ORIGINAL ARTICLE. Rhinologic Computed Tomographic Evaluation in Patients With Cleft Lip and Palate
|
|
- Ambrose Pearson
- 5 years ago
- Views:
Transcription
1 ORIGINAL ARTICLE Rhinologic Computed Tomographic Evaluation in Patients With Cleft Lip and Palate Hideaki Suzuki, MD, PhD; Tai Yamaguchi, DDS, PhD; Masayuki Furukawa, MD, PhD Objective: To investigate the anatomical characteristics of the nasal cavity and paranasal sinuses in relation to the presence of sinusitis in patients with cleft lip and palate. Design: Retrospective survey. Setting: Tertiary care hospital. Patients: Forty-seven consecutive patients with cleft lip and alveolus with or without cleft palate. Main Outcome Measures: The patients underwent computed tomographic scans of the maxilla, and the following parameters were evaluated: nasal septal shift from the midline, soft tissue density shadow of the maxillary sinus, cross-sectional area of the maxillary sinus, and height of the floor of the maxillary sinus. Results: The nasal septum was convex to the cleft side in most of the patients with unilateral clefts, and there was a significant correlation between the cleft side and the direction of nasal septal deviation (P.1). Sinusitis was more severe in the noncleft side than in the cleft side (P =.), and in the concave side than in the convex side (P =.). The cross-sectional area of the maxillary sinus was not statistically different between the cleft side and noncleft side, nor between the septal concave side and convex side. The floor of the maxillary sinus was situated higher in the cleft side than in the noncleft side (P =.). Conclusions: The occurrence of maxillary sinusitis associated with cleft lip and palate is dependent on both the cleft side and the deviated nasal septum, but not on the size of the sinus. The cleft side is responsible for the direction of the septal deviation and the height of the floor of the maxillary sinus. A low-situated sinus floor may be in contact with the root of the teeth, and thus may be one of the etiologic factors of sinusitis in patients with clefts. Arch Otolaryngol Head Neck Surg. 1999;15:1-1 From the Departments of Otolaryngology (Drs Suzuki and Furukawa) and Dentistry and Oral Surgery (Dr Yamaguchi), Sendai National Hospital, Sendai, Japan. PATIENTS WITH cleft lip and palate manifest a variety of anatomical and physiological impairments, including otologic, audiologic, and rhinologic disorders. From the rhinologic viewpoint, nasal airway obstruction is one of the most vital problems because of its high prevalence in patients with clefts and the importance of adequate nasal respiration in mammalian species. Unconditioned inhaled air via mouth breathing damages the lower respiratory tract epithelium, and may induce a parasympathetic reflex, leading to an increase in lower airway resistance. 1, Nasorespiratory dysfunction may also cause abnormal dentofacial growth. 3 Moreover, blockage of the upper airway is often accompanied by snoring, sleep disturbance, and, sometimes, obstructive sleep apnea, hypertension, arrhythmia, and even cor pulmonale.,5 Several authors have so far documented increased nasal airway resistance and mouth breathing in patients with clefts. 6-9 This condition results from a deviated nasal septum, turbinate hypertrophy, rhinosinusitis, external nasal deformity, and other causes, which are commonly associated with cleft lip and palate. 3 The present study was performed in an attempt to investigate the anatomical characteristics of the nasal cavity and paranasal sinuses in relation to the presence of sinusitis in patients with cleft lip and palate. RESULTS NASAL SEPTAL DEVIATION The mean value of the nasal septal shift from the midline was 3.5 ±.3 mm. Fortytwo patients (89%) showed a nasal septal shift of.7 mm or more. The nasal sep- 1 Downloaded From: on 7/5/18
2 PATIENTS AND METHODS PATIENTS We studied 7 consecutive patients, 36 male and 11 female subjects, with cleft lip and alveolus with or without cleft palate, ranging in age from to 35 years (mean age, 13.5 years). Five of them were surgical cases. Eleven patients had cleft lip and alveolus and 36 had cleft lip, alveolus, and palate. The cleft side was left in 8 patients, right in 8, and bilateral in 11. COMPUTED TOMOGRAPHIC SCANS and Nasal Septal Deviation* Nasal Septal Deviation () Left Right No Deviation Total Left 6 8 Right 6 8 Bilateral Total *Data are given as number of patients. The correlation between the cleft side and the direction of nasal septal deviation was statistically significant ( test, P.1). The patients underwent computed tomographic scans of the maxilla. Serial axial plane images were taken every mm, and the following parameters were evaluated. (1) Evaluation of the deviated nasal septum: The maximum value of the nasal septal shift from the midline was measured in each patient. The midline was set to meet the middle point of both edges of the piriform aperture and the midpoint of the clivus. () Evaluation of sinusitis: The soft tissue density shadow of the maxillary sinus was scored on a -point scale; ie, (%-1%), 1 (1%-5%), (5%-8%), and 3 (8%-1%). (3) Measurement of the cross-sectional area of the maxillary sinus: The outline of the maxillary sinus at the level of the zygomatic arch was traced on graph paper, and the cross-sectional area of the sinus was calculated. () Measurement of the height of the floor of the maxillary sinus: The height of the floor of the maxillary sinus was measured. The base plane was set as a horizontal plane that meets the lower end of the lateral lamina of the pterygoid process. STATISTICS Data were expressed as mean ± SEM. The types of statistical tests are described in the Results section. Differences were considered significant at P.5. Left Septal Shift, mm P <.1 P <.1 P =.3 tum was convex to the cleft side in most of the patients with unilateral clefts, and there was a significant correlation between the cleft side and the direction of nasal septal deviation ( test, P.1; Table). The nasal septal shift differed