DocumentsDate added
ORIGINAL ARTICLE
Senior Resident,1 Associate Professor,3Senior Resident,4 and Professor & Head,7 Department of ENT, SHKM GMC, Nalhar,Mewat, Haryana, India
2 Professor and Head, Department of ENT, Shyam Shah Medical College, Rewa,Madhya Pradesh, India
5 Senior Resident, Department of Pediatric and Preventive Dentistry, Eklavya Dental College, Kotputli, Distt Jaipur, Rajasthan, India
6 Assistant Professor, Department of Psychiatry, SHKM GMC, Nalhar, Mewat, Haryana, India
Address reprint requests to
*Dr Ashok Kumar,
Associate Professor,Department of ENT, Flat no. 302, B-1 Block, Residential Campus, SHKM GMC,Nalhar, Mewat 122107, Haryana, India
Article citation: Prasad S, Aggarwal A,Kumar A, Ahlawat B, Chaudhary N, Rozatkar A, Naik SM. Acute invasive fungal rhinosinusitis: survival outcomes related to predefined parameters as variables. J Pharm Biomed Sci 2015;05(12):988–993.
ABSTRACT
The aim of this study was to determine outcomes and identify factors that may affect survival in patients with acute invasive fungal rhinosinusitis (AIFRS). Thirty patients of AIFRS were identified. The underlying reasons for immunosuppression were diabetes mellitus (19 patients), chronic renal failure (5 patients), leukemia (3 patients), acquired immunodeficiency syndrome (2 patients) and post organ transplant (1 patient).
We have found the overall survival rate directly related to AIFRS to be 56.7%. The survival rate is higher for young patients (below 50 years age group), diabetic patients than for patients with other causes of immunosuppression, sufferers of mucormycosis than aspergillosis and those treated with liposomal Amphotricsin B as compared to conventional form in addition to surgical debridements. Intracranial and orbital involvement and failure to recover are the factors that led to poor prognosis in this series.
KEYWORDS acute invasive fungal rhinosinusitis, absolute neutrophil count, mucormycosis, aspergillosis
REFERENCES
1. Plaignaud M. Observation surun fungus du sinus maxillare. J Chir. 1791;1:111–6.
2. de Shazo RD, O’Brien M, Chapin K, Soto-Aguilar M, Gardner L, Swain R. A new classification and diagnostic criteria or invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg. 1997; 23(11):1181–8.
3. Feurguson BJ. Fungal rhinosinusitis. In: Cummings (eds): Otolaryngology Head and Neck Surgery, 5th ed. Philadelphia: Mosby Elsevier, 2010. pp. 709–10.
4. Klossek JM. Fungal rhinosinusitis. In: Michael G, et al (eds): Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery. London,Great Britain: 2008. pp. 1454–5.
5. Gillespie MB, O’Malley BW, Francis HW. An approach to fulminant invasive fungal rhinosinusitis in the immunocompromised host. Arch Otolaryngol Head Neck Surg. 1998 May;124(5):520–6.
6. Talbot GH, Huang A, Provencher M. Invasive aspergillus rhinosinusitis in patients with acute leukemia. Rev Infect Dis. 1991 Mar–Apr;13(2):219–32.
7. Kennedy CA, Adams GL, Neglia JP, Giebink GS. Impact of surgical treatment on paranasal fungal infections in bone marrow transplant patients. Otolaryngol Head Neck Surg. 1997 Jun;116(6 Pt 1):610–16.
8. Sugar AM. Mucormycosis. Clin Infect Dis. 1992 Mar;14 Suppl 1:126–9.
9. Blitzer A, Lawson W. Fungal infections of the nose and paranasal sinuses. Part I. Otolaryngol Clin North Am. 1993 Dec;26(6):1007–35.
10. Fabiana CP, Valera. Prognosis of acute invasive fungal rhinosinusitis related to underlying disease. Int J Infect Dis. 2011;152:841–4.
11. Waitzman AA, Birt BD. Fungal sinusitis. J Otolaryngol. 1994 Aug;23(4):244–9.
12. Turner JH, Soudry E, Nayak JV, Hwang PH. Survival outcomes in acute invasive fungal sinusitis: a systematic review and quantitative synthesis of published evidence. Laryngoscope. 2013 May;123(5):1112–8.
13. McGill TJ, Simpson G, Healy GB. Fulminant aspergillosis of the nose and paranasal sinuses: a new clinical entity. Laryngoscope.1980 May;90(5 Pt 1):748–54.
14. Blitzer A, Lawson W, Meyer BR, Biller JF. Patient survival factors in paranasal sinus mucormycosis. Laryngoscope. 1980 Apr;90(4):635–48.
15. Blitzer A, Lawson W. Mycotic infections of the nose and paranasal sinuses. In: English G (ed): Otolaryngology. St. Louis, Mo: JB Lippincott, 1992. pp. 1–23.
