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Biomedical subjects

I R Munro

Publications and source records attributed to I R Munro.

At least 55 records · Page 3Linked to original sources
PubMed1985

Abnormal measurements and disproportions in the face of Down's syndrome patients: preliminary report of an anthropometric study.

Using 32 measurements taken from the surface of the cranial-orbital-facial-aural area, 9 proportion indices were calculated to detect the most striking locations of disfigurement in 52 Down's syndrome patients (29 males and 23 females), all white North Americans, aged between 3 and 31 years. A shallow upper-third of the face depth (between the nasal root and the ear's tragi) and a short right auricle were the most frequent subnormal findings (each 71.5 percent), with subnormal palpebral fissures in third place (68.8 percent). The most striking supernormality was the inclination of the palpebral fissure, which was greater than the maximum normal in 46.9 percent. The most striking and frequent (46.9 percent) disproportion was caused by the presence of markedly short palpebral fissures in the vicinity of normal-wide spaces between the eyes (enen), followed by hyperteloric orbits (40.4 percent) and disproportionately short noses (28.9 percent). Major (moderate or marked) epicanthi were found in a high percentage (42 percent) of the patients and aggravated the visual impression of the already damaged orbito-nasal area. Preliminary results of the analysis of the proportion indices in various age groups showed that some disproportions in the orbits and face decreased with age.

Adolescent↗
PubMed1985

Vertical and horizontal proportions of the face in young adult North American Caucasians: revision of neoclassical canons.

The validity of nine neoclassical formulas of facial proportions was tested in a group of 153 young adult North American Caucasians. Age-related qualities were investigated in six of the nine canons in 100 six-year-old, 105 twelve-year-old, and 103 eighteen-year-old healthy subjects divided equally between the sexes. The two canons found to be valid most often in young adults were both horizontal proportions (interorbital width equals nose width in 40 percent and nose width equals 1/4 face width in 37 percent). The poorest correspondences are found in the vertical profile proportions, showing equality of no more than two parts of the head and face. Sex does not influence the findings significantly, but age-related differences were observed. Twenty-four variations derived from three vertical profile, four horizontal facial, and two nasoaural neoclassical canons were identified in the group of young adults. For each of the new proportions, the mean absolute and relative differences were calculated. The absolute differences were greater between the facial profile sections (vertical canons) and smaller between the horizontally oriented facial proportions. This study shows a large variability in size of facial features in a normal face. While some of the neoclassical canons may fit a few cases, they do not represent the average facial proportions and their interpretation as a prescription for ideal facial proportions must be tested.

Adolescent↗
PubMed1985

Inclinations of the facial profile: art versus reality.

The average inclinations of five basic facial profile lines and five individual facial profile segments were determined by direct anthropometry in a total group of 232 healthy young adults, all North American Caucasians. Significant sex-related differences were found only in the inclination of the forehead, the lower face, and the lower third of the face, with greater inclinations in males. These results were compared with data obtained from 49 art works produced by ancient, Renaissance, post-Renaissance, and contemporary artists and drawings of the face in scientific papers published by anthropologists, orthodontists, anatomists, and plastic surgeons. In the population study the average inclination of the general and the aesthetic profile lines, the lower face, the forehead, and the lower lip show a receding trend. The upper face is slightly protruded in the males and close to vertical in the females. The chin and the nose are equally prominent in both sexes. The only significant difference is in the greater recession of the lower face in males. The average female population values are reminiscent of those of the Renaissance. The average male inclinations come closest to the findings in the statues of antiquity. The population sample and the contemporary artists showed similar inclinations of the nasal bridge and the lower lip. Generally, the average inclination of the chin in the population is smaller than in any artistic style.

Adult↗
PubMed1985

An analysis of 12 years of craniomaxillofacial surgery in Toronto.

