Facial variability
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Chirurgická anatomie temporální větve lícního nervu byla studována v anatomické laboratoři. Temporální větev se dělí na přední, střední (frontální) a zadní po průchodu parotickou fascií. Přední větev motoricky inervuje m. orbicularis oculi a m. corrugator supercilii, střední větev m. frontalis. Zadní větve nejsou tak významné, jsou určeny pro m. auricularis anterior a superior. Pod zygomatickým obloukem probíhá temporální větev v podkožní vrstvě a nad zygomatickým obloukem pokračuje v subgaleálním prostoru ohraničeném na spodine povrchovou fascií temporálního svalu. Konečné větve pak perforují galeu v různé výšce a končí ve svalech ležících vždy povrchově od galey. Terminálni větve se vyznačují velkou anatomickou variabilitou. Mohou perforovat zevní vrstvu povrchové fascie temporálního svalu a probíhat v ihterfasciálním tuku. Pro klinickou praxi se nabízejí čtyri možnosti preparace v této oblasti. Subgaleální disekce temporofrontálního kožního laloku je spojena S vysokým rizikem poškození temporální větve lícního nervu a s tím spojeným nepriaznivým kosmetickým defektem. Odklopení kožního laloku v jedné vrstvě společně se svalem je nejbezpečnější technikou. Tuto techniku však nelze použít pri transzygomatických přístupech a nevýhodou je i ztížení přístupu k lehni bázi pri pterionální kraniotomii, dané objemným temporálním svalem. Třetí možná metoda disekce byla popsána a propagována Yasargilem. Disekce se provádí v subgaleální vrstvě až do oblasti přední čtvrtiny temporálního svalu, kde se po protnutí zevní vrstvy povrchové fascie tohoto svalu pokračuje preparací v ihterfasciálním prostoru (mezi zevní a vnitřní vrstvou povrchové fascie). Tento chirurgický přístúp může vést též k poranění temporální větve v pňpadě anatomické variace a uložení nervu v této vrstvě. Posledním možným chirurgickým pri'stupem je disekce mezi povrchovou a hlubokou fascií temporálního svalu.
The surgical anatomy of the temporal branch of the facial nerve was studied in the anatomical laboratory. The temporal branch divides into an anterior, middle (frontal), and a posterior ramus after it pierces the parotid fascia. The anterior ramus innervates orbicularis oculi and corrugator supercilii muscles; the middle branch is for the ipsilateral frontalis muscle. The posterior branch innervates the anterior and superior auricular and tragus muscles. Below the zygomatic arch, the temporal branch of the facial nerve is located in the subcutaneous tissue. Above the arch, it continues in the subgaleal space with the superficial temporal fascia deeply. The terminal twigs of the temporal branch penetrate the galea to reach their target muscles that are all located superficial to the galea. There is a significant variability in the course of the temporal branch of the facial nerve. Occasionally, the terminal twigs of the middle ramus may penetrate superficial layer of superficial temporal fascia and run in the intrafascial fat pad before entering the frontalis muscle. There are four available operative techniques in this anatomical location. The subgaleal dissection of a temporofrontal scalp flap is associated with a high incidence of postoperative palsy of the temporal branch of the facial nerve and cosmetically bothersome results. Reflecting the scalp and temporalis muscle together as a single layer is the safest procedure. Unfortunately, this technique can not be used for the transzygomatic approaches and the bulky temporalis muscle may compromise basal exposure in the pterional route. Third technique was described and propagated by Yasargil. He proposed a subgaleal dissection up to the anterior one-fourth of the temporalis muscle where the dissection has to be deepened between the two layers of the superficial temporal fascia (in the interfascial fat pad). This approach may also infrequently injure the temporal branch in case of anatomical variation. The last available operative technique raises the superficial temporal fascia together with the scalp.
