the peri-oral and nasal regions. However, the clinical importance of these findings is limited., Clinical Relevance: MARPE is an effective treatment modality to expand the maxilla, incurring only minimal and clinically insignificant changes to the midfacial soft tissues., (© 2023. The Author(s).)

Backgrounds: 3D simulation is increasingly used in rhinoplasty. However, during the operation, there is no tool to directly link the 3D simulation results with the intraoperative operation. Doctors rely on 3D simulation results only according to their intuition. Recently, the authors have discovered a simple, low-cost, and practical method for intraoperative assessment: a film model can be made according to the contour of the nose shape in its midsagittal view. The authors aimed to evaluate the effectiveness of the innovative method for intraoperative assessment of nasal shape in rhinoplasty., Methods: Thirty-nine patients who underwent rhinoplasty for the first time between January 2019 and January 2021 were included in this study. All the patients confirmed ideal nasal shape based on preoperative three-dimensional photography (INOVA 3D-EX). In the guide group, procedures were based on guide of the film model and a picture of 3D simulation, and in the control group, procedures were performed based on the surgeon's intuition and a picture of 3D simulation., Results: There were no statistical differences in basic data between the two groups before operation. Both groups showed a satisfactory correlation. Except for the columellar lobular angle, the ICC of nasal length, nasal depth, dorsum height, columella length, nasofrontal angle, nasorostral angle, and nasolabial angle were all stronger in the guide group than in the control group., Conclusion: This study demonstrates the usefulness of the nasal-shaped film model, which is made according to the contour of the nose shape in its midsagittal view. This approach is simple, low-cost, and practical., (Copyright © 2022. Published by Elsevier Ltd.)

Objectives: This study aimed to explore the relationship between alveolar cleft and secondary nasal deformity post unilateral cleft lip repair in adults., Methods: A total of 27 patients aged 16-30 years old with unilateral secondary nasal deformity and alveolar cleft were included, 13 of whom underwent bone grafting. Spiral CT data of all preoperative and postoperative patients who had alveolar bone grafting were collected. Then, Mimics software was used for three-dimensional reconstruction to evaluate the correlation between the width, height, and volume of the alveolar cleft and those of the nasal deformity. The difference in nasal deformity before and after alveolar bone grafting was also explored., Results: The width of the alveolar cleft was positively correlated with the difference in bilateral nostril floor width ( P <0.05). As the effective depth of the alveolar cleft increased, the sub-alare inclination angle largened ( P <0.05). However, no significant difference was found in the nasal deformity between before and after alveolar bone grafting., Conclusions: Alveolar cleft is closely related to secondary nasal deformities post unilateral cleft lip repair, especially nasal floor deformities. Alveolar bone grafting benefits adult patients for the improvement of secondary nasal deformities post unilateral cleft lip repair.

