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Assiri H, Abdelkader W, Alfallaj R, Alanazi H, AlEnazi AS, AlDosari B. Measurement of Nasal Skin Thickness and Body Mass Index in Preoperative Rhinoplasty Patients Utilizing Computed Tomography Scanning and Ultrasound Techniques: A Prospective Comparative Study. J Craniofac Surg 2024; 35:e424-e428. [PMID: 38709028 DOI: 10.1097/scs.0000000000010133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/21/2024] [Indexed: 05/07/2024] Open
Abstract
One of the most important indicators of rhinoplasty success is nasal skin thickness. Nasal thickness can lead to irregularities over the osseocartilaginous framework among patients with thin nasal skin and difficulty making tip work changes in patients with thick nasal skin. This study aimed to compare different objective methods. These include computed tomography (CT) and ultrasound (US) techniques, and report the relationship between nasal skin thickness and body mass index (BMI). A prospective cross-sectional study that included all patients at the rhinoplasty clinic (King Abdul-Aziz University Hospital), Riyadh, Saudi Arabia, between December 2022 and March 2023. Age, sex, and Fitzpatrick skin type were collected from the patients' histories and physical examinations. Body mass index was calculated for the subjects. The study sample included 29 patients. The median age of the patients was 25 years (interquartile range: 20-32 y). Most of the included patients were Saudi (89.7%, n = 26). Females represented 62.1% of the study sample. The average BMI was 25.6 ± 4.95 kg/m 2 . The highest correlation was observed between the US and CT tip ( r = 0.544, P < 0.01) and rhinion ( r = 0.525, P < 0.01) measurements. Body mass index was not associated with any US or CT measurements when BMI was used as a continuous or ordinal variable. The correlation between the US and CT measurements was highest for rhinoin and tip measurements, whereas supratip measurements were not correlated ( r = -0.029, P = 0.88). The correlation between mid-dorsum and nasion measurements was low (~0.3). The correlation between nasal skin thickness using CT and US varies depending on the nasal point and location. Body mass index was not associated with nasal skin thickness.
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Affiliation(s)
- Hassan Assiri
- Department of Otolaryngology-Head and Neck-Facial Plastic Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Waleed Abdelkader
- Department of Radiology, King Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Rayan Alfallaj
- Department of Otolaryngology-Head and Neck-Facial Plastic Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Hani Alanazi
- Department of Surgical Specialties, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Abdulaziz Saud AlEnazi
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Fahd Hospital of the University, Al-Khobar, Imam AbdulRahman bin Faisal University, Dammam, Saudi Arabia
| | - Badi AlDosari
- Department of Otolaryngology-Head and Neck-Facial Plastic Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
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Hona TWPT, Stephan CN. Global facial soft tissue thicknesses for craniofacial identification (2023): a review of 140 years of data since Welcker's first study. Int J Legal Med 2024; 138:519-535. [PMID: 37804332 PMCID: PMC10861615 DOI: 10.1007/s00414-023-03087-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/09/2023] [Indexed: 10/09/2023]
Abstract
This year (2023) marks 140 years since the first publication of a facial soft tissue thickness (FSTT) study. Since 1883, a total of 139 studies have been published, collectively tallying > 220,000 tissue thickness measurements of > 19,500 adults. In just the last 5-years, 33 FSTT studies have been conducted. Herein, we add these data (plus an additional 20 studies) to the 2018 T-Table to provide an update of > 81,000 new datapoints to the global tallied facial soft tissue depths table. In contrast to the original 2008 T-Table, some notable changes are as follows: increased FSTTs by 3 mm at infra second molar (ecm2-iM2'), 2.5 mm at gonion (go-go'), 2 mm at mid-ramus (mr-mr'), and 1.5 mm at zygion (zy-zy'). Rolling grand means indicate that stable values have been attained for all nine median FSTT landmarks, while six out of nine bilateral landmarks continue to show ongoing fluctuations, indicating further data collection at these landmarks holds value. When used as point estimators for individuals with known values across 24 landmarks (i.e., C-Table data), the updated grand means produce slightly less estimation error than the 2018 T-Table means (3.5 mm versus 3.6 mm, respectively). Future efforts to produce less noisy datasets (i.e., reduce measurement and sampling errors as much as possible between studies) would be useful.
