Katsuaki Mishima

Application of a new method for anthropometric analysis of the nose

&NA; An accurate, quantitative method of measuring external nasal forms was developed in which facial plaster models were measured with a highly accurate contact‐type three‐dimensional coordinate measurement apparatus. Subsequently, we have developed techniques to identify the landmarks of a face automatically from the threedimensional data and to superimpose two sets of data automatically for the purpose of sectional and longitudinal analyses, respectively. These techniques were applied to patients with unilateral cleft lip nasal deformities. Consequently, we were able to observe shifts in the facial landmarks and subtle three‐dimensional changes.

Lesch-Nyhan syndrome: Successful prevention of lower lip ulceration caused by self-mutilation by use of mouth guard

Lesch-Nyhan syndrome (LNS) is a disorder caused by congenital absence of a purine metabolic enzyme, hypoxanthine guanine phosphoribosyl-transferase (HGPRT). This syndrome is characterized clinically by hyperuricemia and neurologic features including choreoathetoid spasticity, self-mutilation, and mental retardation. We report on a patient in whom self-mutilation of the lower lip was suppressed with the help of a mouth guard made from soft resin.

Three cases of oblique facial cleft

Three patients with an oblique facial cleft are described. One patient displayed ring constriction, lymphoedema, distal pseudosyndactyly and an occipital encephalocele to which an amniotic band was attached at birth. Therefore, it was obvious that the oblique facial cleft was accompanied by an amnion rupture sequence. These signs were not apparent in the other patients. However, one of the patients demonstrated various anomalies, amongst which syndactyly on the right foot, scoliosis, microcephaly, microphthalmia and corneal opacity suggested that the patient may have been affected by the amnion rupture sequence, except for polydactyly on the left foot, cleft hand and vertebra plana.

Case report: hypoglossia-hypodactylia syndrome

A case of hypoglossia-hypodactylia syndrome is described. The infant was characterized by micrognathia, accompanied by a defect of the gingiva, and hypoplasia of the tongue. There was defect in the right arm below the elbow. The right foot manifested syndactyly of the great, second and third toes and osseous fusion of the first and second metatarsi and proximal phalanges. In the left foot brachydactyly of the great and fifth toes, syndactyly of the second, third and fourth toes, hypoplasia of the first and second metatarsi and defect in the first phalanx were evident.

Palatal Configuration in Complete Bilateral Cleft Lip and Palate Infants before and after Cheiloplasty

OBJECTIVE The purpose of this study was to analyze the three-dimensional configuration of the premaxilla, vomer, and lateral segments in bilateral cleft lip and palate (BCLP) infants and to investigate the early changes in the configuration following one- and two-stage cheiloplasty. METHODS This study consisted of 10 complete BCLP infants. One-stage operations were performed in five patients according to Manchesters method at 4 months of age. Two-stage operations were done for the remaining five patients using a triangular flap according to Tennisons method, at 4 and 8 months of age. Serial plaster models before and after the cheiloplasty were measured with a computer-controlled, highly accurate, contact-type measuring apparatus. Temporal changes in the configuration and form of the premaxilla were observed using an automatic superimposition method. The inclination and deviation of the vomer were evaluated using an approximation technique to a straight line with least squares. The distance between the lateral segments and a three-dimensional coordinate of the incisal point were also measured. RESULTS AND CONCLUSIONS The following differences in palatal configuration between the one- and two-stage cheiloplasties were observed: 1) In the two-stage group, the premaxilla shifted toward the cleft edge where the cheiloplasty was performed in both first- and second-stage operations. After the two-stage operation, the premaxilla did not shift greatly, and the premaxilla in cases 4 and 5 shifted downward and toward the cleft edge of the lateral segments where the first operation was performed. Protrusion of the premaxilla remained in the two-stage group. 2) In the one-stage group, the premaxilla in case 4 descended downward and backward without twisting or bending. The premaxilla of the other patients descended downward with twisting and bending. 3) Patients in the two-stage group had a stronger tendency toward medial collapse of the lateral segments than did those in the one-stage group.