16. Hora JF. Primary aspergillosis of the paranasal sinuses and associated areas. Laryngoscope. 1965 May;75:768–73.
17. Gillespie MB, O’Malley BW. An algorithmic approach to the diagnosis and management of invasive fungal rhinosinusitis in the immunocompromised patient. Otolaryngol Clin North Am.2000 Apr;33(2):323–34.
18. Weber RS, Lopez-Berestein G. Treatment of invasive Aspergillus sinusitis with liposomal-amphotericin B. Laryngoscope. 1987 Aug;97(8 Pt 1):937–41.
19. Milroy CM, Blandshard JD, Lucas S, Michaels L. Aspergillosis of the nose and paranasal sinuses. J Clin Pathol. 1989 Feb;42(2):123–7.
20. Levin LA, Avery R, Shore JW, Wooq JJ, Baker AS. The spectrum of orbital aspergillosis: a clinicopathological review. Surv Ophthalmol. 1996 Sep–Oct;41(2):142–54.
21. Parikh SL, Venkatraman G, Del Gaudio JM. Invasive fungal sinusitis: a 15-year review from a single institution. Am J Rhinol. 2004 Mar–Apr;18(2):75–81.
22. Sivak-Callcott J, Livesley N, Nugent RA, et al. Localised invasive sino-orbital aspergillosis: characteristic features. Br J Ophthmalmol. 2004;88:681–7.
23. Talmi YP, Goldschmied-Reouven A, Bakon M, Barshack I, Wolf M, Horowitz Z, et al. Rhino-orbital and rhino-cerebral mucormycosis. Otolaryngol Head Neck Surg. 2002;127(1):22–31.
24. Ochi JW, Harris JP, Feldman JI, Press GA. Rhinocerebral mucormycosis: results of aggressive surgical debridement and amphotericin B. Laryngoscope. 1988 Dec;98(12) 1339–42.
25. Stevens DA, Kan VL, Judson MA, Morrison VA, Dummer S,Denning DW, et al. Practice guidelines for diseases caused by Aspergillus. Infectious Diseases Society of America. Clin Infect Dis. 2000 Apr;30(4):696–709.
26. Walsh TJ, Finberg RW, Arndt C, Hiemenz J, Schwartz C,Bodensteiner D, et al. Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia. National Institute of Allergy and Infectious Diseases Mycoses Study Group. N Engl J Med. 1999 Mar;340(10):764–71.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: None.
Competing interest / Conflict of interest:
The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
CASE REPORT
Anil Aggarwal1*,Shyamakant Prasad2,Ashok Kumar3,Babita Ahlawat4,Bhawana Sethi5
1 Professor and Head, Department of ENT,Shyam Shah Medical College, Rewa,Madhya Pradesh, India
Senior Resident2 and Associate Professor,3 Department of ENT, SHKM GMC, Nalhar,Mewat, Haryana, India
4 Senior Resident, Department of Dentistry,SHKM GMC, Nalhar, Mewat, Haryana, India
5 Associate Professor, Department of Pathology, Faculty of Medicine & Health Sciences, SGT University, Budhera,Gurgaon, Haryana, India
Address reprint requests to
Dr. Ashok Kumar,
Associate Professor,Department of ENT, Flat No. 302; B-1 Block; Residential Campus, SHKM GMC, Nalhar,Mewat 122107, Haryana, India
Article citation: Aggarwal A, Prasad S, Kumar A, Ahlawat B, Sethi B. A rare presentation of sinonasal hemangiopericytoma-like tumour in frontoethmoidal sinus:a diagnostic challenge. J Pharm Biomed Sci 2015;05(12):984–987. Available at www.jpbms.info
ABSTRACT
Sinonasal hemangiopericytoma-like tumour (SHPCL) are rare vascular neoplasms derived from Zimmerman’s capillary pericytes. They originate in a paranasal sinus and extend into the nasal cavity secondarily. Hemangiopericytomas of soft tissue usually occur in the retroperitoneum or the thigh and are an uncommon finding in the nasal and paranasal sinuses. They occur most commonly in adults in the sixth and seventh decades of life and clinically mimic allergic polyps. These patients most commonly present with symptoms of epistaxis and nasal obstruction. Microscopically, these tumours demonstrate a vascular architecture,are composed predominantly of spindle cells, and lack nuclear or cytoplasmic pleomorphism,mitotic activity, haemorrhage or necrosis. These criteria include the presence or absence of mitotic figures, necrosis, anaplasia, and haemorrhage. The present case with early onset in fourth decade with predominantly orbital symptoms, minimal findings on nasal endoscopy and biopsy gives a diagnostic challenge. Treated with complete surgical excision and diagnosis was confirmed by immunohistochemistry reports as a rare SHPCL. Being a locally invasive tumour with very less propensity for metastasis or recurrence, two year of recurrence free endoscopic follow up is sufficiently justified it to be cured.