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Affiliation(s)
- Te Wai Pounamu T Hona
- Laboratory for Human Craniofacial and Skeletal Identification (HuCS-ID Lab), School of Biomedical Sciences, The University of Queensland, Brisbane, 4072, Australia.
| | - Carl N Stephan
- Laboratory for Human Craniofacial and Skeletal Identification (HuCS-ID Lab), School of Biomedical Sciences, The University of Queensland, Brisbane, 4072, Australia
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Piombino P, Esposito E, Committeri U, Barone S, Arena A, Cataldo R, Carraturo E, Vaira LA, De Riu G, Mariniello D, Califano L. Facial soft tissue thickness measurement method and relationship with BMI, age and sex. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101420. [PMID: 36758899 DOI: 10.1016/j.jormas.2023.101420] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Facial aesthetics results from the harmony of various components of the craniofacial region, a structure whose physiognomy and topography are determined by a set of hard and soft tissues. Few works in the literature have investigated the relationship between the variables of sex, age, BMI and soft tissue thickness and have considered how these variables may influence operative outcomes. The purpose of this study is to increase the pre-operative knowledge of the thickness of the soft tissues of the face through an analysis of their measurement conducted on cone beam computed tomography (CBCT) and to investigate the impact that the variables of gender, age and BMI have on their determination. MATERIALS AND METHODS For this study 82 patients were recruited between January 2020 and January 2021 in the Department of Maxillofacial Surgery of the University of Naples "Federico II". A descriptive analysis of the sample was carried out on the selected sample, calculating averages and standard deviations for the individual variables analyzed. RESULTS BMI has a predominant role on some craniometric points while age and sex have a more marginal role. Our analysis shows that some points are affected by only one variable, BMI (G' N' PR' ID' SM' GN' PG' MIO' ACP' GO' ZY' SC' IC' ECMS' and MMB'); some points are affected by both BMI and gender (MP' and MR'); while only two (RHI' and MSO') are influenced by all the three variables. CONCLUSION A priori knowledge through CBCT of the thickness of the soft tissues of the face and a comparison with the data we propose could provide the surgeon with advance notice of the characteristics of the tissues which she/he will encounter.
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Affiliation(s)
- Pasquale Piombino
- Department of Maxillofacial Surgery, Federico II University of Naples, Via Pansini, 5, 80131, Naples, Italy
| | - Eliana Esposito
- Department of Maxillofacial Surgery, Federico II University of Naples, Via Pansini, 5, 80131, Naples, Italy
| | - Umberto Committeri
- Department of Maxillofacial Surgery, Federico II University of Naples, Via Pansini, 5, 80131, Naples, Italy
| | - Simona Barone
- Department of Maxillofacial Surgery, Federico II University of Naples, Via Pansini, 5, 80131, Naples, Italy.
| | - Antonio Arena
- Department of Maxillofacial Surgery, Federico II University of Naples, Via Pansini, 5, 80131, Naples, Italy
| | - Rosanna Cataldo
- Department of Social Science, Federico II University of Naples, Italy
| | - Emanuele Carraturo
- Department of Maxillofacial Surgery, Federico II University of Naples, Via Pansini, 5, 80131, Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy
| | - Domenico Mariniello
- Department of Plastic, Reconstructive, Aesthetic Surgery, Section of Plastic, Reconstructive, Aesthetic Surgery, Department of Public Health, Federico II University, Naples, Italy
| | - Luigi Califano
- Department of Maxillofacial Surgery, Federico II University of Naples, Via Pansini, 5, 80131, Naples, Italy
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Nourmohammadi MJ, Ahmadi SAY, Rezaian J. Structural equation modelling to estimate facial soft tissue thickness parameters based on ethnicity, gender and body mass index: a secondary study on an Iranian dataset. Surg Radiol Anat 2023; 45:739-746. [PMID: 37087723 DOI: 10.1007/s00276-023-03147-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/24/2023]
Abstract
PURPOSE According to the anthropological importance of soft facial tissue thickness parameters, we aimed to find the association of these parameters with Lur and Arab ethnicities, gender and body mass index (BMI). Structural equation modeling (SEM) was used. METHODS As a secondary analysis, SEM was performed on a dataset of 100 participants. The participants were from Lur and Arab populations of Ahvaz province, Iran, from those who referred for magnetic resonance imaging (MRI) due to headache. RESULTS Multivariate regression illustrated that mental eminence (ME), chain-lip fold (CLF) and end of nasals (END) could not be predicted by the independent variables (p > 0.05). Right masseteric region (RMST) had the maximum predictability with R2 = 0.365, followed by middle philtrum (MID) with R2 = 0.358 (p < 0.001). With respect to our criterion to enter SEM, i.e. existing at least two significant covariates at significance level of 0.05, among staying parameters, only parameters of nasion (NA), MID, superior lip (SL), RMST and left masseteric region (LMST) remained. Among these cases, MID was the only parameter that its three covariates illustrated significant association. CONCLUSION MID parameter can be predicted by gender, BMI and Arab ethnicity. By carrying out such studies and creating database, such information can be used in plastic surgery, corpse identification, and facial reconstruction software in archeology.
