Andres Godoy

Not just another face in the crowd: society's perceptions of facial paralysis.

There is a paucity of data showing the perception penalty caused by facial paralysis. Our objective was to measure societys perception of facial paralysis on the characteristic of beauty. We hypothesized that patients with paralysis would be considered by society as less attractive than normals, a difference amplified by smiling.

Bacterial Pattern in Chronic Sinusitis and Cystic Fibrosis

Objective. To assess the association between pathogenic bacteria found in bronchoalveolar lavages and paranasal cavity cultures in patients with cystic fibrosis (CF) who underwent endonasal endoscopic sinus surgery. The authors hypothesized that the pathogenic bacterial pattern of the upper airway would be associated with that of the lower airway. Study Design. Prospective case series with planned data collection. Setting. Tertiary referral center. Subjects and Methods. A group of 16 patients with diagnosis of CF who underwent endonasal endoscopic sinus surgery from July 2001 to August 2009 participated in the study. Culture samples were obtained from bronchoalveolar lavages and paranasal cavities. A Fisher exact test was performed to examine the significance of the association between upper airway and lower airway cultures. Results. The most frequent microorganisms in cultures of para-nasal cavities and bronchoalveolar lavages were Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus viridans. Statistical analysis revealed a significant association between upper airway cultures (paranasal cavities) and lower airway cavities (bronchoalveolar lavages) for the 2 most frequent microorganisms, P aeruginosa and S aureus (P = .007 and P = .030, respectively). Conclusion. The authors confirmed their initial hypothesis that a significant association between bronchoalveolar lavages and sinus cultures was established, once more confirming the idea of a unified airway. They found chronic rhinosinusitis with polyps to be a common clinical presentation in patients with CF. Further studies are required to indicate the role of antibiotics and the pathogenesis of the microorganisms as a manifestation of clinical severity.

What faces reveal: Impaired affect display in facial paralysis

To evaluate affect display in patients with facial paralysis as compared with normal subjects. We hypothesized that patients with facial paralysis would have impaired affect display and be perceived as displaying a negative affect as compared with normal subjects.

How facial lesions impact attractiveness and perception: Differential effects of size and location

To determine the effect of facial lesion size and location on perceptions of attractiveness and importance for repair. We hypothesized that attractiveness scores and importance for repair would be dependent on lesion size and location.

Does Nasal Surgery Improve OSA in Patients with Nasal Obstruction and OSA? A Meta-analysis

Objective To perform a systematic review and meta-analysis to determine if isolated nasal surgery in patients with obstructive sleep apnea and nasal airway obstruction improves obstructive sleep apnea. Data Sources Computerized searches were performed in PubMed, EMBASE, and the Cochrane Library through October 2014. Manual searches and subject matter expert input was also solicited. Review Methods A search protocol was defined a priori, and 2 independent investigators performed the data extraction, focusing on relevant data, including quality data polysomnography data, and taking note of methodological quality and risk for bias. Results The 10 studies meeting criteria included a total of 320 patients. There were 2 randomized controlled trials, 7 prospective studies, and 1 retrospective study. There was a significant improvement in the pooled results of both Epworth Sleepiness Scale (ESS; difference 3.53, 95% confidence interval [CI] [0.64, 6.23]) and Respiratory Disturbance Index (RDI; 11.06, 95% CI [5.92, 16.19]) scores with isolated nasal surgery. There was no significant improvement in the Apnea Hypopnea Index (AHI) in the random effects model (4.83, 95% CI [–1.6, 11.62]). Conclusions The pooled results showed that isolated nasal surgery for patients with nasal obstruction and obstructive sleep apnea improved some sleep parameters, as shown by significant improvements in ESS and RDI, but had no significant improvements on AHI. Future controlled studies with larger groups are needed to confirm the benefits of isolated nasal surgery in this patient population.

The straight truth: Measuring observer attention to the crooked nose†

Quantify attentional distraction to crooked noses pre‐ and postoperatively as compared with normal noses by using an established metric of attention in a pilot study.

Facial Lesions Negatively Impact Affect Display

Objective To evaluate the impact of facial lesions on affect display in patients as compared with individuals without lesions. Study Design Prospective randomized controlled experiment. Setting Academic tertiary referral center. Subjects and Methods Forty-five normal observers viewed photographs of normal faces in repose and faces with lesions in repose. Observers classified the affect display of the patients and the normals using a survey containing choices of primary emotions and personal attributes. Latent class analysis was used to find the unmeasured or “latent” classes. Latent class regression was used to determine the impact of lesion size and location on class membership. Finally, lesion classes and normal classes were checked for differences. Results Latent class analysis identified 4 independent latent classes for faces with lesions. The normal data were best fit by 3 latent classes. As a group, faces with lesions were most likely to be classified as either negative-sad or negative-angry, accounting for a combined probability of 44%. This was in contrast to the normal group, where 62% were classified as positive and only 13.9% as negative. Size and location significantly affected negative class membership. There were significant differences in the lesion classes as compared with the normal classes. Conclusion Faces with lesions were reported to display different affect in repose than normal faces in repose. The classification of the lesion faces was dependent on lesion size and location. These findings provide the first objective evidence of the affect display penalty caused by facial lesions.

Impact of crooked nose rhinoplasty on observer perceptions of attractiveness

To evaluate the impact of a crooked nose on observer perceptions of facial asymmetry and attractiveness and the ability of rhinoplasty to minimize it. We hypothesized that the presence of a crooked nose would penalize symmetry and attractiveness ratings as compared to normal faces. We further hypothesized that straightening rhinoplasty would restore symmetry and improve attractiveness.