significantly among the patients of the left-sided cleft group, right-sided cleft group, and bilateral cleft group (Student t test; Figure 1). SINUSITIS A soft tissue density shadow of the maxillary sinus of grade 1 or more was observed in 15 patients (3%) and in sides (1%). The shadow was mainly observed in the lower portion of the sinus. In the patients with unilateral clefts, sinusitis was more severe in the noncleft side than in the cleft side (Wilcoxon matched pairs signed rank test, P =.; Figure, A). In the patients with nasal septal deviation, sinusitis was more severe in the concave side than in the convex side (Wilcoxon matched pairs signed rank test, P =.; 5 Right Left Right Bilateral Figure 1. Nasal septal shift from the midline in patients with clefts. The maximum value of the nasal septal shift from the midline was measured in each patient. Data are mean ± SEM. The midline was set to meet the middle point of both edges of the piriform aperture and the midpoint of the clivus. Figure, B). No statistical difference of the sinusitis grade was observed between the patients with cleft lip and alveolus and patients with cleft lip, alveolus, and palate ( test, P =.95; Figure, C). CROSS-SECTIONAL AREA OF THE MAXILLARY SINUS The cross-sectional area of the sinus was not statistically different between the cleft side and noncleft side in the patients with unilateral clefts (paired t test, P =.15; Figure 3, A). The cross-sectional area was also not different between the concave side and convex side in the patients with nasal septal deviation (paired t test, P =.15; Figure 3, B). 11 Downloaded From: on 7/5/18
3 1 8 ASinus Area, mm Sinusitis Grade 1 3 A P =. B P =. C P = % of Patients CL CLP Figure. Sinusitis in patients with clefts. Soft tissue density shadow of the maxillary sinus was scored on a -point scale (, %-1%; 1, 1%-5%;, 5%-8%; and 3, 8%-1%). A, Comparison of cleft vs noncleft sides in the patients with unilateral clefts (n = 36). B, Comparison of convex vs concave sides in the patients with nasal septal deviation (n = ). C, Comparison of the patients with cleft lip and alveolus (CL) (n = 1) vs patients with cleft lip, alveolus, and palate (CLP) (n = 33). B 7 P =.15 7 P = Figure 3. Cross-sectional area of the maxillary sinus in patients with clefts. The outline of the maxillary sinus at the level of the zygomatic arch was traced on graph paper, and the cross-sectional area of the sinus was calculated. Data are mean ± SEM. A, Comparison of cleft vs noncleft sides in the patients with unilateral clefts (n = 36). B, Comparison of convex vs concave sides in the patients with nasal septal deviation (n = ). HEIGHT OF THE FLOOR OF THE MAXILLARY SINUS In the patients with unilateral clefts, the floor of the maxillary sinus was situated higher in the cleft side than in the noncleft side (paired t test, P =.; Figure, A). On the other hand, the height was not statistically different between the concave side and convex side in the patients with nasal septal deviation (paired t test, P =.8; Figure, B). COMMENT Although it is well known that sinusitis is frequently associated with cleft lip and palate, 1,11 its etiology is not fully understood. Sinusitis was observed in as many as one third of the patients in the present study. Several possible factors have been proposed to explain the high incidence of sinusitis in patients with clefts. 1,11 First, if these patients have underdeveloped maxilla, malpositioning of the sinus ostium may be an etiologic factor of sinusitis. However, a number of authors have documented that the size of the maxillary sinus of patients with clefts is not different from that of normal control subjects, and that there is no significant difference in the size of the sinus between the cleft side and noncleft side The present results also showed virtually equivalent cross-sectional areas of the sinuses of cleft vs noncleft sides and septal convex vs concave sides (Figure 3), whereas the severity of sinusitis was dependent on the cleft side and the direction of the nasal septal deviation (Figure, A and B). Therefore, hypoplasia of the maxillary sinus is unlikely to be a causative factor of sinusitis in patients with clefts. Second, regurgitation of saliva and food through the cleft or an incompe- 1 Downloaded From: on 7/5/18
4 A P =. 1 B 1 P = Height of Sinus Floor, mm 6 6 Figure. Height of the floor of the maxillary sinus in patients with clefts. The base plane was set as a horizontal plane that meets the lower end of the lateral lamina of the pterygoid process. Data are mean ± SEM. A, Comparison of cleft vs noncleft sides in the patients with unilateral clefts (n = 36). B, Comparison of convex vs concave sides in the patients with nasal septal deviation (n = ). tent velopharynx may irritate the nasal and paranasal sinus mucosa and thereby induce rhinosinusitis. 1,11 Nevertheless, this mechanism cannot account for the present results that sinusitis was more severe in the noncleft side than in the cleft side (Figure, A) and that no difference in the sinusitis grade was observed between the patients with cleft lip and alveolus and the patients with cleft lip, alveolus, and palate (Figure, C). The third factor is impaired nasal mucociliary function in patients with clefts as described by Ishikawa et al, 11 which again cannot explain the asymmetric occurrence of sinusitis shown in the present study. The fourth factor is the deviated nasal septum, which is commonly seen in association with cleft lip and palate. 