Purpose: Bony changes after orthognathic surgery are always followed by changes of the overlying soft tissues. Therefore, morphologic changes of the nose may be expected after procedures involving the maxilla. The purpose of this study was to evaluate the changes in the nasal region due to orthognathic surgery using computed tomography (CT) images of virtually planned patients., Methods: 35 patients who underwent Le Fort I osteotomy, with or without bilateral sagittal split osteotomy, were included. 3D measurements on preoperative and postoperative images were performed and analyzed., Results: The results revealed that aesthetically acceptable results can be achieved by orthognathic surgery alone., Conclusions: According to the results of this study, it can be concluded that it is best to reserve decisions on rhinoplasty to the post-orthognathic period., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Morphometric changes achieved in rhinoplasty are mostly analyzed on two-dimensional (2D) images. However, most of these alterations are amenable to three-dimensional (3D) analysis., Objectives: Objective measurements for rhinoplasty are currently done on 2D photographic analyses. We believe that newer techniques will develop. This is a study to help define new parameters., Methods: Landmarks that are widely used in the literature were used to define the boundaries of these measurements. They comprised certain parts of the nose (tip, dorsum, radix, etc.). Measurements were done on a generic face (GF) 3D model. The model's nose was then morphed using the free, open-source 3D modeling software (Blender) to generate seven different deformed noses and to perform the area and volume measurements., Results: Each nose with a different type of deformity demonstrated significant area and volume differences. For example, comparing area measurements to GF-Pleasant nose, GF-Snub nose showed a significant difference at the tip (43.3% reduction). Volume measurements were found to be mostly parallel to the area measurements; however, some incongruences were noted., Conclusions: We show that new area and volume measurements can be reliably developed for 3D-scanned images. These measurements can be utilized and will enrich the facial analysis and evaluation of the outcomes of rhinoplasty., Competing Interests: Declaration of Competing Interest All authors declare that they do not have any financial or personal relationships with other people or organizations that could inappropriately influence (bias) their work., (Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Objectives: This study aimed to investigate the 3-dimensional (3D) facial morphology of children with skeletal Class II structure with different breathing patterns., Methods: The 3dMDFace system (3dMD Inc.) was used to obtain 3D facial images. A total of 65 patients aged 10 to 12 years with skeletal Class II malocclusion (A point-Nasion-B point angle >5°) were grouped by sex into nasal-breathing (NB) and mouth-breathing (MB) participants. A total of 19 measurements, including linear distances, angles, and ratios, were measured. The measurements were compared using independent sample t test and Mann-Whitney U test. Factor analysis and logistic regression were used to test the correlation between facial morphology and different breathing patterns., Results: For male children, the lower lip was longer in the MB group than in the NB group (P < .05). For female children, compared to NB, MB patients had a narrower mandibular width (P < .05), a smaller ratio of mandibular width to face height (MB: 0.99 ± 0.08 vs NB: 1.04 ± 0.09; P < .05), and a larger ratio of lower lip height to lip width (MB: 1.24 ± 0.10 vs NB: 1.19 ± 0.16; P < .05). In both male and female children, MB participants had a more convex nasolabial angle (P < .05) and an increased ratio of the lower part of the face to the upper facial height (male MB: 1.61 ± 0.17 vs male NB: 1.50 ± 0.12; female MB: 1.52 ± 0.10 vs female NB: 1.50 ± 0.20; P < .05). The logistic regression test showed no significant correlation between facial morphology and breathing patterns., Conclusions: In participants with skeletal Class II pattern, MB children compared with NB children showed different facial morphology in the same sex group. The children with MB showed a more protruded upper lip and increased lower facial height, accounting for a larger proportion of the facial height. However, no significant correlation was found between facial morphology and breathing pattern. Only correlative trends were found., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Congenital absence of the nose or arhinia is an exceptionally rare craniofacial malformation, and the pathophysiology of the arhinia is still unknown. Most arhinia patients can have difficulties with breathing and feeding due to the absence of the nose, nasal cavities, and associated problems. A 38-day-old female patient was referred to our clinic with arhinia. Physical examination revealed the complete agenesis of nasal structures as the nasal bones and vestibulum nasi. The region of the absent nose was flat and firm at palpation. Congenital arhinia may occur with other associated malformations such as ocular, ear, palate, and gonadal. Therefore, it is recommended to evaluate computed tomography/magnetic resonance imaging in the postnatal period. Additionally, a radiological evaluation will help nasal reconstruction by documenting changes in nasal and maxillary anatomy over time. Due to the limited number of arhinia cases presented, the surgical management of this condition has not been standardized. We presented the pyramid-shaped cartilage grafts for the nasal framework and an expanded paramedian forehead flap for the skin coverage for reconstruction of arhinia.