- MeSH
- disekce metody MeSH
- kraniotomie MeSH
- musculus temporalis chirurgie zranění MeSH
- nervus facialis anatomie a histologie chirurgie MeSH
- Publikační typ
- přehledy MeSH
BACKGROUND: Facial nerve schwannomas are rare, challenging tumors to manage due to their nerve of origin. Functional outcomes after stereotactic radiosurgery (SRS) are incompletely defined. OBJECTIVE: To analyze the effect of facial nerve segment involvement on functional outcome for these tumors. METHODS: Patients who underwent single-session SRS for facial nerve schwannomas with at least 3 mo follow-up at 11 participating centers were included. Preoperative and treatment variables were recorded. Outcome measures included radiological tumor response and neurological function. RESULTS: A total of 63 patients (34 females) were included in the present study. In total, 75% had preoperative facial weakness. Mean tumor volume and margin dose were 2.0 ± 2.4 cm3 and 12.2 ± 0.54 Gy, respectively. Mean radiological follow-up was 45.5 ± 38.9 mo. Progression-free survival at 2, 5, and 10 yr was 98.1%, 87.2%, and 87.2%, respectively. The cumulative proportion of patients with regressing tumors at 2, 5, and 10 yr was 43.1%, 63.6%, and 63.6%, respectively. The number of involved facial nerve segments significantly predicted tumor progression (P = .04). Facial nerve function was stable or improved in 57 patients (90%). Patients with involvement of the labyrinthine segment of the facial nerve were significantly more likely to have an improvement in facial nerve function after SRS (P = .03). Hearing worsened in at least 6% of patients. Otherwise, adverse radiation effects included facial twitching (3 patients), facial numbness (2 patients), and dizziness (2 patients). CONCLUSION: SRS for facial nerve schwannomas is effective and spares facial nerve function in most patients. Some patients may have functional improvement after treatment, particularly if the labyrinthine segment is involved.
- MeSH
- dítě MeSH
- dospělí MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nádory kraniálních nervů patologie chirurgie MeSH
- nemoci lícního nervu patologie chirurgie MeSH
- nervus facialis patologie chirurgie MeSH
- neurilemom patologie chirurgie MeSH
- radiochirurgie * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- výsledek terapie * MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
OBJECTIVES: Since the normal, non-pathological facial growth in preschool children is not sufficiently reported, the aim was to follow growth changes of facial surface, sex differences and facial variability in preschool children using 3D stereophotogrammetry. SETTINGS AND SAMPLE POPULATION: Mixed longitudinal sample of healthy Caucasian preschool children without head and facial trauma or craniofacial anomalies from 3.4 to 6.7 years of age consisted of 25 girls and 17 boys. MATERIALS AND METHODS: 136 3D facial models from optical scanner Vectra 3D were evaluated by geometric morphometrics (CPC-DCA, PCA, per-vertex t test). RESULTS: In both sexes, the lower face was widened and elongated, and the prominences of the superciliary arches, lower orbital region, nose, lips and chin increased. Facial surface increments were more even in girls with a maximum between the fourth and fifth year of age, while in boys, there was the most intensive growth between fifth and sixth year of age. Sexual dimorphism was very stable during investigated period, only less statistically significant at the age of 3 years. Boys had more prominent lateral lower part of forehead, nose and lips than girls in every age category. CONCLUSIONS: The longitudinal growth of the face between third and sixth year of age was similar in both sexes, facial sex differences were found in terms of intensity, size and timing. Variability of facial form showed that boys' faces were larger on average and facial shape did not differ. The knowledge of facial growth is essential for diagnostics and clinical practice.
