OBJECTIVE: A retrospective study was conducted on the effect of primary rhinoplasty on infants with unilateral complete cleft lip nasal deformity.
METHODS: Infants with unilateral complete cleft lip in the Department of Cleft Lip and Palate Surgery, College of Stomatology, Xi\'an Jiaotong University were selected. All infants underwent cheiloplasty and primary rhinoplasty. We reconstructed the nasal base and corrected the nasal septum and alar deformity at the same time. The nasal splint was worn 1 week after the surgery. The nasal morphology before surgery as well as 1 week and 1 year after surgery were analyzed.
RESULTS: Significant differences were found on symmetry ratios including nasal base width, nostril height, alar angle and columella deviation angle between before and after operation (P<0.05). There were statistically significant differences in the symmetry ratio of nostril height and columella deviation angle between 1 year after surgery and 1 week after surgery (P<0.05).
CONCLUSIONS: Infants with unilateral complete cleft lip nasal deformity can achieve satisfactory nasal morphology by primary rhinoplasty. Despite few cases of recurrence of nasal deformity, the nasal morphology can be well improved and maintained.
目的: 对单侧完全性唇裂患儿早期鼻畸形整复的手术效果进行回顾性研究，为唇裂鼻畸形整复提供一种治疗思路。方法: 选取于西安交通大学口腔医院就诊的24例单侧完全性唇裂患儿为研究对象，唇裂整复手术同期行鼻畸形整复，重建鼻基底，矫正鼻中隔，整复鼻翼部畸形。术后1周开始佩戴鼻模。评价术前、术后1周及术后1年鼻部形态。结果: 术后1周、术后1年患者的患/健侧鼻孔高度比、健/患侧鼻底宽度比、患/健侧鼻翼角度比、鼻小柱偏斜角度与术前相比，差异有统计学意义（P<0.05）；术后1年患者的患/健侧鼻孔高度比、鼻小柱偏斜角度与术后1周相比，差异有统计学意义（P<0.05）。结论: 单侧完全性唇裂早期鼻畸形整复可获较好的鼻部形态，尽管术后会有一些复发，但对称性仍优于术前，鼻部形态可以得到很好的矫正和维持。.

Introduction  The morphological variants of the nasal septum have been implicated in sinus pathology and pose a challenge during endoscopic surgeries. Objective  The present study aimed at evaluating the prevalence of nasal septum variants in adult Nigerians. Methods  The present study was performed at the Radiology Department of Delta State University Teaching Hospital, Nigeria, following ethical approval. Brain computed tomography (CT) scan images of 336 adults were evaluated for nasal septum variants. The angle of the deviated nasal septum was measured, and the severity was classified. Data were analyzed using IBM SPSS Statistics for Windows, version 23.0 (IBM Corp., Armonk, NY, USA). The angle of deviation was presented in means and standard deviation. Frequencies of the variants were presented in percentages. The Student t -test was used to compare the angle of deviation, while the chi-squared test was used to compare the frequencies in the different groups. A p-value < 0.05 was considered statistically significant. Results  The prevalence of straight and deviated nasal septum was 59.5% and 40.5%, respectively. Deviation was predominant in females (46%) and, more frequently, of moderate severity (75%). The angle of deviation was significantly larger in males (12.55 ± 2.99°) than in females (11.13 ± 2.41°; p  = 0.003). Nasal spur had a prevalence of 11.9%, and its coexistence with deviated nasal septum was observed in 5.06%. Septal pneumatization was seen in 10 patients (3%). Conclusion  Deviation of the nasal septum occurred more in females and toward the left; however, the angle of deviation was significantly higher in males. Nasal septal spur and pneumatization were the least prevalent variants.

