• Title/Summary/Keyword: lateral asymmetry

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Correction of the deviated tip and columella in crooked nose

  • Suh, Man-Koon
    • Archives of Plastic Surgery
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    • v.47 no.6
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    • pp.495-504
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    • 2020
  • The primary procedural components of deviated nose correction are as follows: osteotomy to correct bony deviation, septal deviation correction, manipulation of the dorsal septum to correct upper lateral cartilage deviation, and correction of functional problems (manipulation for correction of internal valve collapse and hypertrophy of the inferior turbinate). The correction of tip and nostril asymmetry cannot be overemphasized, because if tip and nostril asymmetry is not corrected, patients are unlikely to provide favorable evaluations from an aesthetic standpoint. Tip asymmetry, deviated columella, and resulting nostril asymmetry are primarily caused by lower lateral cartilage problems, which include deviation of the medial crura, discrepancy in the height of the medial crura, and asymmetry or deformity of the lateral crura. However, caudal and dorsal septal deviation, which is a more important etiology, should also be corrected. A columellar strut graft, correction of any discrepancy in the height of the medial crura, or lateral crural correction is needed to correct lower lateral cartilage deformation depending on the type. In order to correct caudal septal deviation, caudal septal shortening, repositioning, or the cut-and-suture technique are used. Surgery to correct dorsal septal deviation is performed by combining a scoring and splinting graft, a spreader graft, and/or the clocking suture technique. Moreover, when correcting a deviated nose, correction of asymmetry of the alar rim and alar base should not be overlooked to achieve tip and nostril symmetry.

Radiographic study of mandibular asymmetry (하악 비대칭의 방사선학적 연구)

  • Jeong Yeon-Hwa;Cho Bong-Hae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.1
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    • pp.193-204
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    • 1998
  • The purpose of this study was to perform the radiographic measurements and temporomandibular joint evaluation in mandibular asymmetry. For this study, thirty-two patients who have mandibular asymmetry were selected and submentovertex, panoramic and lateral corrected tomographic radiographs were taken. Horizontal and vertical analysis using various landmarks on these radiographs were performed. Also radiographic and clinical evaluation of temporomandibular joint were obtained. The results were as follows ; 1. On the submentovertex radiograph, the mean distance of Pogonion to midline was 5.0±3.8mm. 2. The mean distance of Pogonion to Gonion was 100.6±9.2mm in deviated side and 104.3±9.1mm in contra-lateral side, and there was a significant difference between the deviated and the contra-lateral side (p<0.001). 3. The distance difference of Pogonion to Gonion between the deviated and the contra-lateral side was significantly related to the degree of asymmetry (p<0.001). 4. On panoramic radiograph, the condylar height of the contra-lateral side was significantly longer than the one of the deviated side(p<0.001). 5. On lateral corrected tomogram, bony changes of temporomandibular joint were observed in 11 condyles of the deviated side and 9 condyles of the contra-lateral side. Erosion and osteophyte were the most common changes in both the deviated and the contra-lateral sides.

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3-Dimensional analysis for class III malocclusion patients with facial asymmetry

  • Kim, Eun-Ja;Ki, Eun-Jung;Cheon, Hae-Myung;Choi, Eun-Joo;Kwon, Kyung-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.4
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    • pp.168-174
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    • 2013
  • Objectives: The aim of this study is to investigate the correlation between 2-dimensional (2D) cephalometric measurement and 3-dimensional (3D) cone beam computed tomography (CBCT) measurement, and to evaluate the availability of 3D analysis for asymmetry patients. Materials and Methods: A total of Twenty-seven patients were evaluated for facial asymmetry by photograph and cephalometric radiograph, and CBCT. The 14 measurements values were evaluated and those for 2D and 3D were compared. The patients were classified into two groups. Patients in group 1 were evaluated for symmetry in the middle 1/3 of the face and asymmetry in the lower 1/3 of the face, and those in group 2 for asymmetry of both the middle and lower 1/3 of the face. Results: In group 1, significant differences were observed in nine values out of 14 values. Values included three from anteroposterior cephalometric radiograph measurement values (cant and both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). In group 2, comparison between 2D and 3D showed significant difference in 10 factors. Values included four from anteroposterior cephalometric radiograph measurement values (both maxillary height, both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). Conclusion: Information from 2D analysis was inaccurate in several measurements. Therefore, in asymmetry patients, 3D analysis is useful in diagnosis of asymmetry.

