Preoperative digital three-dimensional planning for rhinoplasty

BACKGROUND: This report describes preoperative digital planning for rhinoplasty using a new three-dimensional (3D) radiologic viewer that allows both patients and surgeons to visualize on a common monitor the 3D real aspect of the nose in its inner and outer sides. METHODS: In the period 2002 to 2008, 210 patients underwent rhinoplasty procedures in the authors' clinic. The patients were randomly divided into three groups according to the type of preoperative planning used: photos only, a simulated result by Adobe Photoshop, or the 3D radiologic viewer. The parameters evaluated included the number of patients that underwent surgery after the first consultation, the number of patients who asked for a reintervention, patient satisfaction (according to a test given to the patients 12 months postoperatively), the surgical time required for a functional intervention, and the improvement in nasal function by postoperative rhinomanometry and subjective evaluation. RESULTS: Computer-aided technologies led to a higher number of patients deciding to undergo a rhinoplasty. Simulation of the postoperative results was not as useful in the postoperative period due to the higher number of reintervention requests. CONCLUSION: The patients undergoing rhinoplasties preferred new technologies in the preoperative period. The advantages of using the 3D radiologic viewer included improved preoperative planning, reduction in intraoperative stress, a higher number of patients undergoing surgery, reduction in postoperative surgical corrections, reduction in surgical time for the functional intervention, a higher rate of improvement in nasal function, a higher percentage of postoperative satisfaction, and reduced costs

Two load sharing plates fixation in mandibular condylar fractures: Biomechanical basis

Mandibular condylar fractures have a high incidence but there is no consensus regarding the best choice of osteosynthesis. From a review of the literature, it is evident that the technique used most frequently for fixation is the positioning of a single plate despite complications concerning plate fracture or screw loosening have been reported by various authors. Different studies have highlighted that the stability of osteosynthesis is correlated with the mechanical strains occurring in the condylar region, generated by the muscles of mastication. The aim of our study was, through a mandibular finite element model (FEM), to confirm this correlation and to analyse the behaviour of single and double elements of union in the fixation of mandibular subcondylar fractures. We concluded that the use of two plates provides greater stability compared with the single plate, reducing the possibility of displacement of the condylar fragment. Therefore we recommend that this technique should be adopted whenever possible

Ancient Egyptians in Lithuania: A scientific study of the Egyptian mummies at the National Museum of Lithuania and the MK Čiurlionis National Museum of Art

Since 2011, ancient Egyptian mummified human remains from collections in Lithuania have been subjected to scientific analysis in an attempt to assess the lives and deaths of the individuals, and how their bodies were treated after death in order to achieve bodily preservation. In total, six mummies were studied using computed tomography to obtain the maximum amount of useful data in a non-invasive manner. This paper outlines the aims of the research, what has been done to date and the plans for future work on this corpus of material

Human mummification practices among the Ibaloy of Kabayan, North Luzon, the Philippines

The province of Benguet, situated in North Luzon, the Philippines, holds a large number of ancient mummified remains, mostly located within the municipality of Kabayan. Such bodies are mainly associated to the Ibaloy – one of the indigenous groups collectively known as Igorot – and are stored in natural rockshelters or caves carved into the stone, inside wooden coffins often obtained from hollowed pine tree segments. Recent inspections of some of these corpses, carried out in 2002 and 2012, indicated the nature of their mummification process as well as some details regarding their bioanthropological features. Although very little information was initially available on these bodies, the authors have gathered significant oral information on funerary rituals and attitudes towards the ancestors via interviews with the local elders, as well as data on the vegetal materials employed and the practice of tattooing. This paper is the first critical evaluation of these mummies and demonstrates the uniqueness and preciousness of this biocultural heritage now in danger

Autologous fat grafting in facial volumetric restoration

The authors reported their surgical experience about structural fat grafting in the management of facial volumetric deficit. The purpose of this study was to assess the real indications, cosmetic results, complications, and global patient satisfaction of the Coleman technique in redefining facial contours in congenital and postoperative deformities. A retrospective analysis of 32 patients grafted according to Coleman's technique was performed, and the long-term outcomes and patient satisfaction were evaluated. The mean postoperative clinical follow-up was 14 months. The morphological changes were analyzed by comparing the photographic presurgical facial contour and the postoperative correction of soft tissue defects. All consecutive cases reported showed a progressive fat resorption for 3 months after surgery and its stable integration only after this period. Best results were performed in the treatment of genetically determined syndromes, such as the Franceschetti and Romberg syndromes. The authors suggest this surgical technique also for the treatment of unaesthetic cutaneous abscess cavity after incision and drainage. Unsatisfactory outcomes were obtained in the treatment of the posttraumatic facial scar, which needed more surgical procedures

Surgical evolution in the treatment of mandibular condyle fractures

Background: In Literature fractures of the mandible that involve the condyle ranges from 20% to 35% and various possible surgical options are described according to the varying pathological situations. Up to the present, numerous techniques have been used for the surgical treatment of condylar fractures. In this article we are proposing the combination of two surgical techniques as therapy for extra-capsular condylar fractures with dislocation. Methods: From June 2003 to July 2007 30 patients were treated for condylar fractures with the application of a Rigid External Fixator under endoscopic assistance. This method includes a surgical reduction of the fracture with the aid of an endoscope, performing a transcutaneous insertion of a Rigid External Fixator to stabilize the fracture. Results: Out of the total number of patients, 28 reached an optimal result without the need for temporary immobilization of the temporal mandibular joint and pre-auricular cutaneous access, thanks to the decisive aid of the video-endoscope. Conclusions: The endoscope allows perfect control over both the positioning of the external fixator and the surgical reduction, restoring the normal movement of the mandible with a return to full anatomical functioning of the temporo-mandibular joint. This approach avoids possible damages to the facial nerve branches. The rigid external fixation system is better than an internal one, because it is less restrictive in precise anatomical reduction, since with an REF the condylar fragment is kept in the correct anatomical position but is not obliged to maintain that exact position, and therefore it is possible to carry out all the repair mechanisms listed above. Endoscopic assistance allows a good positioning control of the REF although the endoscopy permits an optimal control of the condylemeniscal complex mobility after REF application