• Anatomy and Cell Biology
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• v.55 no.3
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• pp.277-283
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• 2022

To determine the morphology of the lacrimal sac fossa and bony nasolacrimal duct using computed tomography for obtaining detailed anatomical understanding of the drainage system and utilizing these measurements in planning for dacryocystorhinostomy (DCR) and nasolacrimal duct (NLD) obstruction in normal southwest (SW) population of Iran. One-hundred-sixty-five cases referred for the diagnosis of neuro-ophthalmic conditions were retrospectively studied. Measurements of lacrimal sac fossa were taken on three anatomical sections (upper, middle, and lower planes) utilizing a digital caliper/protractor instrument. Lacrimal thickness and two measurements of maxillary bone thickness were taken at each plane-namely, the "midpoint thickness" and the "maximum thickness." The anterior extent of the nasal mucosa and NLD width was also evaluated. The mean maximum thickness of the maxillary bone at the three anatomical planes of the lacrimal sac fossa was 4.07 mm, 4.78 mm, and 5.60 mm, respectively. The midpoint thickness of the maxillary bone at each plane was 2.38 mm, 1.99 mm, and 1.68 mm, respectively, in both sexs. The lacrimal bone thickness at each level was 0.76 mm, 0.69 mm, and 0.67 mm, respectively. The proportion of the lacrimal sac fossa comprising the lacrimal bone at lower plane was 43.57% and showed a positive correlation with age (P=0.01). The mean anteroposterior bony nasolacrimal diameter was 5.94 mm with no significant difference between patient sex and age. According to the results, its indicate that performing an osteotomy during DCR could be easier in the Iranian SW population compared to other ethnics.

• Archives of Craniofacial Surgery
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• v.21 no.2
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• pp.114-118
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• 2020

Adenoid cystic carcinoma (ACC) in the lacrimal gland is a very rare disease with poor overall prognosis. Its primary treatment is surgical excision, including orbital exenteration and radical orbitectomy, which is combined with radiotherapy and chemotherapy. Age, histopathologic type, bone invasion, and tumor extent are known factors that affect the prognosis of ACC. Furthermore, perineural invasion is highly associated with local tumor recurrence and tumor base invasion. Here, we report a rare case of ACC in the lacrimal gland with superior sagittal sinus invasion that repeatedly recurred after the surgical excision.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.1
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• pp.72-78
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• 1994

A naso-orbito-ethmoid(NOE) fracture is very complex diagnostically and therapeutically. The diagnosis of this fractures is usually made by physical findings aided by a CT scan. The primary treatment of NOE fracture must be directed toward the reconstruction of medial canthal ligament and bony skeleton. We prefer to correct lacrimal system abnormalities secondarily A 32-year old male patient visited emergency room of our hospital with NOE fracture. After emergency treatment and consultation with neurosurgery and ophthalmology, we treated this patient by performing reconstruction of medial canthal ligament, bone graft of media orbital rim blowout fracture, and dorsal nasal cantilever bone graft with calvarial bone. The authors present a case report with literature review.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.504-508
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• 2010

Purpose: Traumatic telecanthus can result from nasoethmoid-orbital fractures. Repair of the medial canthal tendon (MCT) using transnasal wiring is regarded as a choice of method to treat telecanthus, however, is often complicated by incomplete anchoring and drift of canthus, extrusion of wire, in-fracture of orbital bone, and eye damage. The authors introduced oblique transnasal wiring method through the Hiraga's epicanthopalsty incision instead of well-known classical bicoronal approach. Methods: Five patients with traumatic telecanthus were treated with this method. Though the Hiraga's epicanthoplasty incision, we could approach the operative field; the medial orbital wall and detached MCT. Oblique transnasal wiring was performed as following steps. After slit skin incision on the contralateral nasal recession area, drill holes were made from this point to the superior and posterior point of lacrimal sac of deformed eye. A 2-0 wire was double-passed through the holes and MCT. Traction was applied to ensure pulling the MCT and the wires were twisted in the contralateral nose, securing the MCT in the correct position. Results: All patients except 1 person showed improvement and rapid recovery. On average each canthus was moved 5.6 mm medially. In all cases, there were no eyelashes disappear, lacrimal canaliculitis, lacrimal duct injury, or infections. Conclusion: The Hiraga's epicanthoplasty incision could give sufficient operative field to reattach the MCT in traumatic telecanthus patients. And the oblique transnasal wiring technique is effective for the Asians who have flat nose and exophthalmic eye. The authors conclude that this technique could be a simple, safe and scarless method to correct traumatic telecanthus.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.22 no.2
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• pp.283-290
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• 1992

The purpose of this study was to evaluate the spatial relationship of facial bone more accurately. For this study, the three-dimensional images of dry skull were reconstructed using computer image analysis system and three-dimensional reconstructive program involved CT. The obtained results were as follows: 1. Three-dimensional reconstructive CT results in images that have better resolution and more contrast 2. It showed good marginal images of anatomical structure on both three-dimensional CT and computer image analysis system, but the roof of orbit, the lacrimal bone and the squamous portion of temporal bone were hardly detectable. 3. The partial loss of image data were observed during the regeneration of saved image data on three-dimensional CT. 4. It saved the more time for reconstruction of three-dimensional images using computer image analysis system. But, the capacity of hardware was limited for inputting of image data and three-dimensional reconstructive process. 5. We could observe the spatial relationship between the region of interest and the surrounding structures by three-dimensional reconstructive images without invasive method.