Objective: In the present study, we investigated the efficacy of morphing technology via Adobe PhotoShop program and its "liquefy" effect in patients planned to undergo augmentation rhinoplasty., Patients and Methods: The retrospective data for 100 consecutive augmentation rhinoplasty cases (64 females and 36 males) were enrolled in our study. Preoperative computer imaging (PCI) steps, a stepwise systematic guide for image editing, including (1) augmenting the dorsum, (2) lengthening the nose, (3) adjusting the tip projection, (4) perfection of the nasal dorsum and (5) exaggerating the tip projection and/or the dorsal augmentation were applied to the patients. After performing the PCI before augmentation rhinoplasty, the patients were allowed to see the options for the final appearance of their noses. Therefore, PCI helped them to decide on their operations., Results: After applying CS-PCI before augmentation rhinoplasty, 71 patients (71%) accepted Step-4, and 19 (19%) accepted Step-3. Furthermore, six patients (6%) requested additional changes during their operational planning. In 95% of the cases, the authors achieved the results agreed upon based on the preoperative simulation., Conclusions: By PCI involving five steps for augmentation rhinoplasty, the patients were allowed to see the options for the final appearance of their noses. Therefore, PCI helped them to decide on their operations. With the help of morphing technology (2D), it is possible to increase interpersonal communication effectively.

The fascial system of the face (superficial musculo-aponeurotic system, SMAS) in the nasal part is a sustained layer that connects the nearby regions. In this paper, we aimed to emphasize the presence of SMAS in different areas of the nasal region: ala nasi, nasolabial fold, nasal dorsum and radix. We performed three studies (anatomical, histological, and radiological) to demonstrate the existence of nasal SMAS. The study group consisted of cadaveric analyses and retrospective analysis of the patient radiological data. The nasal SMAS was identified as a superficial fascia and a subcutaneous adipose layer. The anatomical dissection study together with histological and radiological evaluations demonstrated the presence of SMAS in the nasal region. We identified peculiarities of the nasal SMAS in two areas: in the ala nasi where it is thinner, and the deep part of the dermis does not adhere to the underlying structures and at the radix and dorsum nasi, where the adipose layer is very thin. The results of our research define nasal SMAS as a unit of great value in facial surgeries, such as facial rejuvenation, the resolution of malformations, or tumor removal.

Background: Excessive nasal edema is among the complications after rhinoplasty translating into Skin-Soft Tissue Envelope (SSTE) thickening and disruption in the nasal framework's definition. Revision rhinoplasties are suspected of causing even more nasal edema. The objective postoperative SSTE thickness between revisionary and primary rhinoplasties is compared in this study., Methods: A study was conducted over a recorded database of eligible candidates who had attended the senior author's private clinic in a 12-month period and underwent primary and revisionary open-approach rhinoplasties. The SSTE thickness was measured by ultrasonography in each nasion, rhinion, supratip, and tip region at months 1, 3, 6, and 12 after each episode of rhinoplasty. Paired T-test was used for pairwise comparisons of the corresponding region-time thicknesses between primary and revisionary rhinoplasties. Repeated measure ANOVA tests were used to assess mean thickness changes over time after each surgery-P < 0.05 indicated significance., Results: Of the 36 participants analyzed, the SSTE was significantly thicker after revisionary surgery in all the follow-up sessions and nasal regions, except for the 1-month follow-up in the nasion (p = 0.273) and 12-month follow-up in the rhinion (p = 0.050). Mean nasal SSTE thickness showed decreasing trends in each region after either primary or revisionary surgery, with a lower level of resolution in the nasion region after revision rhinoplasty (p < 0.001)., Conclusions: The nasal SSTE had been significantly thicker in most regions after revisionary procedures than primary ones, and the swelling had subsided slightly slower. Surgeons are recommended to consider revisionary rhinoplasties based on these findings cautiously., Level of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2022. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Objectives: To evaluate the integration accuracy of cone-beam computed tomography (CBCT) images with three-dimensional (3D) facial scans according to different registration areas., Materials and Methods: Twenty-five patients (14 males and 11 females), with a mean age of 19.0 ± 11.3 years, were included in this study. Each patient underwent CBCT and facial scans on the same day in an upright position. The facial scans were integrated with the corresponding soft-tissue images of CBCT scans. Three methods were used to integrate the two imaging modalities based on the facial regions scanned: R1, only the forehead and nasal bridge area were included; R2, the right and left malar area were included; and R3, the forehead, nasal bridge, and malar areas were included. The integration accuracy between the facial scans and CBCT images was evaluated by color-mapping methods and average surface distances, calculated by measuring the 3D distances between the surface points on the two superimposed images., Results: The average surface differences between facial scans and CBCT images were less than 1.0 mm in all three methods. The R3 method showed fewer differences between the facial scans and CBCT images than the other methods did., Conclusions: Facial scans obtained using a low-cost facial scanner showed clinically acceptable performance. The integration accuracy of facial and CBCT scans can be increased by including the forehead, nasal bridge, and malar areas as registration areas., (© 2023 by The EH Angle Education and Research Foundation, Inc.)