5 The present study revealed a high incidence of septal deviation and asymmetric occurrence of sinusitis between both sides of the deviated septum (Figure, B). These observations strongly suggest that sinusitis in patients with clefts is at least partially dependent on the deviated septum. The septum was convex to the cleft side in most of the patients with unilateral clefts (Table). Drettner 6 has reported that unilateral cleft lip and palate is usually accompanied by narrowing of the nasal airway on the same side, which is in agreement with our results. According to Crockett and Bumsted, 3 in patients with unilateral clefts, the caudal end of the cartilaginous septum is shifted to the noncleft side, and the superior portion of the septum is slanted to the cleft side. It is known that patients with sinusitis have a higher degree of septal deviation In general, sinusitis arises in either side of a deviated septum. In the septal convex side, a lateral shift of the middle turbinate narrows the middle meatus and sinus ostium. Meanwhile, lateral nasal wall abnormalities such as concha bullosa and prominent bulla ethmoidalis occur in the septal concave side, and, therefore, the sinus ostium is narrowed as well. 16,18 In practice, the incidence of sinusitis is equivalent in either side of the deviated septum in patients without clefts. 18 Why, then, was sinusitis more severe in the noncleft side than in the cleft side, and in the septal concave side than in the convex side in patients in the present study? According to our observation, sinusitis was mainly seen in the lower portion of the maxillary sinus. This implies that the anatomical configuration of the floor of the sinus may participate in the occurrence of sinusitis. Our next results showed that the floor of the maxillary sinus in the cleft side was situated higher compared with that in the noncleft side (Figure, A), indicating that the sinus cavity in the noncleft side extends more caudally, and thus closer to the root of the teeth. Considering the irregularity of dentition in patients with clefts, it is suggested that dental diseases elicit inflammatory changes of the maxillary sinus, preferably in the noncleft side. Based on this hypothesis, sinusitis would naturally favor the septal concave side in these patients because the noncleft side usually corresponds to the septal concave side. CONCLUSIONS The anatomical characteristics of the nasal cavity and paranasal sinuses in relation to the presence of sinusitis in patients with cleft lip and palate were investigated on computed tomographic scan images. The occurrence of sinusitis was dependent on both the cleft side and the deviated nasal septum. The cleft side was responsible for the direction of the septal deviation and the height of the floor of the maxillary sinus. A low-situated sinus floor may be in contact with the root of the teeth, and thus may be one of the etiologic factors of sinusitis in patients with cleft lip and palate. The topographical relationship between the maxillary sinus and teeth in these patients remains to be investigated in future studies. Accepted for publication March, Reprints: Hideaki Suzuki, MD, PhD, Department of Otolaryngology, Sendai National Hospital, -8-8 Miyagino, Miyagino-ku, Sendai , Japan ( 13 Downloaded From: on 7/5/18
5 REFERENCES 1. Olsen KD. Sleep and breathing disturbance secondary to nasal obstruction. Otolaryngol Head Neck Surg. 1981;89: Settipane GA. Rhino-sino-bronchial reflex. Immunol Allergy Pract. 1985;7: Crockett DM, Bumsted RM. Evaluation and management of nasal airway obstruction in the cleft patient. In: Bardach J, Morris HL, eds. Multidisciplinary Management of Cleft Lip and Palate: Section X. Nasal Airway, Otologic, and Audiologic Problems Associated With Cleft Lip and Palate. Philadelphia, Pa: WB Saunders Co; 199: Lavie P, Zomer J, Eliaschar I, et al. Excessive daytime sleepiness and insomnia. Arch Otolaryngol. 198;18: Josephson GD, Levine J, Cutting CB. Septoplasty for obstructive sleep apnea in infants after cleft lip repair. Cleft Palate Craniofac J. 1996;33: Drettner B. The nasal airway and hearing in patients with cleft palate. Acta Otolaryngol. 196;5: Warren DW, Duany LF, Fisher WD. Nasal pathway resistance in normal and cleft lip and palate subjects. Cleft Palate J. 1969;6: Warren DW, Trier WL, Bevin AG. Effect of restorative procedures on the nasopharyngeal airway in cleft palate. Cleft Palate J. 197;: Turvey TA, Hall DJ, Warren DW. Alterations in nasal airway resistance from superior repositioning of the maxilla. Am J Orthod. 198;85: Jaffe BF, DeBlanc CB. Sinusitis in children with cleft lip and palate. Arch Otolaryngol. 1971;93: Ishikawa Y, Kawano M, Honjo I, Amitani R. The cause of nasal sinusitis in patients with cleft palate. Arch Otolaryngol Head Neck Surg. 1989;115: Havlova Z, Brejcha V, Hajnis K, Ruzickova J. Development of sinus maxillaris in children with complete unilateral clefts (age class -7 years). Acta Chir Plast. 197;1: Robinson HE, Zerlin GK, Passy V. Maxillary sinus development in patients with cleft palates as compared to those with normal palates. Laryngoscope. 198; 9: Francis P, Raman R, Korula P, Korah I. Pneumatization of the paranasal sinuses (maxillary and frontal) in cleft lip and palate. Arch Otolaryngol Head Neck Surg. 199;116: Smith TD, Siegel MI, Burrows AM, Todhunter JS. Formation and enlargement of the paranasal sinuses in normal and cleft lip and palate human fetuses. Cleft Palate Craniofac J. 1997;3: Calhoun KH, Waggenspack GA, Simpson B, Hokanson JA, Bailey BJ. CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg. 1991;1: Yousem DM, Kennedy DW, Rosenberg S. Ostiomeatal complex risk factors for sinusitis: CT evaluation. J Otolaryngol. 1991;: Elahi MM, Frenkiel S, Fageeh N. Paraseptal structural changes and chronic sinus disease in relation to the deviated septum. J Otolaryngol. 1997;6:36-. Archives Web Forum Discuss key clinical issues with your colleagues in the ARCHIVES new World Wide Web forum. These moderated online discussions are based on selections from the ARCHIVES Clinical Challenges in Otolaryngology series. For more details, see the ARCHIVES Web site at 1 Downloaded From: on 7/5/18
Association between Septal Deviation and Sinonasal Papilloma
Tohoku J. Exp. Med., 2013, 231, 315-319 Septal Deviation and Papilloma 315 Association between Septal Deviation and Sinonasal Papilloma Kazuhiro Nomura, 1,2 Takenori Ogawa, 1 Mitsuru Sugawara, 2 Yohei
More informationORIGINAL ARTICLE RELATIONSHIP OF CONCHA BULLOSA WITH OSTEOMEATAL UNIT BLOCKAGE. TOMOGRAPHIC STUDY IN 200 PATIENTS.