KEYWORDS sinonasal hemangiopericytoma-like tumour, hemangiopericytomas, glomangiopericytoma
REFERENCES
1. Li XQ, Hisaoka M, Morio T, Hashimoto H. Intranasal pericytictumors (glomus tumor and sinonasal hemangiopericytoma-like tumor): report of two cases with review of the literature. Pathol Int. 2003 May;53(5):303–08.
2. Theilgaard SA, Buchwald C, Ingeholm P, Kornum Larsen S, Eriksen JG, Sand Hansen H. Esthesioneuroblastoma: a Danish demographic study of 40 patients registered between 1978 and 2000. Acta Otolaryngol. 2003;123(3):433–9.
3. Thompson LD, Miettinen M, Wenig BM. Sinonasal-type hemangiopericytoma:a clinicopathologic and immunophenotypic analysis of 104 cases showing perivascular myoiddifferentiation. Am J Surg Pathol. 2003 Jun;27(6):737–49.
4. Thompson L, Fanburg-Smith J, Wenig B. Tumours of the nasal cavity and paranasal sinuses. Borderline and low malignant potential tumours of soft tissue. In Barnes L, Eveson JW, Reichart P, Sidransky D (eds.) World Health Organization (WHO) Classification of Tumours. IARC Press, Lyon, France: Pathology and Genetics of Head and Neck Tumours; 2005. pp. 43–4.
5. Kanazawa T, Nishino H, Miyata M, Kuriki K, Abe K, Ichimura K.Haemangiopericytoma of infratemporal fossa. J Laryngol Otol. 2001 Jan;115(1):77–9.
6. Angouridakis N, Zaraboukas T, Vital J, Vital V. Sinonasal hemangiopericytoma of the middle turbinate: a case report and brief review of the literature. B-ENT. 2007;3(3):139–43.
7. Dandekar M, McHugh JB. Sinonasal glomangiopericytoma: case report with emphasis on the differential diagnosis. Arch Pathol Lab Med. 2010 Oct;134(10):1444–9.
8. Taglialatela Scafati C, D’Antonio A, Taglialatela Scafati S, Scotto di Clemente S, Parascandolo S. Glomangiopericytoma of the pterygomandibular space: an unusual case. Br J Oral Maxillofac Surg. 2007 Dec;45(8):673–5.
9. Thompson LD. Sinonasal tract glomangiopericytoma (hemangiopericytoma). Ear Nose Throat J. 2004 Dec;83(12):807.
10. Gengler C, Guillou L. Solitary fibrous tumour and haemangiopericytoma:evolution of a concept. Histopathology. 2006 Jan;48(1):63–74.
11. Wilson T, Hellquist HB, Ray S, Pickles J. Intranasal myopericytoma. A tumour with perivascular myoid differentiation: the changing nomenclature for haemangiopericytoma. J Laryngol Otol. 2007 Aug;121(8):786–9.
12. Mosesson RE, Som PM. The radiographic evaluation of sinonasal tumors: an overview. Otolaryngol Clin North Am. 1995;28(6):1097–115.
13. Batsakis JG, Jacobs JB, Templeton AC. Hemangiopericytoma of the nasal cavity: electron-optic study and clinical correlations. J Laryngol Otol. 1983 Apr;97(4):361–8.
14. Nielsen GP, Dickersin GR, Provenzal JM, Rosenberg AE. Lipomatous hemangiopericytoma. A histologic, ultractural and immunohistochemical study of a unique variant of hemangiopericytoma. Am J Surg Pathol. 1995 Jul;19(7):748–56.
15. Gillman G, Pavlovich JB. Sinonasal hemangiopericytoma.Otolaryngol Head Neck Surg. 2004 Dec;131(6):1012–3.
16. Palacios E, Restrepo S, Mastrogiovanni L, Lorusso GD, Rojas R. Sinonasal hemangiopericytomas: clinicopathologic and imaging findings. Ear Nose Throat J. 2005 Feb;84(2):99–102.
17. Lin IH, Kuo FY, Su CY, Lin HC. Sinonasal-type hemangiopericytoma of the sphenoid sinus. Otolaryngol Head Neck Surg. 2006 Dec;135(6):977–9.
18. Weber W, Henkes H, Metz KA, Berg-Dammer E, Kühne D.Haemangiopericytoma of the nasal cavity. Neuroradiology. 2001 Feb;43(2):183–6.
19. Thiringer JK, Costantino PD, Houston G. Sinonasal hemangiopericytoma:case report and literature review. Skull Base Surg.1995;5(3):185–90.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: None.