Objective: To evaluate, by a three-dimensional study, the volumetric and integumentary effects of rapid maxillary expansion on the nose, in mouth breathing kids with maxillary hypoplasia, in the short term, assessing the possible interference of gender, growth and age on the results achieved., Methods: 120 mouth breathing patients with maxilla hypoplasia were divided into an Experimental Group treated by rapid maxillary expansion (n = 104, 62 males and 42 females, mean age 10.1 years, SD = 2.10, ranging from 5.1 to 13.9 years); and Control Group, constituted by 16 patients (9 males and 7 females, mean age 9.3 years, SD = 2.1 years, ranging from 6.1 to 13.2 years). Patients in the experimental group underwent multislice computed tomography examinations at two different times: (T1) pre-expansion and (T2) post-expansion. The control group was submitted to the same tests at the same time intervals. Six soft tissue variables of the nose were studied, besides the volume and area of the nasal cavity, and the measurement and comparison of data between T1 and T2 were performed using the Dolphin Imaging 11.7 Premium software., Results: The experimental group showed significant mean increases in all soft tissue variables studied (p < 0.005), yet there were no significant changes in the control group. In the comparison between groups, only inclination of the nasal dorsum did not present any significant change., Conclusion: Rapid maxillary expansion may alter the nasal shape and physiology, by anatomical changes in the nose soft tissues, making it an important aid in the treatment of mouth breathing in childhood., Level of Evidence: The soft tissues of the nose play an important role in nasal shape and physiology and facial esthetics, and since they are directly related to the nasal valves, they are fundamental for maintenance and stability of the nasal breathing pattern., (Copyright © 2022 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.)