RELATIONSHIP OF CONCHA BULLOSA WITH OSTEOMEATAL UNIT BLOCKAGE. TOMOGRAPHIC STUDY IN 200 PATIENTS. Shrikrishna B H 1, Jyothi A C 2, Sanjay G 3, Sandeep Samson G 4. 1. Associate Professor, Department of
More informationReview Article The Prevalence of Concha Bullosa and Nasal Septal Deviation and Their Relationship to Maxillary Sinusitis by Volumetric Tomography
Hindawi Publishing Corporation International Journal of Dentistry Volume 2010, Article ID 404982, 5 pages doi:10.1155/2010/404982 Review Article The Prevalence of and Nasal Septal Deviation and Their Relationship
More informationUnique Journal of Medical and Dental Sciences Available online: Research Article
ISSN 2347-5579 Unique Journal of Medical and Dental Sciences Available online: www.ujconline.net Research Article STUDY OF ANATOMICAL VARIATIONS OF LATERAL WALL OF NOSE BY ENDOSCOPE Kolvekar VD 1*, Kazi
More informationSpheno-Ethmoidectomy
Diagnostic and Therapeutic Endoscopy, Vol. 5, pp. 1-8 Reprints available directly from the publisher Photocopying permitted by license only (C) 1998 OPA (Overseas Publishers Association) N.V. Published
More informationROLE OF ANATOMICAL OBSTRUCTION IN THE PATHOGENESIS OF CHRONIC SINUSITIS
From the SelectedWorks of Balasubramanian Thiagarajan July 1, 2012 ROLE OF ANATOMICAL OBSTRUCTION IN THE PATHOGENESIS OF CHRONIC SINUSITIS Balasubramanian Thiagarajan Available at: https://works.bepress.com/drtbalu/51/
More informationBoundaries Septum Turbinates & Meati Lamellae Drainage Pathways Variants
The Fastest 20 Minutes in Michelle A. Michel, MD Professor of Radiology and Otolaryngology Medical College of Wisconsin, Milwaukee Overview Nasal cavity Anterior skull base Ostiomeatal complex Frontal
More informationReview Article The Prevalence of Concha Bullosa and Nasal Septal Deviation and Their Relationship to Maxillary Sinusitis by Volumetric Tomography
Hindawi Publishing Corporation International Journal of Dentistry Volume 2010, Article ID 404982, 5 pages doi:10.1155/2010/404982 Review Article The Prevalence of and Nasal Septal Deviation and Their Relationship
More informationCorporate Medical Policy Septoplasty
Corporate Medical Policy Septoplasty File Name: Origination: Last CAP Review: Next CAP Review: Last Review: septoplasty 4/1999 8/2018 8/2019 8/2018 Description of Procedure or Service There are many potential
More informationAn epidemiologic study of factors associated with nasal septum deviation by computed tomography scan: a cross sectional study
Mohebbi et al. BMC Ear, Nose and Throat Disorders 2012, 12:15 RESEARCH ARTICLE An epidemiologic study of factors associated with nasal septum deviation by computed tomography scan: a cross sectional study
More informationTRAUMA TO THE FACE AND MOUTH
Dr.Yahya A. Ali 3/10/2012 F.I.C.M.S TRAUMA TO THE FACE AND MOUTH Bailey & Love s 25 th edition Injuries to the orofacial region are common, but the majority are relatively minor in nature. A few are major
More informationThe frequency of nasal septal deviation and concha bullosa and their relationship with maxillary sinusitis based on CBCT finding
Available online at www.ijmrhs.com ISSN No: 2319-5886 International Journal of Medical Research & Health Sciences, 2016, 5, 11:152-156 The frequency of nasal septal deviation and concha bullosa and their
More informationRadiological anatomy of frontal sinus By drtbalu
2009 Radiological anatomy of frontal sinus By drtbalu Anatomy of frontal sinus is highly variable. Precise understanding of these variables will help a surgeon to avoid unnecessary complications during
More informationThe future of health is digital
Dated: XX/XX/XXXX Name: XXXXXXXX XXXXXXXXXXX Birth Date: XX/XX/XXXX Date of scan: XX/XX/XXXX Examination of the anatomical volume: The following structures are reviewed and evaluated for bilateral symmetry,
More informationNASAL OBSTRUCTION. Andy Whyte PERTH RADIOLOGICAL CLINIC UNIVERSITY OF MELBOURNE UNIVERSITY OF WA
NASAL OBSTRUCTION Andy Whyte PERTH RADIOLOGICAL CLINIC UNIVERSITY OF MELBOURNE UNIVERSITY OF WA INTRODUCTION sinonasal imaging focuses on structural abnormalities of the POSTERIOR (BONY 3/4 ) of the nose
More informationConventional Sinus Surgery Vs Fess
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 7 Ver. III (July. 2017), PP 44-51 www.iosrjournals.org Conventional Sinus Surgery Vs Fess *
More informationAnatomical Variations in Osteomeatal Complex among Patients undergoing Functional Endoscopic Sinus Surgery
V Narendrakumar, V Subramanian Original article 10.5005/jp-journals-10013-1259 Anatomical Variations in Osteomeatal Complex among Patients undergoing Functional Endoscopic Sinus Surgery 1 V Narendrakumar,
More informationwww.oralradiologists.com CONE BEAM CT REPORT CASE XXXX Patient information Patient Name: - Referring Doctor: - Patient DOB: - Scan Date: [Start date] Reason for Exam: Maxillary facial pain Doctor Notes:
More informationSnoring and Obstructive Sleep Apnea: Patient s Guide to Minimally Invasive Treatments Chapter 2
Snoring and Obstructive Sleep Apnea: Patient s Guide to Minimally Invasive Treatments Chapter 2 CAUSES OF SNORING AND SLEEP APNEA We inhale air through our nose and mouth. From the nostrils, air flows
More informationthus, the correct terminology is now rhinosinusitis.
By: Ibrahim Alarifi Introduction Rhinitis and sinusitis usually coexist and are concurrent in most individuals; thus, the correct terminology is now rhinosinusitis. Mucosa of the nose is a continuation
More informationOpen Access Effect of Septal Deviation, Concha Bullosa and Haller s Cell on Maxillary Sinus s Inferior Pneumatization; a Retrospective Study
Send Orders for Reprints to reprints@benthamscience.ae 282 The Open Dentistry Journal, 2015, 9, (Suppl 2: M5) 282-286 Open Access Effect of Septal Deviation, Concha Bullosa and Haller s Cell on Maxillary
More informationPresenter: dr. Labeb Sailan Obad F1
Presenter: dr. Labeb Sailan Obad F1 the correlation between currently existing objective tests for nasal airway patency and the patient s symptoms remains controversial Different measurement tools for
More informationPatient profile, indications, complications and Evaluation of Septoplasty outcome in a Base Hospital in Sri Lanka
Patient profile, indications, complications and Evaluation of Septoplasty outcome in a Base Hospital in Sri Lanka Rubasinghe M.S., De Silva M.D.K., Wanasinghe W.M.S.C.L., De Livera R.J.K., Wimalaratna
More informationA study of causes of nasal obstruction in Garhwal region of Uttarakhand
Original Research Article Amit Arya 1, R S Bisht 2,*, Venkatashivareddy B 3, Richa Mina 4 1,4 Senior Resident, 2 Professor, Dept. of ENT, 3 Assistant Professor, Dept. of Community Medicine, VCSGGMS & RI
More informationThe Incidence of Concha Bullosa and Its Association with Chronic Rhinosinusitis Deviated Nasal Septum and Osteomeatal Complex Obstruction
1 Bahrain Medical Bulletin, Vol. 33, No. 4, December 2011 The Incidence of Concha Bullosa and Its Association with Chronic Rhinosinusitis Deviated Nasal Septum and Osteomeatal Complex Obstruction Fatma
More informationVolumetric Nasal Cavity Analysis in Children With Unilateral and Bilateral Cleft Lip and Palate
The Laryngoscope VC 2015 The American Laryngological, Rhinological and Otological Society, Inc. Volumetric Nasal Cavity Analysis in Children With Unilateral and Bilateral Cleft Lip and Palate Zainab Farzal,
More informationORIGINAL ARTICLE. Computed Tomographic Staging and the Fate of the Dependent Sinuses in Revision Endoscopic Sinus Surgery
Computed Tomographic Staging and the Fate of the Dependent es in Revision Endoscopic Surgery Neil Bhattacharyya, MD ORIGINAL ARTICLE Objectives: To determine the patterns of disease recurrence in chronic
More informationJMSCR Vol 04 Issue 05 Page May 2016
www.jmscr.igmpublication.org Impact Factor 5.244 Index Copernicus Value: 5.88 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: http://dx.doi.org/10.18535/jmscr/v4i5.25 Radiologic Variations of Nose and Paranasal
More informationSnoring and Obstructive Sleep Apnea: Patient s Guide to Minimally Invasive Treatments Chapter 6
Snoring and Obstructive Sleep Apnea: Patient s Guide to Minimally Invasive Treatments Chapter 6 MINIMALLY INVASIVE TREATMENTS OF SNORING AND SLEEP APNEA OVERVIEW The past decade has seen the rise of effective,
More informationHHS Public Access Author manuscript Laryngoscope. Author manuscript; available in PMC 2017 June 01.