Competing interest / Conflict of interest:
The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
Original article
Rakesh Kumar Shahi1*, P. Nigam2
1 Professor of Medicine, R.D Medical College, Gorakhpur, UP, India
2 Ret. Professor and Head, Department of Medicine, R.D Medical College, Gorakhpur,UP, India
Address reprint requests to
*Dr Rakesh Kumar Shahi,
I-83 Rapti Nagar Phase-IV Near BPCl, Gorakhpur, Uttar Pradesh 273001, India
The name of the department(s) and institution(s) to which the work should be attributed:
B.R.D Medical College, Gorakhpur
Article citation: Kumar RS, Nigam P. Evaluation of troponin T level in acute rheumatic carditis. J Pharm Biomed Sci 2015;05(12):980–983.Available at www.jpbms.info
ABSTRACT
Background Acute rheumatic fever (ARF) is more common in children of many developing countries. Aim The purpose of this study is to test whether it is possible to identify myocardial involvement in cases with rheumatic carditis by the measurement of serum cardiac troponin T (cTnT). Methods Eighty patients diagnosed as ARF underwent echocardiography and their cTnT serum levels were measured. Patients were divided into groups as Cases and Control with 40 patients in each group.Results In Cases 57.5% were male and 42.5% were female. All patients complained about joint pain. In 59% of cases troponin T was not detectable. It was detectable in the range of 0.01–0.05 ng/ml in 35% of cases and it was in the range of 0.05–0.1 ng/ml in 7% of cases of endocarditis and pericarditis. Conclusion Measurement of cTnT may be added to diagnostic accuracy of myocarditis.
KEYWORDS acute rheumatic fever, rheumatic heart disease, Troponin-T
REFERENCES
1.Padmavati S, Gupta V. reappraisal if Jones criteria: the Indian experience Z Med J. 1998;101:391–2.
2.Sharma SD, Gupta RK. Pitfalls in diagnosis of acute rheumatic fever. JK SCIENCE. 2007;9(3):148–9.
3.Jones criteria: 1992 update. JAMA. 1992;268:2069–73.
4.Farah CS, Reinach FCR. The troponin complex and regulation of muscles contraction. FASEB3. 1995;9:755–67.
5.Sallakci N, Akcurin G, Köksoy S, Kardelen F, Uguz A, Coskun M, et al. TNF-alpha G-308A polymorphism is associated with rheumatic fever and correlates with increased TNF-alpha production. J Autoimmun. 2005;25:150–4.
6.Lloyd Y, Tani MD. Rheumatic fever and rheumatic heart disease. In: Allen HD, Driscoll DJ, Shaddy RE, Feltes TF, (eds): Moss and Adams’ Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adults, 7th ed. Philedelphia: Lipincott Williams and Wilkins; 2008. pp. 1257–75.
7.Ertug MH, Yilmaz GG, Akçurin G, Kardelen F, Kocabas A, Gumuslu S, et al. Can troponin T levels be useful in the diagnosis of rheumatic carditis? Ann Pediatr Card. 2011;4:156–8.
8.Trivedi S, Saxena SK, Lalchandani A, Chandra R, Verma CM,Singh RP. Evaluation of Troponin T level in acute rheumatic carditis. Indian J Cardiol. 2013;16(1–2):22–31.
9.Gupta M, Lent RW, Kaplan EL, Zabriskie JB. Serum cardiac troponin I is acute rheumatic fever. Am J Cardiol. 2002;90 (11):1277–8.
10.Missov E, Calzolari C, Pau B. Circulating cardiac Troponin I in severe congestive heart failure. Circulation. 1997;96:2953–8.
11.Alehan D, Ayabakan C, Hallioglu O. Role of serum cardiac Troponin T in the diagnosis of acute rheumatic fever and rheumatic carditis. Heart. 2004;90:689–90.
12.Oran B, Coban H, Karaaslan S, Atabek E, Gurbilek M, Erkul I.Serum cardiac troponin-I in active rheumatic carditis. Indian J Pediatr. 2001;68(10):943–4.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
Case Report
Sandhya Manorenj1*,Aditya Malladi1,Dinesh Alla2,Deepthi Punugunta1
1 Department of Neurology, ESIC Superspeciality Hospital, Sanathnagar,Hyderabad, India
2 Department of Radiology, ESIC Superspeciality Hospital, Sanath Nagar Hyderabad, India
Address reprint requests to
*Dr Sandhya Manorenj,
Neurologist and Head, Department of Neurology, Employee State Insurance Corporation, Superspeciality Hospital, Sanath Nagar, Hyderabad, India
Article citation: Manorenj S, Malladi A, Alla D, Punugunta D. An unusual case of recurrent Guillain-Barré syndrome of a different subtype five years after initial diagnosis. J Pharm Biomed Sci 2015;5(12):976–979.Available at www.jpbms.info
ABSTRACT
Guillain-Barré syndrome (GBS) is generally considered to be monophasic, but recurrences do occur in some patients. We report a case of a 57-year-old male, hypertensive,euglycaemic with prior history of GBS 7 years ago, presented with ascending paraesthesia of all four limbs without prior antecedent infection, followed by subsequent quadriparesis,facial paresis, areflexia with reduced single breath count. Nerve conduction study showed sensory motor demyelinating polyradiculoneuropathy with evidence of conduction block.