Resistance of de Quervain\'s disease to conservative treatment has been associated with an intertendinous septum in the first compartment. This study aimed to investigate the relationship between intertendinous septum\'s presence or absence, internal pressure and wrist positon in the first compartment. Fourteen arms were obtained from seven fresh frozen cadavers. A pressure sensor was inserted into the first compartment; if a septum was present, the pressure sensor was inserted into the abductor pollicis longus (APL) side and the extensor pollicis brevis (EPB) side, respectively. Three wrist positions were also tested: neutral, 45° flexion, and 45° extension. Intertendinous septa were present in seven wrists. The average pressure change in the first compartment measured on the EPB side of a present septum was significantly greater than that measured on the APL side of a present septum or where no septum existed: no septum = 54.6 ± 48.3 kPa; septum, EPB = 81.7 ± 76.5 kPa; and septum, APL = 32.8 ± 37.4 kPa. The average pressure change was also significantly greater in the flexion wrist position relative to the neutral and extension positions: neutral = 36.3 ± 58.0 kPa; 45° flexion = 79.5 ± 65.9 kPa; and 45° extension = 50.4 ± 42.6 kPa. Clear relationships existed between (1) the presence of a septum and increased internal pressure on the EPB side in the first compartment and (2) increased internal pressure with the wrist at 45° flexion compared with the neutral and extension position.

The sixth dorsal extensor compartment is a relatively common site of stenosing tenosynovitis in the upper extremity, but the exact location of stenosis is not fully understood. The objective of this study was to investigate the detailed anatomy of structures surrounding the extensor carpi ulnaris (ECU) tendon around the wrist.
Fifty fresh human cadaveric wrists were used for gross observation and morphology measurements of the sixth dorsal compartment and the ECU subsheath. An additional 13 wrists were used for histological examination. We evaluated the morphology of supporting structures in 3 regions: the ulnar groove (zone I), the ulnar styloid process (zone II), and the triquetrum (zone III).
The fibro-osseous tunnel comprising the ulnar groove and the overlying subsheath (zone I) stabilized the ECU tendon, and the subsheath had thin membranous collagen fibers attached to the periosteum. We consistently found the distal extension of ECU subsheath (zone II), which connected the ulnar styloid process and the dorsal radioulnar ligament. Variations in the length of the distal extension increased with the forearm in pronation. Collagen fiber thickness around the ECU tendon in zone II was greater than that of zone I. In zone III, the overlying extensor retinaculum and septa, which were composed of thick circumferential collagen structures, supported the ECU tendon by attaching to the triquetrum on both sides of the ECU tendon. We found the presence of an ulnar septum of the sixth compartment attached to the triquetrum in 84% of dissected wrists.
The ECU tendon was supported by the ECU subsheath, which had thin and elastic collagen fibers over the ulnar groove. Distal extension of the subsheath and surrounding radial and ulnar extensor retinaculum septa attached to the triquetrum provided thicker supporting structures.
Stenosing ECU tenosynovitis may occur not only in the ulnar groove but also in the more distal ulnar styloid process and triquetrum areas.

BACKGROUND: Sinus septa are bony processes that develop in a variable fashion. Such structures present a challenge for surgical procedures of the maxillary sinuses.
OBJECTIVE: This study aims to evaluate the prevalence and patterns of maxillary sinus septa in a sample from the Lebanese population.
METHODS: A retrospective cross-sectional study was conducted on a series of 568 Cone Beam Computed Tomography scans (CBCT) belonging to patients that presented to the Maxillofacial Radiology division of the Faculty of Dental Medicine in the Lebanese University. None of the included patients had sinus pathologies. Age ranged from 18 to 80 years with 332 females and 236 males yielding a total of 1136 maxillary sinus. Sinuses were inspected for septa, specifying their location in multiple dimensions, angulations and number.
RESULTS: 36.27% of studied patients presented at least one septum (27.46% of all sinuses). No predilection towards age or sex was found. A higher number of septa were located in the middle region anteroposteriorly (38.14%), and most were localized in the inferior third coronally (81.16%). Multiple angulations are also reported.
CONCLUSIONS: Our results suggest a common prevalence of maxillary sinus septa in our Lebanese sample and suggest similar distribution and patterns to that of reported literature.