- MeSH
- fotogrammetrie * MeSH
- kefalometrie MeSH
- lidé MeSH
- longitudinální studie MeSH
- nos anatomie a histologie diagnostické zobrazování MeSH
- obličej anatomie a histologie diagnostické zobrazování MeSH
- předškolní dítě MeSH
- zobrazování trojrozměrné * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The aim of this study was to introduce suitable imaging technique and analytical methods for a detailed description of the facial movements in relation to sexual dimorphism and age in adult individuals. Removing of size factor from the analysis, we hypothesised that there will be no significant intersexual difference in facial mobility. We assume facial movements to be more pronounced in the older age category due to increasing the facial surface. We have compared five facial movements - raising eyebrows, closing eyes, pursing of the lips, inflating of the cheeks and smile - in relation to neutral expression of the human face. The material sample comprised three-dimensional facial surface models of healthy adult individuals of the Czech nationality (63 females, 58 males). Methods of geometric morphometry and multivariate statistics were used. Local tissue motion due to facial movements was expressed using colour-coded maps. The movement showing significant intersexual difference was inflating of the cheeks. Ageing in both sexes has significantly influenced the facial mobility on average after 50 years of age. Changes related to senescence have occurred in eye closing, smile and inflating of the cheeks. An enlarged facial surface has been noted in the group of individuals belonging to the older age category, what is probably the result of increased manifestation of skin folds and wrinkles. This is related to the loss of skin elasticity and overall weakening of the underlying muscles, especially in the infraorbital and cheeks area.
- MeSH
- analýza rozptylu MeSH
- anatomické modely MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- obličej anatomie a histologie MeSH
- pohlavní dimorfismus * MeSH
- pohyb MeSH
- stárnutí patologie fyziologie MeSH
- výraz obličeje * MeSH
- zobrazování trojrozměrné MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Peripheral lesion of the facial nerve leads to ipsilateral palsy of facial muscles. Weakening of the orbicularis oculi muscle results in inability to close the eyelids, i.e., lagophtalmos. As a result of lagophtalmos, the lower parts of the eye surface dry and cause a formation of exposure keratopathy of variable severity. Chronic corneal changes lead to development of vascularized corneal scar, which permanently deteriorates the visual acuity. Immediately after the diagnosis of peripheral facial nerve palsy by the neurologist, frequent application of ophthalmic lubricants and an early ophthalmological examination are recommended. The treatment of eye complications depends on the character of corneal involvement and extent of lagophtalmos, considering the possibility of its spontaneous restitution. The therapy is surgical in serious cases, aimed at adjusting the position of the eyelids, and in case of a non-healing corneal ulcer, the amniotic membrane transplant is indicated.
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- MeSH
- amnion MeSH
- anastomóza chirurgická škodlivé účinky MeSH
- Bellova paréza * chirurgie etiologie komplikace patologie terapie MeSH
- blefaroplastika metody škodlivé účinky MeSH
- lagoftalmus chirurgie etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nervus facialis patologie MeSH
- oční symptomy MeSH
- oftalmologické chirurgické výkony metody škodlivé účinky MeSH
- vestibulární schwannom chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
Because of their obvious advantages, active and passive optoelectronic sensor concepts are being investigated by biomedical research groups worldwide, particularly their camera-based variants. Such methods work noninvasively and contactless, and they provide spatially resolved parameter detection. We present 2 techniques: the active photoplethysmography imaging (PPGI) method for detecting dermal blood perfusion dynamics and the passive infrared thermography imaging (IRTI) method for detecting skin temperature distribution. PPGI is an enhancement of classical pulse oximetry. Approved algorithms from pulse oximetry for the detection of heart rate, heart rate variability, blood pressure-dependent pulse wave velocity, pulse waveform-related stress/pain indicators, respiration rate, respiratory variability, and vasomotional activity can easily be adapted to PPGI. Although the IRTI method primarily records temperature distribution of the observed object, information on respiration rate and respiratory variability can also be derived by analyzing temperature change over time, for example, in the nasal region, or through respiratory movement. Combined with current research areas and novel biomedical engineering applications (eg, telemedicine, tele-emergency, and telemedical diagnostics), PPGI and IRTI may offer new data for diagnostic purposes, including assessment of peripheral arterial and venous oxygen saturation (as well as their differences). Moreover, facial expressions and stress and/or pain-related variables can be derived, for example, during anesthesia, in the recovery room/intensive care unit and during daily activities. The main advantages of both monitoring methods are unobtrusive data acquisition and the possibility to assess vital variables for different body regions. These methods supplement each other to enable long-term monitoring of physiological effects and of effects with special local characteristics. They also offer diagnostic advantages for intensive care patients and for high-risk patients in a homecare/outdoor setting. Selected applications have been validated at our laboratory using optical PPGI and IRTI techniques in a stand-alone or hybrid configuration. Additional research and validation is required before these preliminary results can be introduced for clinical applications.