Evaluation of masticatory muscles of mandibular asymmetry patients by computed tomography (전산화단층사진을 이용한 하악골 비대칭 환자의 저작근 평가)

  • Choi Soon-Chul;Lee Sun-Bok;Lee Jin-Koo;Yi Won-Jin;Heo Min-Suk;Lee Sam-Sun
    • Imaging Science in Dentistry
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    • v.34 no.1
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    • pp.31-34
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    • 2004
  • Purpose: To compare the size of the masseter and lateral pterygoid muscle between the affected and the unaffected side of the patients who have the chief complaints of the mandibular asymmetry. Materials and Methods: Twenty two patients (male: 4, female: 18, average age: 21.3 year-old) were radiographed using posterior-anterior (P-A) cephalography and computed tomography (CT). On P-A cephalography, the degree of deviation was determined by the distance from the mentum to the vertical reference line through the crista galli and the anterior nasal spine. On the scanned tracing papers of the maximum cross-sectional area of the masseter and lateral pterygoid muscle using axial CT images, the pixel number was measured. The ratio of the affected : unaffected sides were obtained. For the masseter and lateral pterygoid muscle, the relationship between the muscular volume and degree of skeletal hypoplasia was studied. Results : The half cases showed no skeletal asymmetry. The lateral pterygoid muscle of the affected side was larger significantly than unaffected side (p<0.05). However, there was no significant difference between two sides in the cases of skeletal asymmetry. There was only significant difference in the cases without skeletal asymmetry (p<0.05). Conclusions : To some extent, the slight mandibular hypoplasia could affect the growth of some masticatory muscles.

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Three-dimensional computed tomography evaluation of craniofacial characteristics according to lateral deviation of chin

  • CHOI, Hyo-Won;KIM, Bola;KIM, Jae-Young;HUH, Jong-Ki;PARK, Kwang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.57.1-57.8
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    • 2019
  • Background: The relationship between the lateral deviation of chin and the upper and middle facial third asymmetry is still controversial. The purpose of this study is to evaluate the correlation of upper and middle facial third asymmetry with lateral deviation of chin using 3-dimensional computed tomography. The study was conducted on patients who underwent orthognathic surgery from January 2016 to August 2017. A total of 40 patients were included in this retrospective study. A spiral scanner was used to obtain the 3-dimensional computed tomography scans. The landmarks were assigned on the reconstructed 3-dimensional images, and their locations were verified on the axial, midsagittal, and coronal slices. The Pearson correlation analysis was performed to evaluate the correlation between chin deviation and difference between the measurements of distances in paired craniofacial structures. Statistical analysis was performed at a significance level of 5%. Results: In mandible, the degree of chin deviation was correlated with the mandibular length and mandibular body length. Mandibular length and mandibular body length are shorter on the deviated-chin side compared to that on the non-deviated side (mandibular length, r = -0.897, p value < 0.001; mandibular body length, r = -0.318, p value = 0.045). In the upper and middle facial thirds, the degree of chin deviation was correlated with the vertical asymmetry of the glenoid fossa and zygonion. Glenoid fossa and zygonion are superior on the deviated-chin side than on the non-deviated side (glenoid fossa, r = 0.317, p value = 0.046; zygonion, r = 0.357, p value = 0.024). Conclusion: Lateral deviation of chin is correlated with upper and middle facial third asymmetry as well as lower facial third asymmetry. As a result, treatment planning in patients with chin deviation should involve a careful evaluation of the asymmetry of the upper and middle facial thirds to ensure complete patient satisfaction.

Research on EEG Parameters for Movement Prediction Based on Individual Difference of Athletic Ability and Lateral Asymmetry of Hemisphere (운동능력과 뇌편측성의 개인차에 따른 사지움직임예측을 위한 EEG 변수추출에 관한 연구)

  • Whang, Min-Cheol;Lim, Joa-Sang
    • Journal of the Ergonomics Society of Korea
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    • v.21 no.3
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    • pp.1-12
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    • 2002
  • Recently, EEG gains much interests due to its applicability for people to communicate directly with computers without detouring motor output. This study was designed to address this issue if EEG can be successfully used to predict limb movement. It was found that ordinary people appeared to show significant difference in brainwaves between right hand (foot) and left hand (foot) movement. Lateral asymmetry was also found to interact significantly with EEG. Further research is urged with refined method to provide more useful insights into EEG-based BCI.