Over 12 years, 1092 patients underwent 2019 craniomaxillofacial procedures in Toronto. Overall mortality was 0.64 percent, and that directly related to surgery was 0.18 percent. Major complications developed in 14.3 percent of patients, but not all had permanent sequelae. Infection was the greatest problem, occurring in 5.3 percent of the major operations. The annual incidence of complications dropped to 5.4 percent as our experience increased. Certain types of deformity, particularly those in patients with orbital hypertelorism, Treacher-Collins syndrome, or Crouzon's or Apert's syndrome, require more than one operation to achieve maximum correction. Our procedures have undergone many changes, the main one being a reduced operating time.

Adolescent↗
PubMed1985

Classification and treatment of hemifacial microsomia.

On the basis of 37 surgically treated patients with hemifacial microsomia, an anatomical-surgical classification was developed which divides these patients into five categories to facilitate surgical planning and help standardize treatment. Treatment was founded on the cooperation of a large craniofacial team. Osteotomies of the jaws, construction of the TM joint with costochondral grafts, onlay bone grafts, and genioplasty were performed to improve facial form and function. Facial scars were avoided. After three-dimensional skeletal alignment, there was rarely a compelling need for subsequent soft tissue augmentation.

Adult↗
PubMed1985

Craniofacial disproportions in Apert's syndrome: an anthropometric study.

Twenty craniofacial indices composed of 26 surface measurements taken directly from the head and face were determined in 14 Apert's syndrome patients 18 days to 5 years old (younger subgroup) and 14 patients ages 6 years to 15 years old (older subgroup). All of the patients were North American Caucasians who had undergone early suture release but no facial repair. The indices were compared with those in healthy controls of the same age and sex. The wide intercanthal distance in relation to the narrow soft nose was the most frequent (81.5%) and extensive (17.7% above the maximum normal index value) disproportion. Abnormal indices occurred most often with the combination of one abnormal and one normal measurement (61.0%). All seven of the 16 disproportions seen in both age subgroups increased in frequency nonsignificantly with age: the supernormal cephalic, intercanthal, nasal, and vertical mandibulofacial indices and the subnormal nasofacial, upper face, and jaws' arcs indices. Of the six disproportions that decreased in frequency with age, four changed significantly (the supernormal frontoparietal and frontozygomatic indices and the subnormal mandibulofacial and nasozygomatic indices) and two changed nonsignificantly (the supernormal intercanthoalar and subnormal cheilozygomatic indices). With the exception of two nasal proportions, the extent of the disproportionality decreased in all of the indices that increased with age.

Acrocephalosyndactylia↗
PubMed1985

Surface morphology in Treacher Collins syndrome: an anthropometric study.

Between 27 and 65 anthropometric measurements were taken for the head and face of 18 Treacher Collins syndrome patients. The most defective and frequent findings were subnormal facial depth measurements, which increased in disproportionality toward the mandible. Width of the face was more frequently and more severely subnormal than that of the mandible. The orbits were hyperteloric with disproportionately short eye fissures and an antimongoloid inclination. The ears were microtic (more so in width than in length) in 58.8 percent of cases but low-set in only 20 percent. The nose measurements were mostly normal, which explains the "parrot-beak" character of the nose in the presence of a hypoplastic receding chin; the only nose defects were supernormal height and width in the root and subnormal bridge inclination. The most frequently seen striking disproportions were those between the width of the nasal root and the width of the soft nose, followed by the great discrepancy between the markedly narrow face and the usually normal face height.

Adolescent↗
PubMed1984

Anthropometric proportions in the upper lip-lower lip-chin area of the lower face in young white adults.

The relationships between measurements of the lower lip, chin, upper lip, and lower half and lower third of the face were studied. Fifteen new indices were formed with the help of eleven vertical linear, one horizontal linear, and two surface-arc measurements in the area. Neoclassic canons related to the lower face were not confirmed. On the average, the lower lip was 83% to 85% as large as the upper lip. The upper lip occupied one third of the lower face, while the lower lip occupied more than one third of the lower third of the face and the chin occupied the remainder. Skin covered 73.5% of the upper lip in males and 68% in females; it covered 63% of the lower lip in males and 61.1% in females. The remainder was covered by vermilion, more on the lower than on the upper lip and more protruding in females than in males. Proportion standards are a valuable contribution to the surface anatomy of the lower face of young white adults.