Cerebrospinal fluid analysis showed lymphocyte pleocytosis. Magnetic resonance imaging of spine with contrast showed spinal nerves, lumbar plexus roots and cauda equina root enhancement. He recovered from Hughes’s grade 4 to Hughes’s grade 2 following 5 days of intravenous immunoglobin treatment. Our case represents a recurrence of GBS of AIDP variant with lymphocyte predominant CSF pleocytosis, lumbar and cauda equina root enhancement and response to intravenous immunoglobin in a middle-aged male.
KEYWORDS recurrent Guillain-Barré syndrome, lymphocyte pleocytosis, cauda equina root enhancement.
REFERENCES
1.Kuitwaard K, van Koningsveld R, Ruts L, Jacobs BC, van Doorn PA. Recurrent Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry. 2009 Jan;80(1):569.[PubMed]
2.Mossberg N, Nordin M, Movitz C, Nilsson S, Hellstrand K, Bergström T, et al. The recurrent Guillain Barré syndrome: a long-term population-based study. Acta Neurologica Scandinavica. 2012;126(3):154–61.
3.Huan M, Smith AG. Weakness, (Guillain-Barré syndrome).Emergency Neurol. 2012:211–34.
4.Das A, Kalita J, Misra UK. Recurrent Guillain Barré syndrome. Electromyogr Clin Neurophysiol. 2004;44(2):95–102.
5.Taly AB, Gupta SK, Anisya V, Shanker SK, Rao S, Das KB, et al. Recurrent Guillain Barre’ syndrome: a clinical, electrophysiological and morphological study. J Assoc Physicians India. 1995 Apr;43(4):249–52.
6.Gupta V, Kohli A. Celiac disease associated with recurrent Guillain Barre syndrome. Indian Pediatr. 2010 Sep;47(9):797–8.
7.Grand’Maison F, Feasby TE, Hahn AF, Koopman WJ.Recurrent guillain-Barre syndrome. Clinical and laboratory features. Brain. 1992;115(4):1093–106.
8.Baba M, Matsunaga M, Narita S, Liu H. Recurrent Guillain-Barré syndrome in Japan. Internal Med. 1995;32(10):1015–18.
9.Jones HR Jr. Childhood Guillain-Barre syndrome: clinical presentation, diagnosis, and therapy. J Child Neurol. 1996;11(1):4–12.
10.Hadden RDM. Deterioration after Guillain-Barré syndrome:recurrence, treatment-related fluctuation or CIDP. J Neurol Neurosurg Psychiatry. 2009;80(1):3.
11.Dy M, Leshner RL, Crawford JR. An unusual case of recurrent Guillain-Barre syndrome of a different subtype five years after Initial diagnosis. Case Rep Neurol Med. 2013;2013:356157.
12.Rauschka H, Jellinger K, Lassmann H, Braier F, Schmidbauer M. Guillain-Barré syndrome with marked pleocytosis or a significant proportion of polymorphonuclear granulocytes in the cerebrospinal fluid: neuropathological investigation of five cases and review of differential diagnoses. Eur J Neurol. 2003 Sep;10(5):479–86.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Source of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents,and royalties through this collaborative research.All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the
official policy or position of the Department of Defense.
Review article
Ajmera Deepal Haresh1,2,3, Pradeep Singh1,2,4,Jinlin Song1,2,3*1
1College of Stomatology, Chongqing Medical University, Choongqing, China
2Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
3 Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
4Department of Oral and Maxillofacial Surgery, College of Stomatology, Chongqing Medical University, Chongqing, China
Address reprint requests to
*Jinlin Song, MD, PhD,
Vice President,College of Stomatology, Chongqing Medical University, 426, Songshibei Road, Yubei District, Chongqing, P.R. China Post: 401147
Article citation: Ajmera DH, Singh P, Song J. Soft tissue thickness determination using CBCT in diverse medical disciplines. J Pharm Biomed Sci 2015;05(12):967–972. Available at www.jpbms.info
Abstract:
Accuracy of facial soft tissue thickness has been an important step in formulating a treatment plan for various procedures in the field of oral, maxillofacial health care as well as forensic science. There are various methods to measure soft tissue thickness but accuracy of these methods is questionable till date. The aim of this article is to make people aware of the new technology i.e., cone beam computed tomography (CBCT) its role, accuracy and its reliability in measuring the thickness of the facial and oral soft tissues, which will further help in improving the treatment plan followed by better results. Therefore, we conducted online searches and with all kinds of evidence exists we have provided the readers an overview on this new imaging modality in measuring the thickness on various soft tissue landmarks. Using routine scanning protocols we found out that cone beam CT images are reliable for measuring soft tissue thickness in the orofacial region and give a good representation of the orofacial soft tissues.