- MeSH
- ambulantní monitorování přístrojové vybavení metody MeSH
- časové faktory MeSH
- design vybavení MeSH
- fotopletysmografie * přístrojové vybavení MeSH
- hemodynamika * MeSH
- infračervené záření MeSH
- kůže krevní zásobení MeSH
- lidé MeSH
- mechanika dýchání * MeSH
- měniče MeSH
- optické zobrazování * přístrojové vybavení MeSH
- oxymetrie * přístrojové vybavení MeSH
- prediktivní hodnota testů MeSH
- regionální krevní průtok MeSH
- reprodukovatelnost výsledků MeSH
- rychlost toku krve MeSH
- teploměry MeSH
- teplota kůže * MeSH
- termografie * přístrojové vybavení MeSH
- výraz obličeje * MeSH
- zdravotní stav MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Sticklerův syndrom (STL) je progresivní multisystémové onemocnění pojivové tkáně s incidencí 1 : 7 500 novorozenců, která však může být podhodnocena kvůli velké fenotypové variabilitě znesnadňující stanovení klinické diagnózy. Symptomy STL zahrnují rozštěp patra nebo Pierre-Robinovu sekvenci, nedoslýchavost, poruchy zraku, zejména časnou vysokou myopii a spontánní odchlípení (amoci) sítnice, poruchy pohybového aparátu a typický vzhled obličeje zahrnující plochý profil, vystupující oči a malou ustupující bradu (mikrognacii). Výskyt a závažnost jednotlivých příznaků se může značně lišit dokonce i v rámci jedné rodiny. K dnešnímu datu byly jako příčina STL popsány poruchy sedmi různých genů pro kolageny. Nejčastější formou (80–90 % STL) je typ 1 s autozomálně dominantní (AD) dědičností, způsobený defektem genu COL2A1. Typ 2 (10–20 % STL), spojený s genem COL11A1, je též AD. Všechny ostatní typy s různými formami dědičnosti (AD i autozomálně recesivní) jsou extrémně vzácné. Geneticky potvrzená diagnóza STL umožňuje prevenci rozvoje dalších komplikací, včasné zahájení symptomatické léčby a přesné stanovení rizika STL v rodině.
Stickler syndrome (STL) is a progressive multisystemic disorder of connective tissue with an incidence of 1:7,500 newborns, which is probably underestimated due to its considerable clinical and genetic heterogeneity. STL symptoms include cleft palate or the Pierre-Robin sequence, hearing and/ or vision impairment, namely early high myopia and spontaneous retinal detachment, skeletal dysplasia, and a characteristic facial appearance, including a flat profile, protruding eyes, and micrognathia. STL symptoms show high inter- and even intrafamilial phenotypical variability. Variants in seven different collagen genes can cause STL. Autosomal dominant (AD) type 1 caused by a defect in the COL2A1 gene is the most common form of STL (80–90%); AD type 2 (involving COL11A1 gene defects) is much less common (10–20%). The third AD type and all autosomal recessive types are extremely rare. A genetically confirmed diagnosis of STL facilitates early treatment, prevention, and an accurate genetic risk estimation of STL in the family.