Volumetric Nasal Cavity Analysis in Children with Unilateral and Bilateral Cleft Lip and Palate Zainab Farzal, BS 1, Jonathan Walsh, MD 1, Gabriella Lopes de Rezende Barbosa, DDS, MS 2, Carlton J. Zdanski,
More informationDerriford Hospital. Peninsula Medical School
Asthma and Allergic Rhinitis iti What is the Connection? Hisham Khalil Consultant ENT Surgeon Clinical Senior Lecturer, PMS Clinical Sub-Dean GP Evening 25 June 2008 Plymouth Derriford Hospital Peninsula
More informationSubjective Assessment of Outcomes of Septoplasty
aijoc Punnoose Philip et al Original Article 10.5005/jp-journals-10003-1261 1 Punnoose Philip, 2 Deepika Pratap, 3 Aroor Rajeshwary, 4 Vadisha Bhat ABSTRACT Septal deviation is the leading cause of chronic
More informationIncidence of accessory ostia in patients with chronic maxillary sinusitis
International Journal of Otorhinolaryngology and Head and Neck Surgery Ghosh P et al. Int J Otorhinolaryngol Head Neck Surg. 2018 Mar;4(2):443-447 http://www.ijorl.com pissn 2454-5929 eissn 2454-5937 Original
More informationDimensions of the Cleft Nasal Airway in Adults: A Comparison With
Dimensions of the Cleft Nasal Airway in Adults: A Comparison With Subjects Without Cleft W. MicHiaAeL HairFieup, D.D.S., M.S. DonaLo W. Warren, D.D.S., Ph.D. The prevalence of mouthbreathing among individuals
More informationOriginal Article. Relieving Symptoms of Chronic Sinusitis in Children By Adenoidectomy
Original Article Relieving Symptoms of Chronic Sinusitis in Children By Adenoidectomy * C.A.B.M.S/ENT Summary: Background: To determine the efficacy of adenoidectomy in relieving symptoms of chronic sinusitis
More informationMaxillary Sinus Measurements in Different Age Groups of Human Cadavers
Tikrit Journal for Dental Sciences 1(2013)107-112 Maxillary Sinus Measurements in Different Age Groups of Human Cadavers Mohammad A. Abd-alla BDS, MSc., Ph.D. (1) Abdul-Jabbar J. Mahdi BDS, MSc., Ph.D.
More informationInternational Journal of Health Sciences and Research ISSN:
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Anatomical Study of the Middle Meatus with Emphasis to the Maxillary Ostium and Their Clinical
More informationNasal region. cartilages: septal cartilage (l); lateral nasal cartilage (2); greater alar cartilages (2); lesser alar cartilages (?
Nasal region skull bones: nasal and frontal processes of maxilla cartilages: septal cartilage (l); lateral nasal cartilage (2); greater alar cartilages (2); lesser alar cartilages (?) 1 Nasal cavity Roof
More informationExtranodal Natural Killer/T-Cell Lymphoma Nasal Type: Detection by Computed Tomography Features
The Laryngoscope VC 2014 The American Laryngological, Rhinological and Otological Society, Inc. Extranodal Natural Killer/T-Cell Lymphoma Nasal Type: Detection by Computed Tomography Features Yin-Ping
More informationInternational Journal of Biological & Medical Research
Int J Biol Med Res.2015;6(1):4775-4781 Contents lists available at BioMedSciDirect Publications International Journal of Biological & Medical Research Journal homepage: www.biomedscidirect.com BioMedSciDirect
More informationBisection of Head & Nasal Cavity 頭部對切以及鼻腔. 解剖學科馮琮涵副教授 分機
Bisection of Head & Nasal Cavity 頭部對切以及鼻腔 解剖學科馮琮涵副教授 分機 3250 E-mail: thfong@tmu.edu.tw Outline: The structure of nose The concha and meatus in nasal cavity The openings of paranasal sinuses Canals, foramens
More informationAdvances of Plastic & Reconstructive Surgery
Chapter 1 Advances of Plastic & Reconstructive Surgery Cleft lip nasal deformity: Analysis and treatment Martínez-Capoccioni Gabriel*; Martín-Martín Carlos Servizo Galego de Saúde, Service of ENT Head
More informationSnoring. Forty-five percent of normal adults snore at least occasionally and 25
Snoring Insight into sleeping disorders and sleep apnea Forty-five percent of normal adults snore at least occasionally and 25 percent are habitual snorers. Problem snoring is more frequent in males and
More informationJMSCR Vol 05 Issue 09 Page September 2017
www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 71.58 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i9.52 Relationship of Agger Nasi Cell and Uncinate
More informationMedStar Health considers Septoplasty-Rhinoplasty medically necessary for the following indications:
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.038.MH Septoplasty-Rhinoplasty This policy applies to the following lines of business: MedStar Employee (Select) MedStar MA DSNP CSNP MedStar CareFirst
More informationFigure 1. Basic anatomy of the palate
CHAPTER 10 CLEFT LIP AND PALATE Chen Yan, MD and Sanjay Naran, MD I. ANATOMY AND DEFINITIONS A. Cleft Lip (CL) alone, Cleft Lip with Cleft Palate (CLP), and Cleft Palate (CP) alone 1. CL alone and CLP
More informationThere is no uniform grading system for nasal dorsal deformities currently in general use
ORIGINAL ARTICLE A Grading System for Nasal Dorsal Deformities Matthew A. Kienstra, MD; Holger G. Gassner, MD; David A. Sherris, MD; Eugene B. Kern, MD There is no uniform grading system for nasal dorsal
