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Biomedical subjects

Z Smahel

Publications and source records attributed to Z Smahel.

At least 19 recordsLinked to original sources
PubMed1992

Nasopharyngeal characteristics in children with cleft lip and palate.

Cephalometric assessment of the nasopharynx and its adjacent structures was carried out in two experimental groups of 5-year-old male patients with unilateral cleft lip and palate. The first group included individuals who had not had surgery, and the second was comprised of individuals who were at least 1 year postpalatoplasty with primary pharyngeal flap. They were compared with a control group of boys of comparable average age who did not have clefts. Both groups of patients with clefts showed a reduction of the nasopharyngeal bony framework related to the posterior position and decreased posterior height of the maxilla without hypertrophy of the adenoids. The smaller nasopharyngeal airway was consistent with the reduction of the size of the bony nasopharynx. There was shortening of the anterior cranial base located in the region of the middle cranial fossa. The height of the body of the sphenoid bone was reduced, but the angle of the cranial base was within normal limits.

Adenoids↗
PubMed1992

Growth and development of the face in complete unilateral cleft lip and palate during prepubertal and pubertal periods.

Roentgencephalometry was used for the assessment of the growth and development of the face during prepubertal and pubertal periods in children with complete unilateral cleft lip and palate treated with the same methods. The first series included 16 boys and 15 girls, the second series consisted of 15 boys and 15 girls examined repeatedly at the beginning and at the end of the follow-up period. There were no definite differences in the growth rate of the face between the two periods of age. Therefore, the deterioration of overjet during puberty could be due to the depletion of the compensation and adaptation mechanisms after the previous orthodontic treatment rather than to the enhanced growth rate. As compared to other facial dimensions a lower growth rate showed during both periods the length of the anterior base, the depth of the maxilla and in particular the height of the upper lip. Developmental changes of variables of shape and position proceeded similarly during both periods of age. An exception represented the rotation of the mandible and the inclination of upper incisors. During the prepubertal period the lower jaw showed a very slight posterior rotation, while during puberty an anterior growth rotation was present. A rapid improvement of the proclination of upper incisors was attained only during the prepubertal period. It was accompanied by an improvement of overjet. However, during the period of puberty there was a renewed deterioration of overjet. A marked retrusion of the maxilla developed already in the prepubertal period. During both periods occurred an identical impairment of sagittal jaw relations and of the upper lip prominence, accompanied by a flattening of the facial profile and reduction of the nasolabial angle. The prominence of the nose increased, the angle of the cranial base remained unchanged. Intersexual differences were not demonstrated in any studied characteristics.

Adolescent↗
PubMed1992

Configuration of facial profile in adults with cleft lip with or without cleft palate.

X-ray cephalometric studies were carried out in 114 adult males with cleft lip and with or without cleft palate. According to the type and extent of the cleft they were subdivided into 4 groups and were compared with a control group of 50 normal males matched in age. Investigated were the parameters of the skeletal and soft facial profile. The results showed that cleft lip alone is associated with deviations of local character concerning only soft tissues within the oronasal region. The ascertained deviations included a flattening of the nose, reduction of the height, concavity and prominence of the upper lip, increased height of the upper lip vermilion and a more horizontal slope of the columella leading to a reduction of the nasolabial angle. Cleft lip and palate was associated with deviations of global character related predominantly to the extent of retrusion of the upper and lower jaw. The skeletal profile was altered and its deviations were reflected by changes of the soft profile. Of the deviations of soft tissues per se were most important the flattening of the nose and reduction of the height and thickness of the upper lip, which underlined the presence of retrocheilia. Maxillary retrusion was more marked in complete than in incomplete unilateral clefts, while mandibular retrusion and maxillary dentoalveolar retroinclination were more marked in bilateral than in unilateral clefts. Occlusion was always impaired. In unilateral involvement, especially in complete clefts the more horizontal slope of the columella resulted in a marked reduction of the nasolabial angle. Incomplete clefts, similarly as cleft lip alone were not associated with a reduction of thickness of the upper lip and showed an increase of the vermilion height. Because of the persisting protrusion of the premaxilla bilateral clefts were accompanied by only a slight flattening of the skeletal profile and by an excessive nasal depth after the prolongation of the columella. The nasolabial angle was unchanged. The concavity of the upper lip was reduced in complete unilateral and bilateral clefts. Certain characteristics of the oronasal region disclosed a similarity between incomplete cleft lip and palate (in unilateral involvement) and cleft lip alone, however global deviations (due to skeletal changes) were identical with those recorded in complete clefts.

