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T D Bruintjes

Publications and source records attributed to T D Bruintjes.

6 recordsLinked to original sources

Functional anatomy of the premaxillary area.

Although the gross anatomy of the nasal septum is well-understood, the exact anatomy of its ventrocaudal or premaxillary area is not. More precisely, there is some confusion about the course of the perichondrial and periosteal fibers in this particular region. This paper considers the detailed anatomy of the chondro-spinal and chondro-premaxillary junction. Six cadaver noses were sectioned in the coronal (n = 4) or the transverse (n = 2) plane. The sections were stained according to the Mallory-Cason and the Haematoxylin-Eosine method and examined by light microscopy. At the chondrospinal junction a relatively wide suture line filled with loose connective tissue fibers was found. The caudal margin of the cartilaginous septum is flanked by paraseptal cartilages. These broaden the septal base to fit onto the flat cranial surface of the anterior nasal spine. At the chondro-premaxillary junction a narrow suture with several crossing fibers between the perichondrium and periosteum was seen. Paraseptal cartilages, surrounded by their own perichondrium, cover the periphery of this area. It was concluded that the chondro-spinal junction provides stabilization while allowing some mobility of the septum, whereas the chondro-premaxillary complex stabilizes the septum without allowing mobility.

Adult↗

A functional anatomic study of the relationship of the nasal cartilages and muscles to the nasal valve area.

The functioning of the nasal valve area is largely determined by the stability and the mobility of the lateral nasal wall. To gain insight into the kinematics of the lateral nasal wall, we studied the functional anatomy of the nasal muscles and the intercartilaginous and osseous-cartilaginous junctions. We performed gross and microscopic nasal dissection and serial sectioning in 15 human cadaveric noses. In addition, two noses were used for three-dimensional reconstruction of the nasal cartilages. We conclude that the lateral nasal wall can be seen as made up of three parts. At the level of the osseous-cartilaginous chain of bone, lateral nasal cartilage, and lateral crus, the lateral nasal wall is relatively stable, limited mobility being allowed by translation and rotation in the intercartilaginous joint and a coupled distortion of the cartilages. At the level of the hinge area the lateral nasal wall is supported by one or more accessory cartilages, embedded in soft tissue, and therefore much more compliant. The alar part of the nasalis muscle, which originates from the maxilla and inserts on these cartilages, may dilate the valve area by drawing this hinge area laterally. The third and most compliant part of the lateral nasal wall is the part that is not supported by cartilage, the ala. The dilatator naris muscle largely occupies the ala and is attached to the lateral crus; it opens the vestibule and nostril. The third nasal muscle that influences the lateral nasal wall is the transverse part of the nasalis muscle. It overlies the nose but is not attached to it. This muscle stabilizes the lateral nasal wall, in particular, the lateral nasal cartilage, the intercartilaginous junction, and the hinge area, by moving the nasal skin.

Aged↗

Electromyography of the human nasal muscles.

Electromyographic (EMG) activity of six nasal muscles was monitored in 17 male volunteers without nasal complaints. Surface electrodes were placed on the nasal skin in such a way that they selectively recorded the activity of these muscles. Recordings were made under different breathing conditions and during voluntary nasal movements. Inspiratory EMG activity was observed during nasal and oral breathing in one or more of the following muscles: dilator naris, nasalis muscle (alar and transverse parts) and apicis nasi. EMG activity increased markedly in response to physical exercise and was more often present in subjects with decreased nasal patency. During voluntary nasal movements a combined activity of the six nasal muscles was consistently found. We conclude that the function of the dilator naris, the nasalis muscle and the apicis nasi strongly relates to respiration. These muscles probably contribute to the prevention of collapse of the nasal valve. The role of the procerus and levator labii superioris alaeque nasi seems to be primarily concerned with facial expression.

Adult↗

Review of the functional anatomy of the cartilages and muscles of the nose.

This paper reviews the anatomy of the nasal cartilages and muscles. Accurate anatomical knowledge of these structures may facilitate the design of a model to study the mobility and support of the lateral nasal wall and ala and may thus provide information on the dynamics of valve area. It is concluded that a uniform description of nasal cartilages and muscles is still lacking. This is especially true for the attachments of the nasal cartilages to neighbouring structures, as well as the location and function of the muscles influencing the valve area. The use of uniform, preferably anatomical, terminology is encouraged.

Humans↗

Allergy due to topical medications in chronic otitis externa and chronic otitis media.

Thirty-four patients suffering from chronic otorrhoea were tested for delayed type contact allergy. Patch testing showed a relevant positive reaction in 19 patients (56%). The most frequent allergens were aminoglycosides with neomycin and framycetin as major offenders. Other antimicrobial agents (clioquinol, polymyxin B), cream bases (lanolin) and corticosteroids (tixocortol) were less common allergens encountered. These results indicate that it is almost obligatory to perform patch testing in any patient with long-standing otitis which does not respond to local therapy. Scoring of the patch tests has to be extended to 7 days, as notably the aminoglycosides and corticosteroids only become positive after such a long interval. Because of the high risk of sensitization, topical preparations containing neomycin and framycetin should not be used routinely. We recommend the use of either a topical antiseptic or a topical antibiotic with low allergenic potential for the initial treatment of otorrhoea.

Administration, Topical↗

The interdomal ligament does not exist.

Some authors consider the interdomal ligament to be an important structure of nasal tip support, whereas in other studies of lobular anatomy such a ligament is not mentioned at all. To clarify this question, we performed an anatomical investigation, which included macroscopical dissection and histological sectioning of 14 human cadaveric noses. Our anatomical study failed to reveal the presence of an actual ligament in the interdomal area.

Humans↗