Adolescent↗
PubMed1983

Effect of irradiation on facial growth: a 7- to 25-year follow-up.

This retrospective study is a review of 41 patients who had received irradiation to the head and face during the growth period. Not only is growth of soft tissue and bone of the irradiated area noticeably affected, but other parts of the face can also be involved, especially if the dose is to the upper face and the cranial base. We were able to define a definite cutoff point for a harmful dose for growing facial bones, but the harmful dose for soft tissue could not be determined and may be as low as 400 rads.

Adolescent↗
PubMed1983

Transcutaneous stitch for transperiosteal identification of the medial canthal ligament.

This paper presents a technique whereby the canthal ligament can be identified through the periosteum without creating an external incision. Prior to releasing the tendon from the bones, the assistant will stretch the lateral canthal ligament while the surgeon places a stitch through the medial canthal ligament and tattoos the ligament and the underlying bone. After the forehead flap is mobilized and the ligament is detached from the bone by elevation of the periosteum, the previous stitch on the medial canthal ligament is pulled, which will provide a firmer consistency to the ligament, thereby facilitating the differentiation of the ligament from the surrounding soft tissue. Using this and the tract tattooed previously, the ligament can be identified easily without creating any external scars.

Face↗
PubMed1983

Limberg-latissimus dorsi myocutaneous flap for closure of myelomeningocele.

A method is presented in which two well-recognized plastic surgical flap techniques are coupled; the Limberg rhomboid transposition flap and the latissimus dorsi myocutaneous flap. The technique was used in 2 patients to provide ample, innervated, and well-vascularized skin cover over myelomeningocele defects.

Female↗
PubMed1981

Split-rib cranioplasty.

Cranioplasty using a synthetic material is less than ideal, especially if there is a history of infection at the defect site. Split-rib cranioplasty is a practical approach even in patients with a positive history of infection at or around the defect. We briefly review the historical background of split-rib cranioplasty and report our experience with this procedure in 12 patients. Forty-two pieces of rib, with an average length of 13 cm. were used for reconstruction. We had only 1 complication-a pneumothorax following removal of the rib graft. The follow-up period ranged from three to thirty-six months. All patients had complete regeneration of the donor rib and solid protection of the brain.

Adolescent↗
PubMed1981

Radical treatment for fronto-orbital fibrous dysplasia: the chain-link fence.

Fronto-orbital fibrous dysplasia is a progressive disease whose growth does not cease at puberty. It causes frontal protuberance, orbital dystopia, and proptosis. Occasionally, there is a neural entrapment. Malignant change may occur spontaneously or as a result of irradiation. Radical resection offers the greatest chance of cure and correction of the entire deformity. Five patients treated by the Toronto Craniofacial Team are reported. This team has developed techniques for one-stage removal and immediate reconstruction with rib grafts. Rigid fixation of the grafts utilizing the chain-link fence principle has proved that if bone grafts are considered as skin grafts and rapid revascularization is permitted, no resorption or loss of contour occurs.

Adolescent↗
PubMed1981

Current surgery of craniofacial anomalies.

Craniofacial dysplasia is a term covering all types of skeletal anomalies. Craniofacial surgery has made possible the movement of any bone of the face or skull to correct such deformities. Such surgery is a new and separate subspecialty and should be limited to a few regional centers. There are numerous osteotomies available. The common ones are the Le Fort I, II, and III for advancement of different segments of the midface, orbital hypertelorism correction converting each orbit into a box, which moves medially together with the eyeball, and advancement of the forehead to correct premature coronal synostosis in infancy or forehead recession in Crouzon's or Apert's syndrome. In hemifacial microsomia, the asymmetrical skeleton is rotated about the facial midline to produce symmetry, and the mandibular ascending ramus and temporomandibular joint are constructed if absent. Combinations of the various osteotomies are possible, depending upon the type of deformity as assessed by the craniofacial team. Psychosocial study indicates that surgical correction should be undertaken as early as is technically feasible. The four main complications are death, blindness, brain damage, and infection.

Adolescent↗