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Affiliation(s)
| | - Seyyed Amir Yasin Ahmadi
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Jafar Rezaian
- Research Office for the History of Persian Medicine, Department of Anatomical Sciences, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
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Assiri H, Abdelkader W, Alfallaj R, Alarimah Y, AlMajed H, Alarfaj A. The Association Between Nasal Skin Thickness and Body Mass Index in Preoperative Rhinoplasty Patients: A Prospective Study. EAR, NOSE & THROAT JOURNAL 2023:1455613231162506. [PMID: 36877163 DOI: 10.1177/01455613231162506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
OBJECTIVES Skin quality plays a major role in aesthetics, particularly in determining the success of rhinoplasty. Efficient preoperative estimation of nasal skin thickness can improve postoperative results and patient satisfaction. This study aimed to report on the relationship between nasal skin thickness and body mass index (BMI) as a possible tool to measure skin thickness preoperatively among rhinoplasty patients. METHODS This prospective cross-sectional study targeted patients who visited a rhinoplasty clinic at King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia, between January 2021 and November 2021, and agreed to participate in the study. Data on age, sex, height, weight, and Fitzpatrick skin types were collected. The participant visited the radiology department and underwent ultrasound nasal skin thickness measurement for the five different nasal points. RESULTS The study included 43 participants (16 males and 27 females). The average skin thickness of the supratip area and the tip was significantly higher in males than in females (P < 0.05). The average BMI of the participants was 25.8 ± 5.26 Kg/m2. Participants with a normal BMI or less represented 50% of the study sample, whereas overweight and obese represented one-quarter (27.9%) and one-fifth (21%), respectively. CONCLUSION BMI was not associated with nasal skin thickness. Differences in nasal skin thickness were found between the sexes.
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Affiliation(s)
- Hassan Assiri
- Otolaryngology-Head and Neck surgery Department, King Saud medical city, Riyadh, Saudi Arabia
| | - Waleed Abdelkader
- Radiology department of king abdulaziz university hospital, King Saud University, Riyadh, Saudi Arabia
| | - Rayan Alfallaj
- Otolaryngology, King Saud University, Riyadh, Saudi Arabia
| | - Yasser Alarimah
- Otolaryngology-Head and Neck surgery Department, King Saud medical city, Riyadh, Saudi Arabia
| | | | - Ahmed Alarfaj
- Otorhinolaryngology-Head and Neck, King Saud University, Riyadh, Saudi Arabia
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Hona TWPT, Stephan CN. Cephalometric landmark standards and recent trends in craniofacial identification (2018-22): Avoiding imposters by describing variant landmarks as supplemental. FORENSIC IMAGING 2022. [DOI: 10.1016/j.fri.2022.200525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Karaman A, Genc E. Evaluation of facial soft-tissue values and craniofacial morphology in obese adolescent patients with different skeletal classes. APOS TRENDS IN ORTHODONTICS 2022. [DOI: 10.25259/apos_76_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objectives:
The purpose of this study was to evaluate the facial soft tissue and craniofacial morphological structures in adolescent obese individuals with different skeletal patterns.