Purpose: To study the anatomy of the latero-lateral joint (LLJ) between the upper lateral (ULC) and lower lateral (LLC) crus of the nasal cartilages, usually described as a scroll articulation., Methodology: Six nasal pyramids were taken in monobloc from fresh cadavers and imaged on micro-MRI with 0.4 mm slice thickness. Images were jointly interpreted by two head and neck radiologists and one surgeon. The junction between the ULC and LLC, the presence of ligaments and of sesamoid or accessory cartilages were assessed., Results: Eight LLJs could be analyzed, with four types of junctions: hook-shaped cephalic border of the LLC turned towards the nasal fossa and linear caudal border of the ULC (n = 3), hook-shaped caudal border of the ULC and linear cephalic border of the LLC lateral crus (n = 1), hook-shaped border of both cartilaginous edges with clinging (n = 1) (scroll articulation) or without clinging (n = 3). No ligament or sesamoid cartilage was found, but posterior accessory cartilages were seen in 75% of the cases., Conclusion: The classical scroll articulation of the LLJ has been observed in only 1/8 cases on micro-MRI images. The anatomy of the LLJ could explain the surgical difficulty in raising the tip of the nose in some patients and not in others., (© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Background: A filler injection in the nose can be essential but is also dangerous, especially in the nasal cartilage region. To safely and accurately perform a filler injection, surgeons must have detailed knowledge of nasal anatomy., Objectives: Associated the vessel branches and the characteristics of different nasal regions to provide suggestions for more suitable injection sites., Methods: Fifty specimens underwent computed tomography (CT) after contrast infusion. Qualified specimens were selected for 3D CT reconstruction. Dissection was performed to confirm the accuracy of the CT data., Results: The branches of arteries with large diameters, the dorsal nasal artery (DNA) and the lateral nasal artery (LNA) were distributed within the superficial musculoaponeurotic system layer. The DNA was seen in only 58% of specimens. The artery crossed the midline over the upper lateral cartilage in 16% of specimens. The LNA was a constant branch that traversed the nasal tip. The LNA crossed the midline to the contralateral side in 18% of patients. We divided the nasal cartilage dorsum into two regions for easy handling: the supratip region (STR) and the nasal tip region (NTR). The branches distributed in the STR mostly originated from the DNA (81.6%, 40/49), while those in the NTR mostly originated from the LNA., Conclusions: The vasculature of the nasal cartilage region observed in this study is similar to that observed in previous studies. However, we found that the STR was an advantageous area for filler injection. At the same time, we provided suggestions for more suitable injection methods., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2022. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Two nasal foreign bodies were discovered by a dental practitioner on a routine radiographic examination of a 15-year-old autistic patient. Going over past radiographs, one of the nasal foreign bodies was detected in a radiograph performed 2 years previously. No nasal complaints or other clues to the problem were apparent. The patient was referred to the emergency room, and the foreign bodies were removed by an Ear Nose and Throat specialist, under general anesthesia. This paper reviews the diagnosis and treatment of nasal foreign bodies, and highlights the important role of the dental practitioner in the proper detection and diagnosis, prompt referral for management, and reduction in related complications.

Aim: Nowadays, the use of CBCT in orthodontics and paediatric dentistry is constantly increasing. Since it allows a precise 3D visualisation of the entire head, CBCT can be used to identify alterations and pathologies of the jaws, but also of the sinonasal complex. Despite that, literature lacks studies focusing on the sinonasal complex of healthy orthodontic paediatric patients. Therefore, the aim of this cross-sectional retrospective study is to analyse the prevalence of incidental findings and anatomic variations of the nose and paranasal sinuses in orthodontic patients in the age of development., Methods: The 61 CBCTs that respected all inclusion criteria (patient's age under 15 years old and CBCT scans showing the entire sinonasal complex, data in DICOM format) were searched for: nasal septum deviation, Onodi cells, Haller cells, concha bullosa, sinus underdevelopment, sinus mucosal thickening, sinus cysts or polypoid formations. CBCTs were evaluated by two different orthodontists and their findings were then compared and statistically analysed., Conclusion: Considered the high prevalence of incidental findings, prescription of a CBCT to paediatric patiens seems crucial in order to to detect conditions that would require referral to a specialist.

Background: Augmentation rhinoplasty with autologous fat grafting is a useful procedure to meet the demand for facial harmonization in the Asian population. We used this procedure during orthognathic surgery to address inadequate dorsum projection. This prospective study was conducted to determine the fat retention rate in patients undergoing simultaneous autologous fat injection augmentation rhinoplasty and orthognathic surgery., Methods: Nineteen patients were treated with simultaneous bimaxillary orthognathic surgery and autologous fat grafting of the nasal dorsum and tip. The paired t test was used to compare the nasal volumes before and at least 6 months after surgery measured by 3-dimensional computer tomography scans. All measurements were performed twice by the same evaluator at least 2 weeks apart for intrarater consistency., Results: Seventeen patients completed the study. The volume means before and after surgery were 22.3 ± 4.6 cm 3 and 23.3 ± 4.7 cm 3 , respectively, with a mean difference of 1.0 ± 0.3 cm 3 ( P < .001). The mean retention rate was calculated to be 50.5% ± 7.0% (range: 40.5%-64.7%). Intrarater consistency was high with a Cronbach α of .97 ( P < .001) and .98 ( P < .001), respectively., Conclusion: This prospective study provides objective graft retention measurements for fat injection augmentation rhinoplasty combined with orthognathic surgery. All patients were satisfied with the results and no complications or additional morbidity was noted in the postoperative course. We consider this procedure to be a safe, reliable, and powerful adjunct to improve the aesthetic results of orthognathic surgery.

