Unilateral cleft lip/palate children: the incidence of type 6 septal deformities in their parents

BACKGROUND

The overall incidence of pathological septal deformity has been found to be significantly higher in unilateral cleft lip/palate (UCLP) children than in control children. Of the seven types of septal deformity according to Mladina's classification, type 6 has been found to be the most frequent in UCLP children, occurring in only 3.7% of the control children.

OBJECTIVE

To investigate the incidence of type 6 septal deformity in the parents of UCLP children.

PATIENTS AND METHODS

UCLP children (N=62) and their parents (N=91) were examined for type 6 septal deformities.

RESULTS

Type 6 was found in at least one parent of a UCLP child in 58% of cases. However, it was not found in the parents whose UCLP children did not show a type 6 septal deformity.

CONCLUSION

Type 6 septal deformity is almost a rule in children suffering from UCLP. Type 6 was not seen in the parents whose UCLP children did not show a type 6 septal deformity. There is a morphogenetic predisposition for the development of CLP in children whose parents carry a type 6 septal deformity.

Nasal septal deformities in ear, nose, and throat patients: an international study

PURPOSE

The purpose of this study was to investigate the incidence and characteristics of nasal septum deformities in ear, nose, and throat (ENT) patients in various geographic regions in the world.

MATERIALS AND METHODS

Anterior rhinoscopy without nasal decongestion was performed in 17 ENT centers in 14 countries. The septal deformities were classified according to the classification system proposed by Mladina.

RESULTS

A total of 2589 adult ENT patients (1500 males and 1089 females) were examined. Septal deformities were found in 89.2% of subjects. Left-sided deformities were slightly more prevalent than right-sided deformities (51.6% and 48.4%, respectively). The most frequent type of deformity was type 3 (20.4%). Straight septum was found in 15.4% of females and 7.5% of males.

CONCLUSIONS

Almost 90% of the subjects showed 1 of the 7 types of septal deformity. There were no statistically significant differences in the incidence of their appearance among particular geographic regions. Type 3 was the most frequent type. Straight septum was twice as frequent in females than in males.

Are some septal deformities inherited? Type 6 revisited

OBJECTIVE

There has been little research into inherited septal deformities. While, Pejić carried out a study some 50 years ago, and Grymer more recently suggested that some posterior septal deformities could be inherited, both studies lack a precise definition of the types of septal deformities which were investigated. The aim of this paper is to investigate the hypothetic influence of heredity on the onset of particular types of septal deformities. The authors investigated a very particular and well defined type of septal deformity: type 6 after Mladina's classification.

METHODS

The authors studied a group of 22 children among 779 children aged 7-14, selected at random, suffering from type 6 septal deformity and their 44 parents. They were examined by means of anterior rhinoscopy by two the same ENT specialists in rhinology. The control group consisted of 24 children with a straight nasal septum of the same age and sex distribution and their 48 parents. The results were compared using Fisher's exact probability test.

RESULTS

In the studied group type 6 septal deformity was found in 21 out of 22 both fathers and mothers of these children. Type 6 was not found in any of 48 parents of children with no septal deformity.

CONCLUSIONS

There is a high positive correlation between the appearance of type 6 septal deformities in both mothers and fathers of children with this type of deformity. The high correlation in the incidence of type 6 nasal deformity in mothers and their children and in fathers and their children suggests that this type of nasal deformity is inherited. Most authors hold that only posterior septal deformities result from inheritance factors, while anterior deformities result from environmental factors, that is, from injury to the nose and the central massif of the face. However, our study of type 6 deformities shows that certain types of anterior deformities can be inherited.

An unusual case of heminasal aplasia: proboscis lateralis or cystic teratoma?

Unilateral aplasia of the nose is a rare congenital malformation. It is often associated with other malformations of the facial region, including abnormalities of the eye and lacrimal system, proboscis lateralis, and facial bone malformations. The authors present a case of heminasal aplasia in a 4-year-old boy who underwent surgery immediately after birth because of right-sided proboscis lateralis. A huge hemispheric tumefaction was occupying a large part of the right orbit, medial canthus, and frontonasal region of the face, causing lateroinferior protrusion of the eyeball. The right half of the external nose was aplastic. The patient was operated on by an external approach. The pathohistological findings from the top of tumefaction revealed cystic teratoma. The possible backgrounds for the onset of the tumefaction are discussed in two main directions: the cystic form of the regrowth of the remnants of inadequately excised proboscis lateralis and cystic teratoma of the ethmoidal sinus.

