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ABSTRACTS BARNETT R, SHUSTERMAN S. Fetal Alcohol

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ABSTRACTS BARNETT R, SHUSTERMAN S. Fetal Alcohol ABSTRACTS BARNETT R, SHUSTERMAN S. Fetal alcohol syndrome: a review of literature and report of cases, J Am Dent Assoc 1985; 111:591-593. The purpose of this article is to describe the more distinctive features of fetal alcohol syndrome (FAS) and to report two clinical cases. Children with this condition have prenatal and postnatal growth deficiency, central nervous system dysfunction, and facial dysmorphology. Included among other facial characteristics are microcephaly, hypoplastic maxilla, indistinct philtrum, hypoplastic upper lip, prominent lateral palatine ridges, microdontia, and cleft palate. These authors report two patients with characteristic features of FAS. One is a 15-year-old black male; the other, a 7.5-year-old Hispanic female. Since the ingestion of alcohol during pregnancy has become one of the most common teratogens to which the fetus may be exposed, this article outlines the clinical features of this syndrome to assist the dentist in identifying affected children and in managing their special treatment needs. (Ranalli) Reprints: Dr. Stephen Shusterman Department of Dentistry The Children's Hospital 300 Longwood Avenue Boston, MA 02115 BEnnUN RD, MuULuIKEN JB, KaBan LB, MurrRAy JE. Microtia: a microform of hemifacial microsomia. Plast Reconstr Surg 1985; 76:859-865. This paper retrospectively details the occurrence of isolated microtia at the Harvard Hospital Medical School from 1974 through 1983. This group was distinct from those patients with an established diagnosis of hemifa- cial microsomia. Findings disclosed a 12 percent incidence of ipsilateral facial nerve weakness, all in patients with Grade III microtia. The degree of facial nerve weakness correlated with the grade of the auricular deformity and not the severity of the mandibular hypoplasia. Radiologic findings disclosed the expected stenosis or atresia of the external auditory canal. In addition, there was a right-sided preponderance, an incidence of associated cleft lip and palate, a male predilection, and an equivocal mode of inheritance. Discussion of this article by Dr. David Poswillo reviewing his own personal series concurs with the hypothesis that ear, jaw, and seventh nerve defects are expressions to a greater or lesser degree of the phenomenon of abnormal cell death in the stapedial region with disorganization of actively differentiating tissues by hematoma formation at the anastomosis of the hyoid and ascending pharyngeal arteries before the external carotid system develops. In addition, he feels there is abnormal descent of the middle cranial fossa between the arcuate eminence and squamous temporal bone, sharpening the differentiation between unilateral microtia and the microforms of hemifacial microsomia. This sign is reportedly pathonomatic of the so-called first and second anomalies, thus distinguishing them from mandibulofacial dysostosis. It is in the condition of mandibulofacial dysostosis that the disorganization of mesenchyme also produces ear and/or jaw defects, but the radiologic changes of the middle ear are distinctly different. Thus, the clinician's attention should be drawn to the sig- nificance of microtia as an early marker of mandibular growth deficiency. (Snively) Reprints: Dr. John B. Mulliken The Children's Hospital 300 Longwood Avenue Boston, Mass 02115 237 2,38~ Cleft Palate Journal, July 1986, Vol. 23 No. 3 BIsHARA SE, ARRENDONDO RSM, VALES HP, FAL JA. Dentofacial findings in two individuals with unoperated bilateral cleft lip. Am J Orthod 1985; 88:22-30. The authors described two females, 5 and 12 years of age, one with a bilateral cleft of the lip, the other 'with a bilateral cleft of the lip and alveolus, but without a cleft of the secondary palate. Cephalogram, panorex, dental cast, and photographic records were presented and discussed. (Staley) Reprints: Dr. Samir E. Bishara Department of Orthodontics University of Iowa Towa City, Iowa 52242 BISHARA SE, JAKOBSEN JR. Longitudinal changes in three normal facial types. Am J Orthod 1985; 88:466-501. Longitudinal cephalometric data taken from 20 males and 15 females between ages 5 and 25 years who were classified into three vertical facial types were analyzed in a study of facial growth in the three facial types. Most subjects had the same facial type at 5 and 25 years of age. Growth curves of the measured parameters were parallel in three types. Significant sex differences within the face types were found in dentofacial parameters, and longitudinal analysis of the data showed more consistent findings than cross-sectional analysis. (Staley) Reprints: Dr. Samir E. Bishara Department of Orthodontics University of Iowa Iowa City, Iowa 52242 BIsHARA SE, WILSON LE, PEREZ PT, O'CONNOR JE, PENICHE RH. Dentofacial findings in a child with unrepaired median cleft of the lip at 4 years of age. Am J Orthod 1985; 88:157-162. The authors described the pretreatment dentofacial, audiometric, tympanometric, and speech findings of a patient who had this rare type of facial cleft. The patient