Computational fluid dynamics of the air flow in the human nasal cavities, starting from patient-specific Computer Tomography (CT) scans, is an important tool for diagnostics and surgery planning. However, a complete and systematic assessment of the influence of the main modelling assumptions is still lacking. In designing such simulations, choosing the discretization scheme, which is the main subject of the present work, is an often overlooked decision of primary importance. We use a comparison framework to quantify the effects of the major design choices. The reconstructed airways of a healthy, representative adult patient are used to set up a computational study where such effects are systematically measured. It is found that the choice of the numerical scheme is the most important aspect, although all varied parameters impact the solution noticeably. For a physiologically meaningful flow rate, changes of the global pressure drop up to more than 50% are observed; locally, velocity differences can become extremely significant. Our results call for an improved standard in the description of this type of numerical studies, where way too often the order of accuracy of the numerical scheme is not mentioned., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The aim of this retrospective long-term study was to assess the influence of primary columella lengthening and presurgical nasoalveolar molding (NAM) on the skeletal development at the completion of growth in patients with bilateral cleft lip and palate (BCLP). Lateral cephalometric radiographs at the completion of growth of consecutively treated patients BCLP patients, operated by the same surgeon, who had undergone NAM were compared with a second group of BCLP patients who were not treated with NAM. The groups were matched for sex and age. Independent samples t tests were carried out. 23 Lateral cephalometric radiographs of BCLP patients (mean age 18.2 ± 1.3 years) who had undergone NAM were compared with a second group of 23 BCLP patients (mean age 18.4 ± 1.3 years) who were not treated with NAM. The only two significant differences were observed in Ans-Me/N-Me (control group = 0.6 ± 0.02; sample group = 0.57 ± 0.05; p = 0.019) and ILs^AnsPns (control group = 105.5 ± 7.9; sample group = 112.4 ± 8.6; p = 0.007). No other significant differences were observed in terms of facial skeletal development between the two groups. Presurgical NAM performed during infancy in BCLP patients does not seem to have negative effects on the skeletal development at the completion of craniofacial growth compared to the group of patients treated without NAM., Competing Interests: Declaration of competing interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2022 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Nonsurgical rhinoplasty procedures using soft tissue fillers have gained popularity. With the increasing frequency of such procedures, the incidence of intra-arterial injection of soft tissue filler material and subsequent ischemia has also risen. This article analyzes the topographic anatomy of the dorsal nasal artery in the nasal soft tissue to potentially enhance patient safety in nonsurgical rhinoplasty procedures. The dorsal nasal artery shows a variable topographic course, especially in relationship to the procerus muscle. By understanding the topographic courses of the dorsal nasal artery, aesthetic practitioners may be able to perform nonsurgical rhinoplasty procedures with increased safety and efficacy., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Complete congenital arhinia is a rare defect of embryogenesis leading to the absence of the external nose and airway. We report our novel multistaged reconstructive approach and literature review. Nasal methyl methacrylate prosthesis was created from a stereolithographic model for use as a temporary prosthesis and tissue expander. Lefort 1 with cannulization was utilized for midface advancement and airway formation. External framework was reconstructed with bilateral conchal bowl cartilage and rib osteocartilagenous grafts. Patient was pleased with the aesthetics and had safe decannulation with the ability to breathe through the nose and airway.