Adult↗
PubMed1992

Configuration of facial profile in adults with isolated cleft palate.

X-ray cephalometry was used for the assessment of the configuration of the skeletal and soft tissue profile in 81 adult males with isolated cleft palate. They were assessed in three subgroups, i. e. with complete and incomplete clefts and with clefts of the soft palate alone and were compared with a matched group of controls consisting of 50 normal males, as well as with the situation in the earlier examined series with unilateral cleft lip and palate. In isolated cleft palate both the upper and lower jaws were retruded. The maxilla was most markedly retruded in incomplete clefts and most slightly in clefts of the soft palate alone, while the mandible showed the smallest degree of retrusion in complete clefts. The configuration of the skeletal profile was similar as in unilateral cleft lip and palate, yet positive overjet was on the average restored in all types of isolated cleft palate. A more favourable configuration of the profile was present in patients with cleft soft palate alone, in the absence of an impairment of sagittal jaw relations. Changes in the configuration of the soft profile were due mainly to skeletal deviations. The retrusion of skeletal framework of the middle face was to a large degree masked by the larger thickness of the upper lip, in complete clefts also of the lower lip. Therefore the prominence of the upper lip was only slightly impaired and slight flattening of the face occurred only in complete clefts. The more horizontal slope of the columella resulted in a reduction of the nasolabial angle. Some deviations from the described pattern occurred in clefts of the soft palate alone (steeper slope of the upper lip with an unchanged nasolabial angle, normal thickness of the upper lip a. o.). The findings are suggestive of a differing facial physiognomy in isolated cleft palate.

Adult↗
PubMed1991

Differences between facial configuration and development in complete and incomplete unilateral cleft lip and palate during the prepubertal period.

Mixed-longitudinal roentgencephalometric data were used for the determination of differences between the configuration and development of the face in complete and incomplete unilateral cleft lip and palate at the age of 8 to 12 years. As compared to incomplete clefts patients with complete clefts had a reduced height of the upper face and thus also of the face as a whole and an increased width of the nasal cavity. These findings were in agreement with the situation in adults, but contrary to adults we failed to disclose any difference in the depth of the maxilla and thus there were also no differences of the retrusion of the upper jaw, sagittal jaw relations, facial convexity, occlusion of incisors and the prominence of the upper lip. The thickness of the upper lip did not differ as well. The global results showed that the differences between facial configuration in these two types of clefts were much smaller up to the onset of puberty than in adults. Throughout the investigated period of time the growth and development of the investigated parameters proceeded identically in both forms of clefts. The reduction of upper face height in complete clefts confirmed an early, probably prenatal origin of this deviation from normal.

Cleft Lip↗
PubMed1991

Craniofacial morphology in unilateral cleft lip and palate in adults.

X-ray measurements were used for studies of craniofacial morphology in unilateral (right-sided) cleft lip and palate in 58 adult males operated upon with the same technique. The results obtained showed a slightly smaller neurocranium without marked changes of the cranial base. Basic facial skeletal deviations included a shortening of maxillary depth, reduction of the upper face height, widening of some maxillary dimensions (interorbital and of nasal cavity), retroinclination of upper incisors and alveolar process and mandibular changes resulting from growth deficiency (they consisted of shortening of the body and ramus, elongation of anterior mandibular height, obtuse gonial angle, acute chin angle, steeper slope of the body, retroinclination of incisors and retrognathia). Described changes caused an impairment of sagittal and vertical jaw relations, anterior crossbite, flattening of the face and a limitation of its anterior growth rotation. There was also a displacement of the whole maxilla backwards and a reduction of the height and of the thickness of the upper lip (increasing retrocheilia). The elongation of the lower face and thus of the whole face was produced by the increase of the anterior height of the mandible, impaired overjet and by maxillary dentoalveolar retroinclination. A slight transversal flattening of the face (greater retrusion in the centre than in the zygomatic regions) was present as well.