More informationAnatomical variants of the uncinate process CT scan imaging study
Romanian Journal of Rhinology, Vol. 2, No. 7, July - September 2012 original Study Anatomical variants of the uncinate process CT scan imaging study Vasilica Baldea 1, Mihail Dan Cobzeanu 2, Florina Mihalcea
More informationJMSCR Vol 05 Issue 10 Page October 2017
www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 71.58 ISSN (e)-2347-176x ISSN (p) 2455-45 DOI: https://dx.doi.org/1.18535/jmscr/v5i1.116 Nasal Polyps- Causes and Associated Symptoms-
More informationEvaluation With Acoustic Rhinometry of Patients Undergoing Sinonasal Surgery
ORIGINAL ARTICLE Evaluation With Acoustic Rhinometry of Patients Undergoing Sinonasal Surgery R L A Raja Ahmad, MS (ORL)*, B S Gendeh, MS (ORL)** Department of Otolaryngology-Head & Neck Surgery, Kulliyyah
More informationRESPIRATORY LAB. Introduction: trachea, extrapulmonary bronchi, and lungs b) passage for and conditioning of air (moisten, warm, and filtering)
RESPIRATORY LAB Danil Hammoudi.MD Introduction: a) system includes nasal cavity, pharynx, larynx, trachea, extrapulmonary bronchi, and lungs b) passage for and conditioning of air (moisten, warm, and filtering)
More informationKatya A. Shpilberg 1 Simon C. Daniel 1 Amish H. Doshi 1 William Lawson 2 Peter M. Som 1. Neuroradiology/Head and Neck Imaging Original Research
Neuroradiology/Head and Neck Imaging Original Research Shpilberg et al. CT of Paranasal Sinuses and Nasal Cavity Neuroradiology/Head and Neck Imaging Original Research Katya A. Shpilberg 1 Simon C. Daniel
More informationOriginal Article Effect of lamina papyracea ingression on orbito-ocular complications after functional endoscopic sinus surgery
Int J Clin Exp Med 2016;9(6):10317-10321 www.ijcem.com /ISSN:1940-5901/IJCEM0025371 Original Article Effect of lamina papyracea ingression on orbito-ocular complications after functional endoscopic sinus
More informationSphenoid rhinosinusitis associated with abducens nerve palsy Case report
Romanian Journal of Rhinology, Volume 8, No. 30, April-June 2018 CASE REPORT Sphenoid rhinosinusitis associated with abducens nerve palsy Case report Lucian Lapusneanu 1, Marlena Radulescu 1, Florin Ghita
More informationTitle. Author(s)Matsushita, Kazuhiro; Yamamoto, Hidekazu. CitationBritish journal of oral and maxillofacial surgery, 5. Issue Date
Title Bilateral hypoplasia of the maxillary sinus : swelli Author(s)Matsushita, Kazuhiro; Yamamoto, Hidekazu CitationBritish journal of oral and maxillofacial surgery, 5 Issue Date 2017-04 Doc URL http://hdl.handle.net/2115/68826
More informationA radiological study of anatomical variations in ostiomeatal complex in patients with chronic rhinosinusitis
International Journal of Otorhinolaryngology and Head and Neck Surgery Rajneesh et al. Int J Otorhinolaryngol Head Neck Surg. 2017 Jul;3(3):528-533 http://www.ijorl.com pissn 2454-5929 eissn 2454-5937
More informationThe Respiratory System
The Respiratory System Respiration Includes Pulmonary ventilation Air moves in and out of lungs Continuous replacement of gases in alveoli (air sacs) External respiration Gas exchange between blood and
More informationThe advent of high-resolution computerized tomography
An anatomic classification of the ethmoidal bulla REUBEN C. SETLIFF, III, MD, PETER J. CATALANO, MD, FACS, LISA A. CATALANO, MPH, and CHAD FRANCIS, BA, Sioux Falls, South Dakota, and Burlington, Massachusetts
More informationCongenital Nasal Pyriform Aperture Stenosis Is There a Role for Nasal Dilation?
Research Original Investigation Is There a Role for Nasal Dilation? Todd M. Wine, MD; Kavita Dedhia, MD; David H. Chi, MD IMPORTANCE Congenital nasal pyriform aperture stenosis (CNPAS) may require sublabial
More informationLongitudinal Evaluation of Articulation and Velopharyngeal
_ Longitudinal Evaluation of Articulation and Velopharyngeal Competence of Patients with Pharyngeal Flaps D. R. Van Demark, PH.D. M. A. Harpin, PH.D. In this study, 129 patients with cleft palate who had
More informationMalignant growth Maxilla management an analysis
ISSN: 2250-0359 Volume 3 Issue 2 2013 Malignant growth Maxilla management an analysis *Balasubramanian Thiagarajan *Geetha Ramamoorthy *Stanley Medical College Abstract: Malignant tumors involving maxilla
More informationVolume 2 issue 4 ISSN A STUDY ON CHRONIC OTITIS MEDIA ACTIVE MUCOSAL TYPE WITH SINUSITIS AS FOCAL SEPSIS
Volume 2 issue 4 ISSN 2250-0359 A STUDY ON CHRONIC OTITIS MEDIA ACTIVE MUCOSAL TYPE WITH SINUSITIS AS FOCAL SEPSIS * Sankaranaryanan Gopalakrishnan, * Satheesh kumar * Kilpaulk Medical College, Royepettah
More informationISSN X (Print) Research Article. *Corresponding author Dr.V. Krishna Chaitanya
Scholars Journal of Applied Medical Sciences (SJAMS) Sch. J. App. Med. Sci., 2015; 3(1G):508-513 Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources)
More informationChapter Five. 1 of 8 11/3/2008 2:52 PM.