- Klíčová slova
- Sticklerův syndrom, Pierre-Robinova sekvence,
- MeSH
- diagnostické techniky molekulární metody MeSH
- kolagen nedostatek MeSH
- lidé MeSH
- myopie etiologie genetika MeSH
- odchlípení sítnice etiologie genetika MeSH
- poruchy sluchu genetika MeSH
- vzácné nemoci * genetika patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
Úvod a cíl práce: Okulo-aurikulo-vertebrální spektrum (OAVS) je vrozený komplex malformací s extrémně variabilním fenotypem. Jsou postiženy jednostranně obličejové struktury vznikající během embryonálního vývoje z prvního a druhého žaberního oblouku a zasahující první žaberní váček, první žaberní štěrbinu a základ temporální kosti. Cílem předkládané práce je seznámit čtenáře s klinickým obrazem onemocnění, jehož nejnápadnějším projevem je faciální asymetrie provázená řadou funkčních poruch, a dále představit neinvazivní vyšetřovací metody 3D morfometrie, která umožňuje systematické sledování a vyhodnocování rozvoje a rozsahu morfologické deviace a asymetrie obličeje. Metoda: U šesti pacientů (ve věkovém rozmezí od šesti do 15 let; 5 , 1 ) s okulo-aurikulo-vertebrálním spektrem bylo vytvořeno přesné geometrické 3D zobrazení obličeje pacientů optickou metodou – stereofotogrammetrií. Pomocí metody CPD-DCA (coherent point drift – dense correspondence analysis) byla provedena vzájemná registrace faciálních modelů. U každého pacienta byl zkonstruován dokonale symetrický obličej. Rozdíly mezi konstruovaným symetrickým obličejem a skutečným obličejem byly znázorněny pomocí barevné mapy. Takto zobrazené individuální asymetrie pacientů byly kvantitativně zpracovány a analyzovány v časovém rozpětí 9–23 měsíců. Výsledky: Prokázaly se pouze malé rozdíly ve změně asymetrie obličeje pacientů s OAVS, což svědčí o nevýznamné dynamice rozvoje faciálních malformací u pacientů s tímto onemocněním. Nenašli jsme závislost mezi změnami reliéfu obličeje a věkem pacienta během sledovaného období. Taktéž nebyla nalezena korelace mezi závažností vady a rozvojem asymetrie. Oproti předpokladům se nepotvrdilo významné zhoršování morfologie obličeje u rostoucích pacientů s OAVS, což umožňuje uspokojivou kompenzaci vady včasnou ortodontickou léčbou. Neinvazivní 3D morfometrické vyšetření obličeje je optimální metodou pro sledování vývoje obličejových asymetrií.
Introduction and aim: Oculo-auriculo-vertebral spectrum (OAVS) is a congenital complex of extremely variable phenotypes. Typically, unilaterally aff ected structures are facial structures developing from the fi rst and second branchial arches and fi rst pharyngeal pouch and fi rst branchial cleft and the basis of temporal bone. The aim is to introduce the clinical conditions of the disease whose facial asymmetry is accompanied by a number of functional disorders. Moreover, it presents non-invasive 3D morphometry, that enables evaluation of the morphological deviation of the aff ected area. Methods: An accurate geometric 3D image of the patient's face was created by the optical method – stereophotogrammetry in six patients (age from 6 to 15; 5 , 1 ) with OAVS. Using the construction of dense correspondence mapping by CPD-DCA (coherent point drift – dense correspondence analysis) method between facial meshes, model registration were performed. A perfectly symmetrical face was constructed for each patient. The diff erences between the constructed symmetrical face and the real patient's face were shown using a color map. The individual asymmetry thus displayed was quantitatively processed and analyzed over a period of nine to 23 months. Results: Only minor differences in facial asymmetry of OAVS patients have been demonstrated, suggesting an insignificant dynamics in the development of facial malformations in patients with this disease. We did not find a dependence between face relief changes and patient age during the reference period. There was also no correlation between the severity of the defect and the development of asymmetry. Conclusion: Significant worsening of facial morphology in growing OAVS patients has not been confirmed as supposed. That allows satisfactory compensation of defects by early orthodontic treatment. Non-invasive 3D morphometric facial scanning is an optimal method for monitoring the development of facial asymmetries.