Correlation between the asymmetry of the infrasternal angle and trunk side shift distance (명치각의 비대칭 성과 몸통 측 이동 거리 사이의 상관 관계)

  • Jung, Sung-hoon;Choi, Sil-ah;Ha, Sung-min
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2021.07a
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    • pp.691-694
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    • 2021
  • The malalignment of the trunk causes abnormal stress in a specific area and lead to trunk instability. The purpose of this study was to investigate the correlation between the angle between the infrasternal angle and the trunk side shift distance. The participants in this study 22 subjects were participated. The infrasternal angle and trunk side shift distance were measured using a camera and analyzed using the Image J program. The correlation between the asymmetry of the infrasternal angle and trunk side shift distance was moderate (r=-0.413; p=0.028). According to the asymmetry of the infrasternal angle, it was confirmed that trunk lateral shift appeared in a specific direction. Based on result, it suggests that infrasternal angle and trunk side shift should be considered in the intervention plan of patients with asymmetry of the infrasternal angle.

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Horizontal change of philtrum after orthognathic surgery in patients with facial asymmetry

  • Joh, Yewon;Park, Hyun Soo;Yang, Hoon Joo;Hwang, Soon Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.48.1-48.7
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    • 2019
  • Background: Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods: Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results: Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values. Conclusion: The horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.

THE CORRECTION OF CLASS III MANDIBULAR ASYMMETRY USING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY AND LATERAL ANGLE REDUCTION (외측 하악각 골절제술을 동반한 시상분할골절단술을 통한 골격성 3급 하악골 비대칭 환자의 치료)

  • Kang, Hee-Jea;Song, In-Woo;Kang, Yung-Ki;Kim, Jong-Ryoul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.132-140
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    • 2010
  • Purpose: The aim of this study is to identify the usefulness of unilateral mandibular angle ostectomy, so-called "Lateral Angle Reduction", in asymmetric prognathism patients by the assessment of postoperative stability and esthetic results Patients and methods: For the retrospective study, 10 skeletal class III mandibular asymmetry patients who were performed SSRO and unilateral mandibular angle ostectomy, Lateral Angle Reduction, was selected. Lateral and posterioanterior cephalogram was taken before surgery (T0), 1day after surgery (T1) and 6month after surgery (T2). To know the esthetic results the facial width and lateral facial contour were examined on posterioanterior cephalogram and to know the postoperative stability B point and Incisor inferius was examined on lateral cephalogram. Statistical analysis was performed. Results: From T0 to T1, Intergonial width was significantly decreased, dominantly at shortened side but no significant changes at lengthened side. Those were well-maintained during 6 months. Lateral facial angle and Ramus angle was significantly decreased on only shortened side from T0 to T1. As a result, after surgery, there were no significant differences in all measurements between shortened side and lengthened side. Ramus deviation angle in shortened side and ramus angle in lengthened side which reflect the angulation of ramus on frontal plane didn't show significant changes after surgery and during postsurgical periods. Lower dental midline showed no statistical changes during postsurgical period. The relapse rate on B-point was 11.92%. Conclusion: Unilateral "Lateral angle reduction" in the asymmetric mandible is valuable to obtain the narrow lower face and symmetric facial contour with a good stability.

Sagittal split ramus osteotomy, intraoral vertical ramus osteotomy, and lateral corticectomy for asymmetric mandibular prognathism

  • Lee, Joo Young;Han, Se Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.4
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    • pp.249-256
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    • 2021
  • Objectives: The purpose of this study was to evaluate the postoperative anteroposterior stability and improvements in facial asymmetry after performing LeFort I osteotomy in the maxilla, sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) in the mandible, and lateral corticectomy on the IVRO side. Materials and Methods: From July 2009 to October 2018, a retrospective analysis was performed on 11 subjects. Lateral cephalometric radiograph was performed preoperatively (T0), postoperatively (T1), and at 12 months of follow-up (T2), and the B point distance was measured. Posteroanterior cephalometric radiograph was performed preoperatively (S0) and at 12 months of follow-up (S1) and was used to measure five indicators (Ag angle, M-Ag, Co-Ag, Co-Me, and Ag-Me) of facial asymmetry. Results: The B point distances for T0 and T1 were significantly different (P=0.007), whereas those for T1 and T2 were not significantly different (P=0.1). In addition, there was a significant difference between the B point distances of T2 and T0 (P=0.026). Comparison of the facial asymmetry indicators before and after surgery showed a significant difference for all indicators between S0 and S1: the P-values of Ag angle, M-Ag, Co-Ag, Co-Me, and Ag-Me were 0.003, 0.003, 0.008, 0.006, and 0.004, respectively. The Z value was based on negative ranks. Conclusion: There was no significant difference in the B point distances from postoperation to the 12-month follow-up. However, there were significant differences in all five indicators related to facial asymmetry before and after surgery. The values for the five indicators of facial asymmetry all increased postoperatively.