1 of 8 11/3/2008 2:52 PM Email : myousefmian@hotmail.com Chapter Five FRONT COVER Introduction Acknowledgement CHAPTERS Chapter One Chapter Two Chapter Three Chapter Four Chapter Five Chapter Six Chapter
More informationofunusual and Occult Clefts of the Palate JOHN MARQUIS CONVERSE, MD. SIDNEY L. HOROWITZ, D.D.S. MELVIN H. BECKER M.D, New York New York-4:11
TheUse oftomographyin: the Diagnosis ofunusual and Occult Clefts of the Palate JOHN MARQUIS CONVERSE, MD. SIDNEY L. HOROWITZ, D.D.S. MELVIN H. BECKER M.D, New York New York-4:11 The ma or1ty of patients
More informationBonifacius Hariyanto and 2 Andi Nilawati Usman
Research Paper JMS (ISSN 1682-4474) is an International, peer-reviewed scientific journal that publishes original article in experimental & clinical medicine and related disciplines such as molecular biology,
More informationDIFFICULT-TO-TREAT CHRONIC
MANAGEMENT STRATEGIES FOR DIFFICULT-TO-TREAT CHRONIC RHINOSINUSITIS DR ZULKEFLI HUSSEIN CONSULTANT EAR NOSE & THROAT SURGEON PANTAI HOSPITAL PENANG DISCLAIMER Nothing to disclose PENANG ISLAND, MALAYSIA
More informationThe Relationship of Concha Bullosa with Nasal Septal Deviation and Paranasal Sinus Disease
International Journal of Advances in Health Sciences (IJHS) ISSN 2349-7033 Vol2, Issue6, 2015, pp762-770 http://www.ijhsonline.com Research Article The Relationship of Concha Bullosa with Nasal Septal
More informationoften the opposing teeth will manifest symptoms as well, due to extrusion of the tooth from increased pressure from the cyst.
Mucous Retention Cysts of the Maxillary Sinus and Superiority of 3D Cone Beam CT Scans versus Traditional Panoramic Imaging Rebecca L Griffiths, BS, DMD Mucous retention cysts of the maxillary sinus are
More informationRespiratory System. Clinical notes. Published on Second Faculty of Medicine, Charles University ( https://www.lf2.cuni.cz)
Published on Second Faculty of Medicine, Charles University ( https://www.lf2.cuni.cz) Respiratory System The test of the respiratory system follows the general rules for written tests (see Continuous
More informationThe Egyptian Journal of Hospital Medicine (July 2017) Vol.68 (3), Page
The Egyptian Journal of Hospital Medicine (July 2017) Vol.68 (3), Page 1390-1394 Anatomical Variations of Nasal Structures in Chronic Rhinosinusitis as Detected by Computed Tomography Scan Omar Adnan Hasan,
More informationEndoscopic septoplasty
Endoscopic septoplasty Claudiu Manea, MD, PhD University of Medicine and Pharmacy Carol Davila, Bucharest, Romania Septal deviation is a common clinical finding in patients reporting nasal obstruction.
More informationWhite Paper: Balloon Sinuplasty for Chronic Sinusitis, The Latest Recommendations
White Paper: Balloon Sinuplasty for Chronic Sinusitis, The Latest Recommendations For Health Plans, Medical Management Organizations and TPAs Executive Summary Despite recent advances in instrumentation
More informationThis pamphlet has been designed as
This pamphlet has been designed as an educational resource for patients with Obstructive Sleep Apnea (OSA). The successful use of CPAP requires no further intervention; however, not every patient is able,
More informationOPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY
OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY INFERIOR MAXILLECTOMY Tumours of the hard palate and superior alveolus may be resected by inferior maxillectomy (Figure 1). A Le Fort
More informationA COMPUTERIZED TOMOGRAPHIC STUDY OF UNCINATE PROCESS OF ETHMOID BONE
Original Article A COMPUTERIZED TOMOGRAPHIC STUDY OF UNCINATE PROCESS OF ETHMOID BONE N. Vinay Kumar * 1, E. Kamala 2, T. S. Guga Priya 3, S. D. NalinaKumari 4. *1,2 Assistant professor, Department of
More informationAnatomical Analysis of the Frontal Recess Cells in Endoscopic Sinus Surgery An Indian Perspective
ORIGINAL ARTICLE Anatomical Analysis of the Frontal Recess Cells in Endoscopic Sinus Surgery An Indian Perspective 1 Dhingra Shruti, 2 Agarwal AK, 3 Passey JC, 4 Kaul JM 1 Resident, Department of Otolaryngology
More informationA Study of Anatomical Variations in Patients with Chronic Rhinosinusitis.
DOI: 10.2127/aimdr.201..2.EN1 Original Article ISSN (O):239-222; ISSN (P):239-21 A Study of Anatomical Variations in Patients with Chronic Rhinosinusitis. Smruti Swain 1 1 Associate Professor, Department
More informationRetrospective Analysis of Patients with Allergy Sinusitis
Original article: Retrospective Analysis of Patients with Allergy Sinusitis G.S. Thalor Senior Specialist (MS) (department of Oto Rhino Laryngology), Govt. S.K. Hospital, Sikar, Rajasthan, India. Corresponding
More informationRelationship between Severity of Nasal Septum Deviation and Pneumatization of Mastoid Cells and Chronic Otitis Media
Original Article J Babol Univ Med Sci Vol 20, Issu 2; Feb 2018. P:27-32 Relationship between Severity of Nasal Septum Deviation and Pneumatization of Mastoid Cells and Chronic Otitis Media E. Shobeiri
More informationORIGINAL ARTICLE. cone beam computed tomography, pharyngeal airway, unilateral cleft
The Cleft Palate Craniofacial Journal 52(3) pp. 346 351 May 2015 Ó Copyright 2015 American Cleft Palate Craniofacial Association ORIGINAL ARTICLE Three-Dimensional Evaluation of Pharyngeal Airway in Complete
More informationEvaluation of the Change in Recent Diagnostic Criteria of Chronic Rhinosinusitis: A Cross-sectional Study
Abhishek Ramadhin REVIEW ARTICLE 10.5005/jp-journals-10013-1246 Evaluation of the Change in Recent Diagnostic Criteria of Chronic Rhinosinusitis: A Cross-sectional Study Abhishek Ramadhin ABSTRACT There
More informationCleft Lip and Palate: The Effects on Speech and Resonance
Ann W. Kummer, PhD, CCC-SLP Cincinnati Children s Cleft lip and/or palate can have a negative impact on both speech and resonance. The following is a summary of normal anatomy, the types and causes of
More informationThe Effect of Beclomethasone Nasal Spray on the Size of Adenoid and its Related Obstructive Symptoms in Children with Adenoid Hypertrophy.