- Klíčová slova
- 3D morfometrie, morfometrie,
- MeSH
- asymetrie obličeje diagnostické zobrazování patofyziologie MeSH
- dítě MeSH
- Goldenharův syndrom * dějiny diagnostické zobrazování patofyziologie MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- mladiství MeSH
- mnohočetné abnormality diagnostické zobrazování patofyziologie MeSH
- obličej abnormality diagnostické zobrazování MeSH
- zobrazování trojrozměrné metody MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
The human face is a complex assemblage of highly variable yet clearly heritable anatomic structures that together make each of us unique, distinguishable, and recognizable. Relatively little is known about the genetic underpinnings of normal human facial variation. To address this, we carried out a large genomewide association study and two independent replication studies of Bantu African children and adolescents from Mwanza, Tanzania, a region that is both genetically and environmentally relatively homogeneous. We tested for genetic association of facial shape and size phenotypes derived from 3D imaging and automated landmarking of standard facial morphometric points. SNPs within genes SCHIP1 and PDE8A were associated with measures of facial size in both the GWAS and replication cohorts and passed a stringent genomewide significance threshold adjusted for multiple testing of 34 correlated traits. For both SCHIP1 and PDE8A, we demonstrated clear expression in the developing mouse face by both whole-mount in situ hybridization and RNA-seq, supporting their involvement in facial morphogenesis. Ten additional loci demonstrated suggestive association with various measures of facial shape. Our findings, which differ from those in previous studies of European-derived whites, augment understanding of the genetic basis of normal facial development, and provide insights relevant to both human disease and forensics.
- MeSH
- cAMP-fosfodiesterasy genetika MeSH
- celogenomová asociační studie * MeSH
- černoši MeSH
- fenotyp MeSH
- jednonukleotidový polymorfismus MeSH
- lidé MeSH
- maxilofaciální vývoj genetika MeSH
- mladiství MeSH
- morfogeneze genetika MeSH
- myši MeSH
- obličej anatomie a histologie MeSH
- transportní proteiny genetika MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- myši MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Tanzanie MeSH
BACKGROUND: Maladaptive behaviors and interpersonal difficulties in patients with borderline personality disorder (BPD) seem connected to biased facial emotion processing. This bias is often accompanied by heightened amygdala activity in patients with BPD as compared to healthy controls. However, functional magnetic resonance imaging (fMRI) studies exploring differences between patients and healthy controls in facial emotion processing have produced divergent results. The current study explored fMRI and heart rate variability (HRV) correlates of negative facial emotion processing in patients with BPD and healthy controls. METHODS: The study included 30 patients with BPD (29 females; age: M = 24.22, SD = 5.22) and 30 healthy controls (29 females; M = 24.66, SD = 5.28). All participants underwent the "faces" task, an emotional face perception task, in an fMRI session simultaneously with ECG. In this task, participants are presented with emotional expressions of disgust, sadness, and fear (as a negative condition) and with the same pictures in a scrambled version (as a neutral condition). RESULTS: We found no differences in brain activity between patients with BPD and healthy controls when processing negative facial expressions as compared to neutral condition. We observed activation in large-scale brain areas in both groups when presented with negative facial expressions as compared to neutral condition. Patients with BPD displayed lower HRV than healthy controls in both conditions. However, there were no significant associations between HRV and amygdala activity and BPD symptoms. CONCLUSION: The results of this study indicate no abnormal brain activity during emotional facial processing in patients with BPD. This result contrasts with previous studies and more studies are needed to clarify the relationship between facial emotion processing and brain activity in patients with BPD. Possible reasons for the absence of brain activity differences are discussed in the study. Consistent with previous findings, patients showed lower HRV than healthy controls. However, HRV was not associated with amygdala activity and BPD symptoms.
- Publikační typ
- časopisecké články MeSH