KEYWORDS CBCT, 3D technique, soft tissue thickness, facial reconstruction, facial asymmetry, gingivay.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of Support: Project supported by (1) The Program For Innovation Team Building at Institutions of WHO Education in Chongqing;(2) The Program for Innovation Team Building at Institutions of Higher Education in Chongqing in 2013; and (3) The National Clinical Key Specialty Constitution Program of China for 2013–2014.
Acknowledgements: The Affiliated Hospital of Stomatology, Chongqing Medical University.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research.
The authors Ajmera Deepal Haresh and Pradeep Singh contributed equally to this manuscript and authors Ajmera Deepal Haresh and Pradeep Singh should be considered as first joint authors. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
References:
1.Greenberg J, Laster L, Listgarten MA. Transgingival probing as a potential estimator of alveolar bone level. J Periodontol.1976;47(9):514–7.
2.Wara-aswapati N, Pitiphat W, Chandrapho N, Rattanayatikul C, Karimbux N. Thickness of palatal masticatory mucosa associated with age. J Periodontol. 2001;72(10):1407–12.
3.Vu T, Bayome M, Kook YA, Han SH. Evaluation of the palatal soft tissue thickness by cone-beam computed tomography. Korean J Orthodont. 2012;42(6):291–6.
4.Grayson B, Cutting C, Bookstein FL, Kim H, McCarthy JG. The three-dimensional cephalogram: theory, technique, and clinical application. Am J Orthod Dentofacial Orthop. 1988 Oct;94(4):327–37.
5.Fourie Z, Damstra J, Gerrits PO, Ren Y. Accuracy and repeatability of anthropometric facial measurements using cone beam computed tomography. Cleft Palate Craniofac J. 2011 Sep;48(5):623–30.
6.Farkas LG, Bryson W, Klotz J. Is photogrammetry of the face reliable? Plast Reconstr Surg. 1980 Sep;66(3):346–55.
7.Shintaku WH, Venturin JS, Azevedo B, Noujeim M. Applications of cone-beam computed tomography in fractures of the maxillofacial complex. Dent Traumatol. 2009 Aug;25(4):358–66.
8.Sukovic P. Cone beam computed tomography in craniofacial imaging. Orthod Craniofac Res. 2003;6 Suppl 1:31–6; discussion 179–82.
9.De Greef S, Claes P, Vandermeulen D, Mollemans W, Suetens P, Willems G. Large-scale in-vivo Caucasian facial soft tissue thickness database for craniofacial reconstruction. Forensic Sci Int. 2006 May 15;159(Suppl 1):S126–46.
10.Phillips VM, Smuts NA. Facial reconstruction: utilization of computerized tomography to measure facial tissue thickness in a mixed racial population. Forensic Sci Int. 1996 Nov 11;83(1):51–9.
11.Fourie Z, Damstra J, Gerrits PO, Ren Y. Accuracy and reliability of facial soft tissue depth measurements using cone beam computer tomography. Forensic Sci Int. 2010 Jun 15;199 (1–3):9–14.
12.Amit K Nayar DGT. Facial profile approximation—a simplified technique. Int J Appl Res Studies. 2012;I(II):218.
13.Gerasimov MM. The Face Finder. Philadelphia, PA: JB Lippincott Co.; 1971.
14.Aulsebrook WA, Iscan MY, Slabbert JH, Becker P. Superimposition and reconstruction in forensic facial identification: a survey. Forensic Sci Int. 1995 Oct 30;75(2-3):101-20.
15.Prag J, Neave R. Making Faces: Using Forensic and Archaeological Evidence. London: British Museum Press; 1997.
16.Taylor KT. Forensic Art and Illustration. Boca Raton: CRC Press; 2001.
17.Wilkinson C. Forensic Facial Reconstruction. Cambridge:Cambridge University Press; 2004.
18.Kim KD, Ruprecht A, Wang G, Lee JB, Dawson DV, Vannier MW.Accuracy of facial soft tissue thickness measurements in personal computer-based multiplanar reconstructed computed tomographic images. Forensic Sci Int. 2005 Dec 1;155(1):28–34.
19.Aulsebrook WA, Becker PJ, Yaşar MY. Facial soft-tissue thicknesses in the adult male Zulu. Forensic Sci Int. 1996;79(2):83–102.
20.Aulsebrook WA, Becker PJ, Yaşar MY. An evaluation of two techniques used for facial reconstruction in forensic anthropology. S Afr J Sci. 1986;82:448.
21.Krogman WM, Yaşar MY. The Human Skeleton in Forensic Medicine. Springfield, IL:Charles C. Thomas; 1986.
22.Suzuki K. On the thickness of the soft parts of the Japanese face. J Anthropol Sot Nippon. 1948;60:7–11.
23.Rhine JS, Campbell HR. Thickness of facial tissues in American blacks. J Forensic Sci. 1980;25(4):847–58.