In the name of God Shiraz E-Medical Journal Vol. 10, No. 1, January 2009 http://semj.sums.ac.ir/vol10/jan2009/86051.htm The Effect of Beclomethasone Nasal Spray on the Size of Adenoid and its Related Obstructive
More informationFunctional and aesthetic correction of secondary unilateral cleft lip nasal deformities
Free full text on www.ijps.org Review Article DOI: 10.4103/0970-0358.57195 Functional and aesthetic correction of secondary unilateral cleft lip nasal deformities Mimis Cohen, David E. Morris, Aisha D.
More informationPrevalence of Anatomical Variations of the Sinonasal Region and their Relationship with Chronic Rhinosinusitis
Prevalence of Anatomical Variations of the Sinonasal Region and their Relationship with Chronic Rhinosinusitis Karki S, 1 Pokharel M, 2 Suwal S, 1 Poudel R 1 ABSTRACT Background 1 Department of Radiology
More informationOsteomeatal unit OMU
20074724752 CT Osteomeatal unitomu Assessment of the Relationship between Odontogenic Maxillary Sinusitis and Findings in the Ostiomeatal Unit on Coronal CT Images Miya Kato, Takashi Kaneda, Masataka Kato,
More informationRole of x-rays in Rhinology
Role of x-rays in Rhinology January 30, 2013 Rhinology Author Balasubramanian Thiagarajan Abstract X rays in the present day context is considered to be outdated by Rhinologists. CT scan images have replaced
More information04 Development of the Face and Neck. Development of the Face Development of the neck
04 Development of the Face and Neck Development of the Face Development of the neck Development of the face Overview of facial development The fourth week ~ the twelfth week of prenatal development Between
More informationUNIVERSITY OF MEDICINE AND PHARMACY GR. T. POPA - IASI FACULTY OF DENTAL MEDICINE
UNIVERSITY OF MEDICINE AND PHARMACY GR. T. POPA - IASI FACULTY OF DENTAL MEDICINE ABSTRACT CONTRIBUTIONS OF THREE-DIMENSIONAL IMAGING TO THE DIAGNOSIS AND MANAGEMENT OF CLEFT LIP AND PALATE PhD ADVISOR,
More informationCanine Fossa Puncture for Severe Maxillary Disease in Unilateral Chronic Sinusitis With Nasal Polyp
The Laryngoscope VC 2013 The American Laryngological, Rhinological and Otological Society, Inc. Canine Fossa Puncture for Severe Maxillary Disease in Unilateral Chronic Sinusitis With Nasal Polyp Jang
More informationAssessment of the Airway Characteristics in Children with Cleft Lip and Palate using Cone Beam Computed Tomography
ORIGINAL ARTICLE Assessment of 10.5005/jp-journals-10005-1324 the Airway Characteristics in Children Assessment of the Airway Characteristics in Children with Cleft Lip and Palate using Cone Beam Computed
More informationUCL Repair: Emphasis on Muscle Dissection and Reconstruction
UCL Repair: Emphasis on Muscle Dissection and Reconstruction Unilateral cleft lip repair is performed using rotation-advancement technique. Markings are made on columella base, redlines, Cupid s bow on
More informationSANDHYA CA SHYAM LOHAKARE Professor, Orthodontics Department, Chattisgarh Dental College & Research Centre, Rajnandgaon, C.G
International Journal of Applied and Natural Sciences (IJANS) ISSN(P): 2319-4014; ISSN(E): 2319-4022 Vol. 5, Issue 6, Oct Nov 2016; 49-58 IASET CEPHALOMETRIC STUDY OF UPPER AND LOWER PHARYNGEAL AIRWAYS
More informationSTUDY OF CORRELATION BETWEEN NASAL ENDOSCOPY AND RHINOGENIC HEADACHE Santhosha Kumar B 1, Manjunath Rao S. V 2
STUDY OF CORRELATION BETWEEN NASAL ENDOSCOPY AND RHINOGENIC HEADACHE Santhosha Kumar B 1, Manjunath Rao S. V 2 HOW TO CITE THIS ARTICLE: Santhosha Kumar B, Manjunath Rao S. V. Study of Correlation between
More informationThe Relation between Anatomical Variations of Osteomeatal Complex & Nasal Structures and Chronic Sinusitis by Computed Tomography
International Journal of Medical Imaging 2015; 3(2): 16-20 Published online March 6, 2015 (http://www.sciencepublishinggroup.com/j/ijmi) doi: 10.11648/j.ijmi.20150302.12 ISSN: 2330-8303 (Print); ISSN:
More informationDubai Standards of Care (Septoplasty)
Dubai Standards of Care 2017 (Septoplasty) Preface Ear, nose and throat disorders are the most common problem dealt with in daily practice. In Dubai, the management of ear, nose and throat disorders were
More informationNEUROCRANIUM VISCEROCRANIUM VISCEROCRANIUM VISCEROCRANIUM
LECTURE 4 SKULL NEUROCRANIUM VISCEROCRANIUM VISCEROCRANIUM VISCEROCRANIUM CRANIUM NEUROCRANIUM (protective case around brain) VISCEROCRANIUM (skeleton of face) NASOMAXILLARY COMPLEX MANDIBLE (DESMOCRANIUM)
More informationClinical Policy Title: Pediatric rhinoplasty
Clinical Policy Title: Pediatric rhinoplasty Clinical Policy Number: 11.03.06 Effective Date: October 1, 2017 Initial Review Date: August 17, 2017 Most Recent Review Date: September 21, 2017 Next Review
More informationBones Ethmoid bone Inferior nasal concha Lacrimal bone Maxilla Nasal bone Palatine bone Vomer Zygomatic bone Mandible
splanchnocranium - Consists of part of skull that is derived from branchial arches - The facial bones are the bones of the anterior and lower human skull Bones Ethmoid bone Inferior nasal concha Lacrimal
More information