Materials and Methods:
The study was carried out on 292 adolescents examined under three groups based on their body mass indexes (BMIs) as obese, healthy, and overweight. The subjects were also categorized based on skeletal classes as Class I, Class II, and Class III.
Results:
The glabella, nasion, labiale inferius, labiomentale, and pogonion values of the female patients were significantly higher in obese group. In the obese and overweight groups, effective midfacial and mandibular length, anterior and posterior facial heights, and SN values of the females were higher than males. In the obese group, the mean effective midfacial and mandibular length (Co-A and Co-Gn), anterior and posterior facial heights (S-Go and N-Me), and anterior cranial base (SN) values were significantly higher than other groups.
Conclusion:
Soft-tissue thicknesses increase as BMI value increases. Craniofacial morphology reveals significant differences between BMI groups.
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Affiliation(s)
- Ahmet Karaman
- Department of Orthodontics, Istanbul Aydin University, Istanbul, Turkey,
| | - Esra Genc
- Department of Orthodontics, Ordu University, Ordu, Turkey,
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Nasal soft tissue envelope in Caucasian patients seeking for reduction rhinoplasty: a radiological study. EUROPEAN JOURNAL OF PLASTIC SURGERY 2022. [DOI: 10.1007/s00238-021-01932-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fourgeot E, Graillon N, Savoldelli C, Dessi P, Adalian P, Michel J, Radulesco T. Intra-Individual Aging of the Facial Skeleton. Aesthet Surg J 2021; 41:NP1907-NP1915. [PMID: 33999176 DOI: 10.1093/asj/sjab228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Midface skeletal changes through aging have been conceptualized as a clockwise rotation relative to the cranial base. This finding is mainly supported by cross-sectional population studies based on comparisons between groups of individuals in different age ranges. Few papers have evaluated the intra-individual evolution of the facial skeleton, and those that have included only a limited number of patients. OBJECTIVES The authors sought to analyze the intra-individual evolution of the facial skeleton. METHODS We conducted a retrospective study including patients who underwent 2 separate facial computed tomography scans (T1 and T2) with a minimum gap of 7 years. Employing 3-dimensional reconstructions, we measured and compared 7 facial angles (glabellar, orbital, piriform, maxillary, subdental, chin, gonial) and 6 facial distances (lacrimal crest, orbital floor, piriform, zygoma, labiomental, gnathion) on both computed tomography scans. RESULTS A total of 56 patients (29 males and 27 females) were included. Mean ages at T1 and T2 were 50 and 59 y, respectively. We found a significant decrease between T1 and T2 in facial angles at the midface (glabella, orbital, piriform, and maxillary angles, all P < 0.0001). We found a significant increase in all facial distances between T1 and T2 for the overall population and for men (all P < 0.05). For women, all distances increased, but only piriform and zygoma distances showed significant changes (P < 0.001 and P < 0.04, respectively). Bone remodeling appeared earlier in women. CONCLUSIONS Our study confirms the clockwise rotation of the midface during aging. This finding could lead to a better understanding of aesthetic medicine practices.
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Affiliation(s)
- Eugénie Fourgeot
- APHM, Department of Oto-Rhino-Laryngology and Head and Neck Surgery, La Conception University Hospital, Marseille, France
| | - Nicolas Graillon
- Aix-Marseille Univ, APHM, LBA, La Conception University Hospital, Department of Oral and Maxillofacial Surgery, Marseille, France
| | - Charles Savoldelli
- Head and Neck Institute, University Hospital of Nice, Department of Oral and Maxillofacial Surgery, Nice, France
| | - Patrick Dessi
- APHM, Department of Oto-Rhino-Laryngology and Head and Neck Surgery, La Conception University Hospital, Marseille, France
| | | | - Justin Michel
- Aix-Marseille Univ, APHM, IUSTI, La Conception University Hospital, Ear Nose Throat - Head and Neck Surgery Department, Marseille, France
| | - Thomas Radulesco
- Aix-Marseille Univ, APHM, IUSTI, La Conception University Hospital, Ear Nose Throat - Head and Neck Surgery Department, Marseille, France
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Midsagittal and bilateral facial soft tissue thickness: A cone-beam computed tomography assessment of Brazilian living adults. FORENSIC IMAGING 2021. [DOI: 10.1016/j.fri.2021.200444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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