Adult↗
PubMed1990

[Somatometric characteristics of patients with hypertrophic cardiomyopathies].

The authors evaluated anthropometric data from 43 men and 17 women aged 20-45 years suffering hypertrophic cardiomyopathy. The affected individuals had a higher body weight associated with larger circumferences of trunk and arms, but smaller circumferences of the lower extremities. The deviations could be due to a lower physical activity of the patients and consistent with this, they were recorded only in the subgroup of patients with subjective complaints. Contrary to these findings, after classification of the patients according to the extent of myocardial hypertrophy, higher body weight was found only in patients with mild affection. The difference could be suggestive of a higher mortality of patients with a more severe affection, accompanied simultaneously by overweight or obesity. Of the dimensions of head and face was enlarged only the head circumference in men. The authors recommend to follow-up the height-weight proportionality of patients.

Adult↗
PubMed1989

[Dermatoglyphic analysis of patients with hypertrophic cardiomyopathy].

Complete dermatoglyphic analysis of the hands in 69 men and 31 women with hypertrophic cardiomyopathy revealed only two significant abnormalities. In both sexes the total frequency of double loops on the fingers was increased (table 1) and the main palmar line had a more longitudinal course on the palm with its termination more frequently in area 3, less frequently in area 5 than in both compared controls (table 2). The differences are, however, not marked enough to use them in practice to screen affected individuals in families at risk. No differences were revealed in relation to the severity of the disease and the genealogical situation in the pedigree.

Cardiomyopathy, Hypertrophic↗
PubMed1989

Effects of certain therapeutic factors on facial development in isolated cleft palate.

Roentgencephalometry was used during the investigation of the effects of some therapeutic factors on the growth and development of the jaws in 64 adult males with an isolated cleft palate repaired by pushback. The anterior growth of the maxilla was not related to the age at the time of surgery or to orthodontic therapy with removable appliances. A small number of individuals operated during adolescence had also a shorter depth of the maxilla similarly as patients operated upon during early childhood. Anterior crossbite developed mostly in patients with reduced proclination of the upper alveolar process, while, on the contrary, a retrusion of the maxilla played no essential part. This observation proves useful for the prediction of the development of this malocclusion. The angle of sagittal jaw relations does not represent necessarily a valid criterion of the development of the jaws. In the presence of an overbite retrusion of the maxilla is associated with a retroposition of the mandible and thus the angle of sagittal jaw relations remains unchanged. Thus overbite represents an effective mechanism acting on the position of the mandible. A differentiated approach for the determination of the age of choice at the time of palate surgery according to the type and extent of the cleft is proposed.

Adult↗
PubMed1989

Effects of primary osteoplasty on facial growth in unilateral cleft lip and palate after ten years of follow-up.

An assessment of X-ray cephalometric studies was carried out in 32 boys and 25 girls with complete unilateral cleft lip and palate aged ten years and operated upon with the technique of primary bone grafting, as well as in 30 boys and 25 girls with the same type of cleft treated with the same methods, but without bone grafting. Individuals with primary osteoplasty had a deficiency of vertical growth of the upper face and a more marked retroinclination of upper incisors. We failed to disclose any other significant differences. Both series had a markedly deficient anterior growth of the maxilla. Thus the introduction of the method of primary bone grafting did not result in an improved development of the upper jaw, just on the contrary some parameters were suggestive that it exerted an adverse effect. Therefore it was not possible to advocate the use of this surgical procedure in the treatment of clefts.

Bone Transplantation↗
PubMed1989

[Relation between the level of involvement of the ear, the middle ear and the face in microtia].

Based on examination of 80 adult men with unilateral microtia the authors examined the relationship between the affection of the ear lobe, middle ear and face. The revealed significant relations were due solely to subjects with the most severe or with the slightest affection. Correlation coefficients therefore do not characterize relations in the majority of patients and their magnitude is influenced by the ratio of marginal variants of the anomaly in the group. The calculation of the relationship for the entire range of variation of the defect thus is useless. These findings may have a more general validity. They are consistent with the experimental evidence on a haematogenic origin of branchiogenic defects and assumptions derived from this hypothesis. Facial asymmetry is a prognostically important sign for the estimation of the extent of damage of the middle ear.