OBJECTIVE: It is important to reinforce nasal tip support for long-term satisfactory results. Two workhorses of tip support are strut grafting and the tongue-in-groove technique. Tongue-in-groove causes retraction and stiffness; the strut causes loss of rotation and projection of tip. We introduced a novel technique that avoids these consequences.
METHODS: Between February 2018-February 2019, 40 female underwent primary rhinoplasty. Mean age: 27 years (18-41 years).
RESULTS: 1-2 years. In first group (20 patients), caudal septum was resected and strut was not fixated to caudal septum. In second group (20 patients), tongue-like extension (septal autoextension) was preserved at caudal septum and sutured to strut. Preoperative, peroperative, and postoperative images were compared.
RESULTS: Tip projection ratio calculations, nasolabial angle measurements were evaluated by statistical analyses. The change in projection ratios between peroperative period and 1-year postoperative period of strut-only group was higher than septal autoextension group (p = 0.001). This result indicates that nasal tip projection loss in strut-only group was higher compared to septal autoextension group. The change in nasolabial angle measurements from peroperative period to 1-year postoperative period differed significantly between two groups (p = 0.001). Significant difference was observed between 1-year postoperative nasolabial angle measurements of two groups (p = 0.006); septal autoextension group measurements were higher than strut-only group. These results showed that fixation of strut graft to the septal autoextension provides better preservation of the nasolabial angle and stabilization of nasal tip projection. CONCLUSıON: Fixation of septum and strut graft through septal autoextension provides satisfactory stabilization of tip projection and rotation without stiffness or rigidity.

暂无摘要。

Resistance of de Quervain\'s disease to conservative treatment has been associated with an intertendinous septum in the first compartment; little is known about the histological features of such a septum. This study aimed to examine the intertendinous septum histologically and note its variations. After dissecting the first extensor compartment of 24 hands from 12 fresh frozen cadavers, the presence of any intertendinous septa was determined. The length of the extensor retinaculum and intertendinous septum was measured; histological findings of the first compartment with or without septa were studied and compared with those of the third/fourth compartment. Intertendinous septa were observed in 12 of 24 wrists. Histological assessment of the intertendinous septum revealed tissue similar in composition to the retinaculum observed between the third and fourth compartments.

Preserving the L-shaped strut during septoplasty is a crucial step in the prevention of several types of postoperative nasal deformities. In this study, we aimed to identify the intranasal anatomic landmarks to establish reliable and feasible measurements to preserve an adequate L-strut during an endoscopic septoplasty.
A prospective study was conducted on 20 cadaver heads. Three measurements were studied within each side of the nasal cavity. The dorsal strut (DS) was measured from the dorsal line to the septal dorsum edge. Then, the caudal strut was measured from 2 different landmarks: the axilla of the inferior turbinate (CSIT) and the pyriform aperture (CSP).
We examined a total of 40 nasal cavities from 20 cadavers. The DS showed an average length of 15.1 mm (standard deviation [SD], 3.2 mm). The average lengths of the CSIT and CSP were 23.6 (SD, 3.6) mm and 19.4 (SD, 2.7) mm, respectively.
Suggested landmarks to identify the dorsal and caudal struts in endoscopic septoplasty are the axilla of the middle turbinate and pyriform aperture bone, respectively. The utilization of the inferior turbinate axilla as a caudal strut landmark showed larger variability and would potentially leave excessive caudal cartilage that could be manipulated if deviated.

BACKGROUND: Anatomical variations of the first dorsal extensor compartment (1st EC) are commonly noted.
METHODS: Forty cadaver hands were dissected to define the 1st EC. Through the gross findings, we classified the contents according to the presence of septation, subcompartment, and variation of tendons. Bony cross-section of the wrist was performed to reveal any bony pattern within the 1st EC. We also measured the anatomical structures of the 1st EC.
RESULTS: A septum that results in subcompartments was present in 24, complete in 2 and incomplete in 22 hands distally. The mean size of the 1st EC was 20.69±12mm in length, and 8.65±0.67mm in width. The mean length of the septum was 11.18±5.18mm, while the mean width of the subcompartment was 3.18±0.40mm. All the subcompartments enclosed only extensor pollicis brevis (EPB) tendons. The mean number of abductor pollicis longus and EPB tendon slips was 2.6±0.5 and 1.1±0.2, respectively. The bony floor of the 1st EC was classified into five types. Two distinctive grooves separating two tendons with protruding osseous ridge (type I, n=9), two distinctive grooves separating two tendons without protruding osseous ridge (type II, n=10), a single distinct groove with osteophytes (type III, n=16), indistinct groove with fibrous septum separating two tendons (type IV, n=4), and indistinct groove without fibrous septum (type V, n=1).
CONCLUSIONS: Knowledge about the 1st EC abnormality is mandatory for the successful treatment of de Quervain\'s disease.