Fifty years of plastic surgery in the Netherlands. VIII. Craniofacial surgery

Craniofacial surgery has developed its own identity in the last 3 decades. The Frenchman Tessier can be seen as the founding father. His concept of intracranial correction of craniofacial malformations is still valid today. There have been many new developments such as distraction osteogenesis and biodegradable miniplate fixation. Microvascular surgery and vascularised calvarial bone grafts help to obtain more predictable results. Three-dimensional CT imaging techniques and modelling result in better surgical planning and help to understand the underlying pathology. Biomolecular knowledge of gene mutations leads to better understanding of the clinical diagnosis. The future will bring minimalisation of surgery and more therapy focused on biomolecular science. The psychosocial welfare of the patient will play a central role in the multidisciplinary team treatment.     

Teratogenesis of Craniofacial Malformations in Animals

In the rat the toxic actions of various pesticides such as ethion, dioxathion (Navadel), EPN, azin-phosmethyl, and parathion are markedly, and often totally, inhibited by such typical catatoxic steroids as ethyiestrenol, SC-11927, spironolactone, and norbolethone. To a lesser extent this is also true of oxandrolone, prednisolone, and progesterone, which also proved to be somewhat less potent in detoxicating other substrates. Triamcinolone, desoxycorticosterone, hydroxydione sodium succinate, estradiol, and thyroxine, previously shown to be essentially devoid of any catatoxic activity, also failed to offer consistent protection against the pesticides just mentionedm DDT, physostigmine sulfate and pralidoxime chloride, tested for comparative purposes, proved to be much more resistant against detoxication by even the most powerful catatoxic steroids,. Many pesticides are highly amenable to detoxication by potent catatoxic steroids,. This detoxicating effect is independent of the classic hormonal properties of the steroids examined.     

Colchicine-Induced Craniofacial Defects in the Mouse Embryo

A new technique for studying in vivo mucus transport and mucus production has been developed using the chicken. This technique is based on the observation that the trachea is easily exteriorized (into the chicken’s mouth) and experiments conducted on an in situ tissue. This procedure may be repeated without any apparent harm to the chicken. Exposing animate to smoke from regular or carbon filter cigarettes once a day for 32 days does not appear to produce permanent impairment in ciliary function. Mucus output was markedly increased during the period of smoke exposure.

These in vivo studies indicate that gas-phase components (particularly hydrogen cyanide [HCN] and acrolein) are of major importance in the inhibition of ciliary transport and that appropriate filters can significantly reduce this inhibitory effect, but not the increase in mucus production observed during smoking.     

The Siblings of Children With Craniofacial Anomalies

The birth of a child with a handicapping condition creates tremendous turmoil and disruption in the family. Because of stresses inherent in the diagnosis of a child with a congenital handicap, researchers have indicated that these families often experience clinical depression, marital difficulties or divorce, loss of social support, disruptions in everyday family life, and strained or problematic sibling relationships and adaptation. In particular, the siblings of children with disabilities have often been found to be suffering from psychological, behavioral, and somatic problems. In this investigation, we explored the behavioral adjustment of the siblings of children with craniofacial anomalies. One hundred and twenty age and sex matched children with craniofacial anomalies were split into groups based upon the visibility of their diagnosis. The siblings of children with visible anomalies (cleft lip, any craniofacial syndromes) and children with invisible anomalies (cleft palate, submucous cleft) were compared with siblings of a comparison group. To assess the siblings' behavior, care-givers were asked to complete the Child Behavior Checklist. In addition, other variables that have been found to be influential in the adaptation of siblings to a handicapped child were measured. The severity of the child's impairments were assessed by the Revised Denver Developmental Screening Test. Similarly, caregivers were asked to complete the Social Support Questionnaire and the Short Marital Adjustment Test. Results indicated that the siblings of children with craniofacial anomalies did not experience significant levels of behavior problems when compared to a control group. The visibility of the child's deformity, the degree of parental social support, parental marital satisfaction, and maternal depression did, however, seem to significantly impact sibling behavior.     

汉族人头面部特征分析

目的通过对汉族人进行头面部尺寸测量,了解中国汉族人头面部特点,分析不同民族的头面部特征差异,为头面部产品特别是头面劳动保护用品生产提供重要依据。方法采用标准测量方法,对头面指标和人体指标进行测量。按照年龄、性别和地区抽取中国汉族人作为测量对象。选取头长宽指数、形态面指数和鼻指数3项头面指数研究汉族人头面尺寸的特点,比较不同民族、不同时期、不同国家头面尺寸大小。结果共测量3000名汉族人,男性头面尺寸明显大于女性头面尺寸,汉族人以圆头型、阔面型以及中鼻型为主。中国人的头型特点及尺寸大小和美国人存在明显差异,中国人唇长、面宽明显较大,形态面长和鼻深则较小。表现出宽度较大,而长度较小的特点。结论中国汉族人头面特征表现为面阔、鼻阔。不同时期、不同民族和不同国家其头面特征是有差异的。头面产品的设计应该充分考虑这些因素的影响。     

Rapid Development of a Craniofacial Consumer Health Web Site

Abstract

There is a paucity of information describing how Web site project planning and management concepts apply to the unique concerns of developing consumer health Web sites, and a void of resources relative to rapid cycling in health Web site development. This article provides a framework for approaching these types of projects, within the context of a case study involving a Web site for patients with facial differences or craniofacial anomalies that was designed and developed in a two-month period. The second part of this article discusses the active part of the process, including the development of the mission and vision statements, timeline, architecture, content, information needs profile and survey, prototype, marketing, and planning of the inaugural event and official release of the site.     

