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Biomedical subjects

Yu-Ray Chen

Publications and source records attributed to Yu-Ray Chen.

42 records · Page 3Linked to original sources
PubMed2002

Effects of cheiloplasty on maxillary dental arch development in infants with unilateral complete cleft lip and palate.

OBJECTIVE: To identify and analyze quantitatively the development of the maxillary dental arch before and after cheiloplasty. DESIGN: Prospective, longitudinal study of maxillary dental arch development at age of 1, 3, 6, and 12 months. SETTING: All patients were treated at a university hospital craniofacial center. PATIENTS: Twenty-seven infants with nonsyndromic, unilateral complete cleft lip and palate. INTERVENTION: Millard's rotation-advancement cheiloplasty was performed between the ages of 3 and 4 months. RESULTS: The anterior portion of the nonclefted segment (I-G), anterior ridge length of the nonclefted segment (I-C), and anterior ridge length of the clefted segment (L-C') continuously increased from 1 to 12 months of age. The anterior cleft width (G-L), anterior arch depth (I perpendicular to CC'), anterior basal angle (angle GC-CC'), and anterior arch curature angle (angle GIC) continuously decreased after the cheiloplasty. CONCLUSIONS: Cheiloplasty could mold the anterior portion of the maxillary dental arch palatally by exerting continuous pressure.

Analysis of Variance↗
PubMed2002

Computed tomography characteristics of non-syndromic craniofacial fibrous dysplasia.

BACKGROUND: Fibrous dysplasia is a benign fibro-osseous tumor of bones commonly involving the craniofacial region. Computed tomography (CT) imaging study of the disease is useful for evaluation and treatment planning. However, few studies have evaluated such large patient series. METHODS: A total of 46 patients with complete medical records and CT images was included in this study. All of these patients were non-syndromic, had fibrous dysplasia involving only the craniofacial region, and had no skin pigmentation or other evidence of endocrine problems. Data analyses were performed on the clinical manifestations, time of onset, signs and symptoms, involvement of cranial and facial bones, and CT appearance of the tumors in this patient group. RESULTS: Painless swelling was the chief clinical problem in 78% of patients, followes by dental malocclusion in 22%. Onset of the disease was reported to have occurred before 6 years of age in 34%, between 6 and 10 years in 27%, and older than 10 years in 39% of patients. Extreme timings such as onset at infancy or older than 20 years of age were also noted. The average number of bones involved was 3.2 bones per patient. Involvement of more than one craniofacial bone occurred in 70% of patients. The maxilla, orbital, and frontal bones were most commonly involved. CT images appeared sclerotic or homogenous in 34%, mixed white and dark or heterogenous in 55%, and cystic in 11%. A correlation between the age of onset of the disease and the number of bones involved was not observed. CONCLUSIONS: Findings of this study demonstrate that craniofacial fibrous dysplasia displays a wide spectrum of clinical behaviors. CT imaging generally revealed extensive involvement of the tumor in the craniofacial region.

Adolescent↗
PubMed2002

Mandibular dysmorphology in patients with unilateral cleft lip and cleft palate.

BACKGROUND: Conventional studies of the cleft lip/palate (CLP) dysmorphology have mainly focused on deformities of the lip, nose, and maxilla, while ignoring the mandible. Reasons for that were the lack of well-defined mandibular deformity and restriction from the research methodology. METHODS: This study used 3-dimensional computed tomography (CT) imaging data from 35 patients with unilateral CLP. The 3-dimensional images were rotated into a neutral position. Eight cephalometric landmarks were recorded: the pogonion (PG) and the infradentale (ID) from the frontal view; and the condylion (CO), the tip of coronoid process (CP), and the gonion (GO) from both sides of lateral views. The nasion was used as a reference point for the facial midline. Nine linear distances and four angular measurements were calculated from these landmarks. Each mandible was segmented into two hemi-mandibles for volume measurements. The image manipulation and measurements were performed using a personal computer running Analyze' program. Landmark deviation from the facial midline was computed, and comparisons were made between the cleft and non-cleft sides. RESULTS: The results showed that the precision and accuracy of landmark localization was high with an average error of 0.4%. Deviation from the midline of the ID and PG points, and spatial distances between bilateral CP, CO, and GO points varied without a specific pattern. The average differences were within 2 mm. The volume of the cleft side hemi-mandible was consistently larger than that of the non-cleft side (p < 0.0001). Among linear and angular measurements, CP-GO-PG, CO-ID, CP-ID, and CP-GO showed significant difference between the two sides. CONCLUSION: This study demonstrated that mandibular asymmetry and deformity existed and was measurable in patients with unilateral CLP. The influence of CLP to the mandibular development was expressed by the significant differences of hemi-mandible volume and some of the linear and angular measurements between the cleft and non-cleft sides.

Cleft Lip↗
PubMed2002

Facial reconstruction after a complicated gunshot injury.

Facial gunshot injuries are unusual and complicated clinical entities. Because of the mechanism of injury, early aggressive primary reconstruction might not be ideal. Initial conservative management followed by staged secondary reconstruction could be performed to obtain satisfactory functional and aesthetic results. Reconstruction of the cranio-maxillo-facial deformities requires a multi-disciplinary approach, the same way as for patients with cleft lip/palate deformities. We present a male patient with severe facial gunshot injuries. A team approach revealed maxilla recession, dental malocclusion, a large oronasal fistula over his hard palate, velopharyngeal insufficiency, and a stable psychosocial status. His main concern was facial appearance, which included the nose, lip, and scars. Staged reconstructions were performed, consisting of orthognathic surgery, rhinoplasty, lip-switch flap, and revisions of scars. A satisfactory outcome was obtained. The results indicated the importance of preoperative evaluation and treatment planning for this uncommon problem.

Adult↗
PubMedDate not supplied

Management of posttraumatic enophthalmos.

Posttraumatic enophthalmos is one of the common sequelae that appears after facial injury and remains a challenge to treat for craniomaxillofacial surgeons. Several theories have been advocated regarding enophthalmos; however, the most well accepted concept is the enlargement of the orbital cavity after displacement due to orbital fractures. Generally, a 1 cm3 increase in orbital volume causes 0.8 mm of enophthalmos. Thorough knowledge of the orbital anatomy is fundamental and critical for the successful surgical correction of enophthalmos because most treatment failures are due to inadequate orbital dissection from fear of injuring the optic nerve and globe. A complete preoperative plan should be built on a comprehensive clinical examination of the periorbital soft tissue and bony components, detailed ophthalmic examination, and high resolution computed tomography scans in the axial, coronal and reformatted sagittal planes. Based on the anatomic deformities, there are two major fracture types including orbital blow out fractures and zygomatico-orbital fractures, resulting in posttraumatic enophthalmos. Treatment modalities and methods of approach are adapted according to the severity of the orbital deformities. Minor complications include ectropion, entropion, dystopia, diplopia, and residual enophthalmos. Rare but severe complications such as intraconal misplacement of the bone graft or retrobulbar hemorrhage with subsequent blindness may be encountered. The success of the procedures depend on adequate dissection and mobilization of the displaced soft tissue, correct repositioning of the dislocated or malunited bony orbit, and proper intra-orbital grafting.

Enophthalmos↗