Osteoma of the internal auditory canal

Osteomas of the internal auditory canal, inaccesible to clinical examination, are rare lesions. There are only 14 cases of osteomas and exostoses of the internal auditory canal reported in the international medical literature. A patient with an osteoma of the internal auditory canal is presented, along with differential diagnosis and possible etiologic factors for the lesion. The auditory brainsteam evoked response testing showed increased absolute latencies of 1 wave and discrepancy of the wave morphology due to bony compression of the eight nerve in the internal auditory canal. Computed tomography showed a bony growth in the internal auditory canal. Magnetic response showed no abnormalities. No surgery was performed since the symptoms improved by conservative therapy.

Correlation between the minimal cross-sectional area of the nasal cavity and body surface area: preliminary results in normal patients

Nasal symptoms often are inconsistent with rhinoscopic findings. However, the proper diagnosis and treatment of nasal pathology requires an objective evaluation of the narrow segments of the anterior part of the nasal cavities (minimal cross-sectional area [MCSA]). The problem is that the value of MCSA is not a unique parameterfor the entire population, but rather it is a distinctive valuefor particular subject (or smaller groups of subjects). Consequently, there is a need for MCSA values to be standardized in a simple way that facilitates the comparison of results and the selection of our treatment regimens. We examined a group of 157 healthy subjects with normal nasal function. A statistically significant correlation was found between the body surface area and MCSA at the level of the nasal isthmus and the head of the inferior turbinate. The age of subjects was not found a statistically significant predictor for the value of MCSA. The results show that the expected value of MCSA can be calculated for every subject based on anthropometric data of height and weight.

Nasal septum deformities in children and adolescents: a cross sectional study of children from Zagreb, Croatia

OBJECTIVE

Numerous epidemiologic studies on the prevalence of nasal septum deformities in children have been performed over the last three decades. As these studies were performed in children of various age groups and used different classifications of septal deformities (without detailed morphologic systematization), it is no surprise that the results differ greatly from study to study. The purpose of the study was to evaluate clinical data on the total prevalence of nasal septum deformities and particular types of deformity in children and adolescents.

METHODS

The study population consisted of 1797 randomly selected subjects divided into pre-school (aged 2-6), primary school (aged 7-14), secondary school (aged 15-18) and university (aged 19-22) groups. The native state was determined by means of anterior rhinoscopy without previous application of vasoconstrictive drugs. The observed pathologic septal deformities were classified into seven types according to Mladina's classification. A straight septum was designated as S. The prevalence of septum deformities in the population was calculated with 95% probability. Differences with respect to sex and types of deformity were tested by chi(2)-test.

RESULTS

The prevalence of nasal septum deformities according to age groups was 28.0% in the 2-6 group, 21.1% in the 7-14 group, 40.6% in the 15--18 group and 41.8% in the 19-22 group. The distribution of the seven types of septal deformity was 51.1, 23.5, 5, 0.8, 10.0, 9.0 and 0.6%, respectively. The mean values (%) and 95% confidence intervals for the seven types of septal deformity were 14.7 (13.1-16.4%), 6.8 (5.6-7.9%), 1.4 (0.9-1.9%), 0.2 (0.0-0.4%), 2.9 (2.1-3.7%), 2.6 (1.9-3.4%) and 0.2 (0.0-0.4%), respectively. Total distribution in gender showed no difference (P = 0.102).

CONCLUSIONS

In the youngest age group (2-6 years), types 1 and 2 (deformities of anterior septal segments) were exclusively found, whereas types 5 and 6 were found in older age groups (become visible during and after the puberty). Types 1 and 2 are characteristic septal deformities for small children. Since, septal deformities can affect the growth and development of the maxilla and vice versa, the authors recommend examination of the nasal septum by an rhinologist who will be a part of a team performing the regular systematic health examination of children.