24.George RM. The lateral craniographic method of facial reconstruction. J Forensic Sci. 1987;32:1305–30.
25.Lebedinskaya GV, Balueva TS, Vaselovskaya VS. Principles of facial reconstruction. In: Forensic Analysis of the Skull. New York: Wiley-Liss; 1993.
26.Farman AG, Scarfe WC. Development of imaging selection criteria and procedures should precede cephalometric assessment with cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2006 Aug;130(2):257–65.
27.Moerenhout BA, Gelaude F, Swennen GR, Casselman JW, Van Der Sloten J, Mommaerts MY. Accuracy and repeatability of cone-beam computed tomography (CBCT) measurements used in the determination of facial indices in the laboratory setup. J Craniomaxillofac Surg. 2009 Jan;37(1):18–23.
28.Heiland M, Pohlenz P, Blessmann M, Habermann CR, Oesterhelweg L, Begemann PC, et al. Cervical soft tissue imaging using a mobile CBCT scanner with a flat panel detector in comparison with corresponding CT and MRI data sets. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Dec;104(6):814–20.
29.Bittner C, Pancherz H. Facial morphology and malocclusions.Am J Orthod Dentofacial Orthop. 1990;97(4):308–15.
30.Kim WS, Lee KH, Hwang HS. Comparison of asymmetric degree between maxillofacial hard and soft tissue in facial asymmetric subjects using three dimensional computed tomography. Korean J Orthodont. 2005;35:163–73.
31.Hwang HS, Yuan D, Jeong KH, Uhm GS, Cho JH, Yoon SJ. Three-dimensional soft tissue analysis for the evaluation of facial asymmetry in normal occlusion individuals. Korean J Orthodont. 2012;42(2):56–63.
32.Proffit WR, Fields Jr WJ, Sarver DM. Contemporary Orthodontics,4th ed. St Louis: Mosby; 2007.
33.Proffit WR, Phillips C, Dann CT. Who seeks surgical-orthodontic treatment? Int J Adult Orthodont Orthognath Surg. 1990;5(3): 153–60.
34.Edler R, Wertheim D, Greenhill D. Comparison of radiographic and photographic measurement of mandibular asymmetry. Am J Orthod Dentofacial Orthop. 2003;123(2):167–74.
35.Lee JK, Jung PK, Moon CH. Three-dimensional cone beam computed tomographic image reorientation using soft tissues as reference for facial asymmetry diagnosis. Angle Orthod. 2014 Jan;84(1):38-47.
36.Severt TR, Proffit WR. The prevalence of facial asymmetry in the dentofacial deformities population at the University of North Carolina. Int J Adult Orthodon Orthognath Surg. 1997;12(3):171–6.
37.Farkas LG. Anthropometry of the Head and Face, 2nd ed.New York: Raven Press; 1994.
38.Cavalcanti MG, Vannier MW. Quantitative analysis of spiral computed tomography for craniofacial clinical applications.Dentomaxillofac Radiol. 1998;27(6):344–50.
39.Periago DR, Scarfe WC, Moshiri M, Scheetz JP, Silveira AM,Farman AG. Linear accuracy and reliability of cone beam CT derived 3-dimensional images constructed using an orthodontic volumetric rendering program. Angle Orthodontist. 2008;78(3):387–95.
40.Yoon SJ, Wang RF, Na HJ, Palomo JM. Normal range of facial asymmetry in spherical coordinates: a CBCT study. Imaging Sci Dentist. 2013;43(1):31–6.
41.Katsumata A, Fujishita M, Maeda M, Ariji Y, Ariji E, Langlais RP. 3D-CT evaluation of facial asymmetry. Oral Surg Oral Med Oral Pathol Oral Radiol Endodont. 2005;99(2):212–20.
42.Maeda M, Katsumata A, Ariji Y, Muramatsu A, Yoshida K, Goto S, et al. 3D-CT evaluation of facial asymmetry in patients with maxillofacial deformities. Oral Surg Oral Med Oral Pathol Oral Radiol Endodont. 2006;102(3):382–90.
43.AlHadidi A, Cevidanes LH, Mol A, Ludlow J, Styner M. Comparison of two methods for quantitative assessment of mandibular asymmetry using cone beam computed tomography image volumes. Dentomaxillofac Radiol. 2011 Sep;40(6):351–7.
44.Broadbent BH. A new x-ray technique and its application to orthodontia. Angle Orthodont. 1981;51(2):93–114.
45.Ueno D, Sekiguchi R, Morita M, Jayawardena A, Shinpo S, Sato J, Kobayashi K. Palatal mucosal measurements in a Japanese population using cone-beam computed tomography. J Esthet Restor Dent. 2014 Jan-Feb;26(1):48–58.
46.Spear FM, Kokich VG, Mathews DP. Interdisciplinary management of anterior dental esthetics. J Am Dent Assoc. 2006; 137(2):160–9.