had normal head form, cephalometric findings, dentition, and hearing. His speech demonstrated nasal emission and hypernasality. The surgery that corrected the abnormally aligned upper lip musculature was described. (Staley) Reprints: Dr. Samir E. Bishara Department of Orthodontics University of Iowa College of Dentistry Iowa City, Iowa 52242 Boo-CHAI K. The proboscis lateralis-a 14-year follow-up. Plast Reconstr Surg 1985; 75:569-577. The author reports his treatment of an infant with proboscis lateralis and provides a classification of this unusual congenital defect and a review of 34 reported cases. The four groups are proboscis lateralis, a normal nose, adnexa, and a fourth group with cleft lip or palate or both added to the nasal, eye, and adnexal defects. The reported patient had all four defects. Nasal reconstruction was accomplished first, followed by bilateral cleft lip repair in two stages and a Wardill-Kilner pushback repair of the palate. Although orbital reconstruc- tion had not yet been accomplished by age 14 years, further nasal revision was planned. Dilatation of the canal of the proboscis was performed to provide tissue for nasal reconstruction. (Trier) Reprints: Dr. Khoo Boo-Chai 621 Geylang Road Singapore 1438 ABSTRACTs 239 CAHILL DR. Parasagittal anatomy of the head and neck. Mayo Clin Proc 1986; 61:127-139. Modern imaging techniques and plans for surgery entail thorough knowledge of anatomic details. One of the common planes selected for visualization of the central nervous system, the spine, and the visceral and muscle compartments of the head and neck area is the sagittal projection. Midsagittal plane views are found in many references, but parasagittal views are not often available. In this paper, the author presents a series of illustrations of four parasagittal planes through the head and neck. There are two to four drawings of each section and two orientation views. The drawings are intended to relate to a general audience, so detail was given to each of the major systems and no attempt was made to relate them to particular clinical applica- tions. The drawings are black and white, very precise and extremely well done, and have excellent labels. Facial anomalies, per se, are not the focus of this manuscript, but the information contained in this paper should be of interest to all who deal with head and neck problems. (Gregg) Reprints: Dr. D.R. Cahill Department of Anatomy Mayo Clinic Rochester, MN 55905 DIEwERT VM. Development of human craniofacial morphology during the late embryonic and early fetal periods. Am J Orthod 1985; 88:64-76. The author studied facial growth in 55 human fetuses ranging in age from 6 to 12 weeks post conception. Measurements were taken from medial and coronal sections. Facial structures grew predominately in the sagittal plane, with a four-fold increase in length and a two-fold increase in height, but little change in width. During the 2 weeks before the palatal shelves elevated, the angular relations between the anterior cranial base and the maxilla and mandible increased by 25 degrees and 30 degrees respectively. The cranial base angle and achieved maxillary angulation to the anterior cranial base were similar to angulations present later, prenatally and postnatally. The significance of the findings was discussed. (Staley) Reprints: Dr. Virginia M. Diewert Department of Orthodontics Faculty of Dentistry University of British Columbia 2199 Wesbrook Mall Vancouver, British Columbia Canada V6T 127 FARKAS LG, HRECZKO TA, KoraArR JC, Munro IR. Vertical and horizontal proportions of the face in young adult North American Caucasions: revision of the neoclassical canons. Plast Reconstr Surg 1985; 75:328-337. Facial proportions used by plastic surgeons, orthodontists, and others in judging the aesthetic harmony of facial features are derived from the work of scholars and artists of the Renaissance based on classical Greek canons and described by artist-anatomists of the seventeenth to nineteenth centuries. The authors tested the validity of nine of these neoclassical canons by comparing them with normal data obtained from measure- ments of North American Caucasian children and young adults. Variations of the neoclassical canons were identified and their frequency determined in a group of 153 young adults. The frequency of recurrence and incidence of six of the nine neoclassical canons were calculated. Four canons concerned vertical measure- ments of the face: head height equals face height, head-nose-lower face height in three equal dimensions, scalp-forehead-nose-lower face in equal quarters, and nose length equal to ear length. Four other canons con- cerned horizontal relationships: interocular distance equals inter-alar base distance; interocular distance equals width of palpebral fissure; mouth width equals 1% inter-alar base distance; and inter-alar base distance equals 4 facial width of the level of the zygomatic prominences. Finally, the canon of nasal bridge inclination equalling the inclination of the longitudinal axis of the auricle was tested. The two canons show to be valid most often 240 -_ Cleft Palate Journal, July 1986, Vol. 23 No.
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