Adult↗
PubMed1988

Multiple correlations between craniofacial characteristics: an x-ray study.

The method of multiple correlations was used to assess the interrelations between basic characteristics of the facial bony framework and the cranial base. The study was based on x-ray measurements in 50 normal adult males, and the result disclosed the extent to which the variability of the investigated characteristics was determined by the variability of several combined facial parameters. The characteristics of shape and position of individual facial structures were more closely interrelated than characteristics of size. The lowest degree of association was shown by the parameters of the cranial base, which confirmed its independent development. The highest degree of interrelations was shown by the parameters of shape and position of the lower jaw, which characterized the marked adaptation and compensation capacity of the mandible. Some of these relations were causal. The present findings could be useful in orthodontic therapy and during anthropologic reconstructions.

Adult↗
PubMed1988

Effects of primary periosteoplasty on facial growth in unilateral cleft lip and palate: 10-year follow-up.

Cephalometric radiographic assessment of facial growth was carried out in 35 10-year-old boys with complete unilateral cleft lip and palate, operated upon in childhood with the technique of primary periosteoplasty. They were compared with two matched series of boys with clefts; one group was treated with primary osteoplasty and the second with the technique of surgical repair without a bone graft or periosteal flap. Comparison of the three surgical techniques disclosed that subsequent jaw development was most advantageous after primary periosteoplasty and least satisfactory after bone grafting. Facial changes after periosteoplasty consisted of a milder retrusion of the upper jaw, a maintenance of the overjet, and a more satisfactory prominence of the upper lip. Analysis also revealed that orthodontic treatment appeared to play a major part in improving the facial configuration.

Bone Transplantation↗
PubMed1988

Roentgencephalometric study of cranial interrelations.

Lateral X-ray films of the skull obtained in 50 normal adult males were used for studies of correlations between 26 characteristics of the size, shape, and position of the face and nine characteristics of the neurocranium in all mutual combinations. The results disclosed that the relations between individual cranial components were regulated by certain principles. The correlations between size dimensions were mostly slight; a closer relationship showed some characteristics of the shape and position. The most important variable exerting an effect on the configuration of the skull as a whole represented the angle of the cranial base which produced the rotation of the neurocranium and the face and thus acted on a series of other correlations. Of some importance as well was the length of the mandibular ramus acting on the shape and position of the lower jaw and on the vertical maxillomandibular relations. The close relationship between the anteroposterior position of both jaws was due to compensation mechanisms rather than to the identical size of both jaws. On normalization of the disturbed saggital jaw relations, the dentoalveolar components of both jaws as well as the subalveolar component of the mandible participated equally. In vertical direction the lower face showed a certain developmental independence. The discussed interrelations formed the basis for studies of the mechanisms regulating the intracranial development and the changes occurring in various anomalies, as well as for understanding the compensation and adaptation abilities of individual cranial components.

Adult↗
PubMed1987

Craniofacial morphology in isolated cleft palate prior to palatoplasty.

Roentgencephalometry was used in a study of 30 boys and 30 girls with isolated cleft palate prior to palatoplasty. Their ages ranged from 3.5 to 4.5 years. These patients were compared with a control series and with a group of 20 boys with unilateral cleft lip and palate, examined similarly prior to palatoplasty. The isolated cleft palate (CP) group showed four basic differences from the control group: a shortening of maxillary depth and mandibular length (body and ramus), a reduction of the posterior height of the upper face, and a marked widening of the nasal cavity. In contrast to the unilateral cleft lip and palate group the CP group failed to demonstrate a shortening of the anterior height of the upper face or an elongation of the lower face. There was also no indication of a posterior displacement of the upper jaw, of a dentoalveolar retroinclination of the maxilla, or of an increase of the interocular distance. The observed shortening of both jaws in the CP group might be of importance in understanding the pathogenesis of isolated cleft palate. Unilateral cleft lip and palate was not associated with a reduction of the depth of the upper jaw, although the observed shortening of the lower jaw and of the posterior height of the upper face and the widening of the nasal cavity were similar to those seen in isolated cleft palate.

Cephalometry↗