47.Januario AL, Barriviera M, Duarte WR. Soft tissue cone-beam computed tomography: a novel method for the measurement of gingival tissue and the dimensions of the dentogingival unit. J Esthet Restor Dent. 2008;20(6):366–73; discussion 374.
48.Muller HP, Eger T. Gingival phenotypes in young male adults. J Clin Periodontol. 1997;24(1):65–71.
49.Wolf HF, Rateitschak-Pluss, Klaus H, et al. Color Atlas of Dental Medicine—Periodontology, 3rd ed. Stuttgart (Germany): Thieme; 2004. Anthony WG, Wentz FM, Orban B. Dimensions and relations of the dentogingival junction in humans. J Periodontol. 1961;32(3):261–7.
51.Savitha B, Vandana KL. Comparative assesment of gingival thickness using transgingival probing and ultrasonographic method. Ind J Dent Res. 2005;16(4):135–9.
52.Kobayashi K, Shimoda S, Nakagawa Y, Yamamoto A. Accuracy in measurement of distance using limited cone-beam computerized tomography. Int J Oral Maxillofac Implants. 2004 Mar-Apr;19(2):228–31.
53 Muller HP, Schaller N, Eger T. Ultrasonic determination of thickness of masticatory mucosa: a methodologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Aug;88(2): 248–53.
54.Mah J, Hatcher D. Current status and future needs in craniofacial imaging. Orthod Craniofac Res. 2003;6 Suppl 1:10–6; discussion 179–82.
55.Mormann W, Schaer F, Firestone AR. The relationship between success of free gingival grafts and transplant thickness. Revascularization and shrinkage—a one year clinical study. J Periodontol. 1981;52(2):74–80.
56.Kim HJ, Yun HS, Park HD, Kim DH, Park YC. Soft-tissue and cortical-bone thickness at orthodontic implant sites. Am J Orthod Dentofacial Orthop. 2006 Aug;130(2):177–82.
57.Eger T, Muller HP, Heinecke A. Ultrasonic determination of gingival thickness. Subject variation and influence of tooth type and clinical features. J Clin Periodontol. 1996;23(9): 839–45.
58.Studer SP, Allen EP, Rees TC, Kouba A. The thickness of masticatory mucosa in the human hard palate and tuberosity as potential donor sites for ridge augmentation procedures. J Periodontol. 1997;68(2):145–51.
59.Lawson RB, Jones ML. An evaluation of a noninvasive method of assessing alveolar bone levels in an experimental model of cleft lip and palate. Cleft Palate Craniofac J. 1998 Jan;35(1):1–8.
60.Ueno D, Sato J, Igarashi C, Ikeda S, Morita M, Shimoda S, et al. Accuracy of oral mucosal thickness measurements using spiral computed tomography. J Periodontol. 2011;82(6): 829–36.
61.Song JE, Um YJ, Kim CS, Choi SH, Cho KS, Kim CK, et al. Thickness of posterior palatal masticatory mucosa: the use of computerized tomography. J Periodontol. 2008;79(3):406–12.
62.Al-Ekrish AA, Ekram M. A comparative study of the accuracy and reliability of multidetector computed tomography and cone beam computed tomography in the assessment of dental implant site dimensions. Dentomaxillofac Radiol. 2011;40(2):67–75.
63.Suomalainen A, Vehmas T, Kortesniemi M, Robinson S, Peltola J. Accuracy of linear measurements using dental cone beam and conventional multislice computed tomography. Dentomaxillofac Radiol. 2008;37(1):10–7.
64.Ludlow JB, Ivanovic M. Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Jul;106(1):106–14.
65.Barriviera M, Duarte WR, Januario AL, Faber J, Bezerra AC. A new method to assess and measure palatal masticatory mucosa by cone-beam computerized tomography. J Clin Periodontol. 2009;36(7):564–8.
66.Guerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging for preoperative planning of implant placement. Clin Oral Investig. 2006 Mar;10(1):1–7.
67.Dvorak G, Arnhart C, Schon P, Heuberer S, Watzek G, Gahleitner A. The “puffed cheek method” to evaluate mucosal thickness: case series. Clin Oral Implants Res. 2013 Jul;24(7):719–24.
68.Muller HP, Schaller N, Eger T, Heinecke A. Thickness of masticatory mucosa. J Clin Periodontol. 2000;27(6):431–6.
69.Hoste S, Vercruyssen M, Quirynen M, Willems G. Risk factors and indications of orthodontic temporary anchorage devices: a literature review. Aust Orthod J. 2008 Nov;24(2):140–8.
70.Chen YJ, Chang HH, Huang CY, Hung HC, Lai EH, Yao CC. A retrospective analysis of the failure rate of three different orthodontic skeletal anchorage systems. Clin Oral Implants Res. 2007 Dec;18(6):768–75.