• The korean journal of orthodontics
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• v.16 no.1
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• pp.71-84
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• 1986

The purpose of this study was to analyze the effect of orthopedic forces on the craniofacial complex utilizing the three kinds of the head gear. (high pull head gear, straight pull head gear, cervical pull head gear) For this study, the teeth and alveolar bone and palate were reproduced from birefringent materials and other parts of craniofacial complex were coated with birefringent material on the model. The effect of orthopedic forces on the craniofacial complex was analyzed by photoelastic method using transmission polariscope and reflection polariscope. The results were as follows. 1. The cervical pull head gear had the greatest tipping effect on the maxillary molars and high pull head gear had the least tipping effect. 2. In areas stressed, the cervical pull head gear stressed the greatest degree. 3. Only cervical pull head gear produced stress at the zygomaticofrontal suture and the posterior region of palate. 4. The straight pull head gear and high pull head gear produced stress at just inferior to the anterior nasal spine. 5. The cervical pull head gear and straight pull head gear produced tensile stress at the fronto-maxillary suture. 6. The pterygoid plates of the sphenoid bone, the zygomatic arches, the junction of the maxilla with the lacrimal and ethmoid bone, and the maxillary molars were affected by three types of head gear.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.4
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• pp.373-378
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• 1998

In the midfacial fracture, the orbital region presents many additional complication unique to the orbit. Among them are ectropion, entropion, lid ptosis, injury to the lacrimal apparatus, diplopia or the late development of enophthalmos. The residual problem confronting the surgen is usually enophthalmos or diplopia. Enophthalmos becomes cosmetically obvious at 3mm and if more severe it can interfere with vision from obstruction by the orbital rim. In this clinical situation, many patients prefer the simpler intraorbital volume expansion to the more complex orbital osteotomy. In general, except in mild cases of enophthalmos, the procedure of choice is osteotomy and repositioning for zygoma fracture and volume augmentation for blow-out fracture. Late treatment is performed by volume augmentation based on the CT findings behind the axis of the globe. Inferiorly placed grafts elevate the globe, posterior superior grafts move the globe anterior and medially positioned grafts push the globe laterally. In this two cases, the patients who has stable orbitozygomatic rim, the use of calvarial bone grafts more than 3 areas around intraorbital content, we corrected late enophthalmos combined with diplopia. As result, the first patient had 2mm advance in exophthalmometric check with improvement of the diplopia gradually. The second patient had 1.5mm advance with correction of vertical ocular dystopia and cosmetically good results respectively.

• Archives of Craniofacial Surgery
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• v.20 no.4
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• pp.219-222
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• 2019

The purpose of this study is to discuss several approaches to addressing naso-orbito-ethmoidal (NOE) fracture. Orbital fracture, especially infraorbital fracture, can be treated through the transconjunctival approach easily. However, in more severe cases, for example, fracture extending to the medial orbital wall or zygomatico-frontal suture line, only transconjunctival incision is insufficient to secure good surgical field. And, it also has risk of tearing the conjunctiva, which could injure the lacrimal duct. Also, in most complex types of facial fracture such as NOE fracture or panfacial fracture, destruction of the structure often occurs, for example, trap-door deformity; a fracture of orbital floor where the inferiorly displaced blowout facture recoils to its original position, or vertical folding deformity; fractured fragments are displaced under the other fragments, causing multiple-packed layers of bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.407-413
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• 1997

The soft tissue injuries of Oral & Maxillofacial region include abrasion, contusion, simple laceration, laceration of skin with underlying tissue, soft tissue injuries combined with facial bone fracture and involving functional structures such as facial nerve and vessel, orbit, lacrimal duct and salivary gland and so on. The results obtained were as follows ; 1. The age range was 1 to 97, and the highest incidence occured in the 3rd decade(23.4%), followed by the 1st decade(20.2%), 4th decade(18.1%), 4th decade(18.1), and 5th decade(14.3%) 2. The sexual ration was 4 : 1(M : F). 3. The most common cause of facial laceration was a accident(54.5), followed by blow(17.8%), traffic accident(15.9%) and unknown(10.8%). 4. The most frequently occurred site of injury was a forehead(24), followed by oral cavity(16.9%), lip(15%), eyebrow(14.5%), cheek(14%), chin(11.8%), nose(2%), scalp(1.4%) and neck(0.9%). 5. Most of wound size was less than 3cm in length. 6. 28 patients suffered facial bone fracture, representing 7%. 7. The major complications following facial laceration were infection and facial paralysis caused by facial nerve injuries, representing 4.5% and 1.9%.

• Korean Journal of Veterinary Research
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• v.40 no.1
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• pp.27-34
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• 2000

A 20-day-old female Diprosopia in Holstein calf was observsd macroscopically and radiographically. Anterior head duplication(Diprosopia) was observed and all structures caudal to it were normal. She had two muzzles, three eyes, two ears and two tongues. The tongues were joined at their base just posterior and had one hyoid bone. Schistognathia and cleft lips were also observed in the lower jaws. She had an oral cavity, single epiglottis and a laryngeal cavity communicated with one trachea. The cerebral hemispheres were duplicated and fused together in the caudal region. The olfactory and optic nerves were duplicated. The incisive, nasal, pterygoid, parietal, ethmoid bones and vomer were duplicated, respectively. The skull of Diprosopia was shared by an occipital bone. The mandibules, palatines and sphenoid bones were duplicated incompletely. Three orbits and two fontanelles were observed. The medial lacrimal bones and maxillae were duplicated incompletely and fused with each other, respectively. Cleft palates were observed. Medial mandibular mass which was fused together and was duplicated incompletely at the part of its cranial, was shown synchondrosis with the left mandible, but not with the right.