螺旋CT低剂量扫描在颅面部外伤中的应用价值

目的：探讨不同低剂量CT扫描在颅面部外伤中的应用价值。方法：将60例颅面部外伤患者分为4组,其中1组行常规剂量扫描,其余3组行不同低剂量CT扫描,比较常规剂量组（120kV,220mA）和低剂量组（120kV,160、80、60mA）共4组的图像质量及患者所受辐射剂量。结果：低剂量（160、80mA）CT扫描所得CT图像较好,60mA组患者所受辐射剂量较低,比常规剂量组单次扫描权重剂量指数分别降低了33%、67%和73%;低剂量（160、80mA）与常规剂量组所得图像质量比较无明显差异,60mA组与常规剂量组所得图像质量比较有显著性差异。结论：可利用低剂量（80mA）对颅面部外伤进行扫描,所得的图像对疾病的诊治无影响。     

A Prospective Study of Coping and Adjustment in Adolescents With Craniofacial Conditions

This study aimed to examine the role of coping strategy use in concurrent and later adjustment in adolescents with craniofacial anomalies (CFAs). It was expected that better adjustment at both baseline and 12 months would be related to greater baseline perceived coping efficacy, greater use of active coping and social support seeking, and less use of avoidance strategies. Eighty adolescents with CFAs and their parents completed measures of adjustment, coping strategy use, and efficacy in response to CFA-related stressful situations. Fifty-five families completed these measures again 12 months later. Overall, the predicted pattern of correlations between coping and adjustment was found. However, coping and efficacy at baseline did not explain a significant proportion of the variance in adjustment measures 1 year later, after controlling for baseline adjustment. Such prospective findings are beginning to bring into question the assumed importance of coping in pediatric adjustment.     

CT三维表面重建辅助颌面部整形手术的初步研究

在计算机Windows 2000环境下,用C＋＋语言编写,并通过CT扫描、三维重建以及模拟手术等步骤对5例颌面部畸形患者进行虚拟手术,建立一个可进行虚拟颅面部整形手术的计算机系统。结果表明：利用CT三维表面重建辅助颅面部整形手术系统成功地摸拟进行了颌面部畸形整形手术。     

Craniofacial anomalies: description and evaluation of treatment under the Brazilian Unified Health System

The first initiative for treating craniofacial anomalies under the Brazilian Unified Health System was in 1993. An important step was the creation of the Reference Network for Craniofacial Treatment. There are now 29 services listed in this Network. The current study aimed to describe and assess the general characteristics of healthcare in this Network. Data were collected by a questionnaire, sent to the centers. Response rate was 86.2%. The results showed an increase in services in Southeast Brazil, in universities, and in relation to cleft lip and palate; public financing was prevalent; team composition was largely in accordance with North American standards; routine care occurred in 90%; and 70% used clinical protocols. The Network's name does not appear to entirely reflect its scope. The results show the need to review the Network's definition, aims, and achievements and the standards for inclusion of craniofacial centers.     

Creation and Implementation of Standardised Craniofacial Views for the Institute of Medical Illustrators National Guidelines

Vetter states, “Standardisation is the key word in all discussions of clinical photography”. As part of clinical photography standardised guidelines form an integral part of providing a basis to obtaining standardised images. The Institute of Medical Illustrators (IMI) provides sets of standardised guidelines that have been developed in consultation with relevant clinicians, providing theory and standardised images that are to be considered as guides to good clinical photography practice. At the time of the study there were no official standardised IMI guidelines for craniofacial photography, for this reason, the primary objective of this project was to produce a set of standardised craniofacial guidelines that could be utilised by other clinical photographers for guidance on taking craniofacial images. This paper describes the development, evaluation and implementation of the guidelines.     

Craniofacial fibrous dysplasia. conservative surgical management. Review of literature and report of a case

The present study presents a case of craniofacial fibrous dysplasia attenuating the orbit and the nasal airway, which was treated by conservative surgical approaches. Nasal and orbital decompression, and facial recontouring were performed simultaneously. This was done via a transconjunctival and transcaruncular approaches with a lateral canthotomy, which provided access to the four walls of the orbit, midface and the lateral nasal wall. The reduction of the turbinates was done through a standard turbinectomy approach and the nasal decompression was done via intercartilaginous access and a full transfixion incision and nasal degloving. The bulk of the lesion was removed with chisels, gauges, and rotary instruments. The orbital debulking extended to the orbital apex, which was not involved by the fibrous dysplasia. Approximately 200 mg of dysplastic bone was removed. The functional and aesthetic results were good. The symptoms of chronic conjunctivitis and nasal obstruction have been alleviated and there is no deterioration of his condition. The symptoms of anosmia have also disappeared. Conservative surgical treatment of craniofacial dysplasia in adults with stable disease is recommended.     

损伤控制性外科理念在胃肠外科中的应用

目的?研究探讨损伤控制性外科理念在胃肠外科包括非创伤急症、创伤外科中的应用.方法?对该院32例损伤控制性手术及16例行常规手术患者的临床资料进行回顾性分析,综合对比两组患者术后表现及康复情况.结果?损伤控制组与常规手术组患者术后的体温、氧饱和度等方面差异无显著意义,凝血酶原时间差异具有统计学意义.结论?损伤控制性外科理念在胃肠外科急、重病症中具有着重要的意义.