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MINISTRY OF EDUCATION AND TRAINING MINISTRY OF DEFENCE VIETNAM MILITARY MEDICAL UNIVERSITY - LAM NGOC ANH RESEARCH ON SOME CHARACTERISTICS OF AURICLE ANTHROPOMETRY OF ADULTS IN VIETNAM SPECIALITY: BIOMEDICAL SCIENCE CODE: 9720101 SUMMARY OF THESIS Ha noi – 2021 THIS RESEARCH WAS COMPLETED AT MILITARY MEDICAL UNIVERSITY Supervisors: Assoc Prof.PhD Tran Ngoc Anh Assoc Prof.PhD Pham Dang Dieu The first reviewer: Assoc Prof.PhD Nguyễn Văn Huy The second reviewer: Prof.PhD Nguyễn Đình Phúc The third reviewer: Prof.PhD Lê Gia Vinh The thesis will (or has been) defended at the State Thesis Judging Council that meeting at the Military Medical University At …, … 2021 The thesis can be found at: National Library Library of Military Medical University LIST OF PUBLISHED ARTICLES Lam Ngoc Anh, Tran Ngoc Anh, Pham Dang Dieu (2020) “Research on the relationship between the characteristics of Vietnamese adult’s auricle ears with sex” Journal of Military Pharmaco-medicine, 45 (7), pp 219-223 Lam Ngoc Anh, Tran Ngoc Anh, Pham Dang Dieu (2020) “Nghiên cứu đặc điểm hình thái dái tai người Việt trưởng thành phương pháp đo trực tiếp” Journal of Practical Medicine, 1141 (7), pp 40-43 BACKGROUND Ear deformity or loss of outer ear not only affects the hearing ability but also affects the aesthetics, psychological development and behavior of children Based on research characteristics of hellix anthropometry, clinicians have the clearest judgment about the shape of pavilion of the ear by race in each cultural period and economical stage; they will have suitable plastic surgery for each patient Up to now, there are many indicators related to the size and position of ear that have been studied and applied in surgical interventions In the world, Hae Gwon Jang performed on Koreans (2011), Richard did that in 2011 In Vietnam, Le Gia Vinh and Nguyen Thi Minh (1994) conducted a survey on nerve and vascular anatomy of ear to used in plastic surgery; Le Viet Khuong (2005) studied some ear size indexs for identification in criminology; Ly Xuan Quang (2018) studied the shape of small ears by the improved Nagata method These studies have contributed a great valuable database of hellix anatomy, helping surgeons to apply in clinical practice However, these studies have little in terms of both the number of ear anthropometric indexs as well as the sample size; they have not shown a correlation between the ear sizes with age, sex as well as some face indexs Therefore, it is difficult to predict the size and shape of the ear, especially in the case of both sides of ear deformity Therefore, we conducted this research with the objectives: Describe some characteristics of morphological and size of auricle for Vietnamese adults Evaluate the correlation between auricle sizes with some anthropometric features and face size index of Vietnamese adults MATERIALITY AND CONTRIBUTIONS OF THE THESIS The meaningful of research The study was outlined the landmarks, the size of the ear of normal Vietnamese adults; creating a basis for plastic surgeons to judge the right ear, making treatment plans for patients; producing headphones suitable for Vietnamese people We found a correlation between ear size with face size, correlate with sex and age, as well as identified the most common ear type We also developed the regression equation of ear length and earlobe by age: Male: Ear length = 57.159 + 0.188 x age Earlobe length = 14.328 + 0.099 x age Female: Ear length = 55.309 + 0.154 x age Earlobe length = 14.139 + 0.100 x age These are the data that help the cosmetic surgery to determine what a beautiful ear is, that suitable for the face, especially to rejuvenate the earlobes that are transformed with age, in order to restore beauty to the patients The layout of the thesis The dissertation consists of 129 pages with 35 tables, 16 charts and 57 pictures, including parts: pages for introduction; overview 35 pages; subject and method 22 pages; 36 pages of research results; discussion 31 pages; conclusion pages, with 121 references (14 Vietnamese, 107 English) CHAPTER - LITERATURE REVIEW 1.1 Characteristic of anatomical auricle 1.1.1 Location of auricle Auricle consists of a pair that located on either side of the head, in front of the mastoid, behind the branch to the lower jaw, below the temporal region and continuously with the outer ear canal inward The pavilion of the ear as an acoustic horn which has protrusions to help us receive sound from all sides, both sides stick to the head, in front of the mastoid bone, behind the temporomandibular joint, height are from to 6.5 cm, width are from 25 - 35mm, the auricle has two sides and one circumference Limit of the auricle: - Above: lying on a straight line that crosses your bow - Below: lying on a straight line across the base of the nose - The axis is the straight line passing through the highest point of the auricle to the anterior margin of the earlobe and parallel to the bridge of the nose - The front axis of the auricle coincides with the posterior margin on the lower jawbone 1.1.2 The sides of the ears: Exterior (front) In the middle is a hollow that called concha auricularis - The ear or rim is the edge running along the edge of auricle, the front end of the ledge starts from concha auricularis which called the crus helix - Antihelix is a Y-shaped curved cartilage ledge, running parallel to the front and in the helix - The tragus is a small ledge that blocked infron of the concha auricularis - Antitragus is a small ledge located opposite the tragus and separated from the tragus by the equilibrium defect (equilateral defect) - The lobe at the bottom is cartilage-free software The earlobe is a fold of connective tissue and fat is covered with skin Inside (back) The side that pressed against the scalp and facing back, with a protrusion against the outer surface The inner ear is limited to the lateral surface of the skull by a groove which called the posterior ear groove 1.2 The auricle anthropometry 1.2.1 Morphology of the auricle Triage by Osunwoke Based on the shape of the circumference, the auricle has four main forms: - Circle auricle - Oval auricle - Rectangular auricle - Triangular auricle 1.2.2 Morphology of the earlobe Triage earlobe by Kollali Normally, earlobe can be simply divided into three groups according to the angle of the earlobe joint to the cheek: the sharp angle (the earlobe is not attached to the cheek), the right angle, the obtuse angle Triage earlobe by Navjot Kaur Sidhu The shape of the earlobe was classified by the angle measured between the line drawn from the attachment point of the earlobe and the scalp following the contour of the earlobe and the vertical axis There are types: - Tapering when the angle measured from 30-69 ° - Square when the angle measured from 70-109 ° - Pendulous when the measured angle is greater than 110 ° 1.2.3 The anthropometric index of the auricle Up to now, there are many indexs that related to the size and position of the auricle (ear) which were used by anthropologists and clinicians such as: - Ear length: distance between the highest point on the crown and the lowest point of the earlobe - Ear width: the distance between the axis in front of the ear and the line parallel to it through the most convex point of the posterior edge of ear - Ear axis: straight line passing through the highest point of ear to anterior margin of earlobe - The anterior axis of the ear coincides with the posterior margin of the branch to the lower jawbone - The distance between the grip of the ear on the scalp and the outer edge of the orbit - The distance between the outer face of the mastoid bone and the posterior edge of the ear that also called the helix - the mastoid bone - The angle created by the ear axis and the in front of the ear axis - The angle created by the ear and the outer surface of the mastoid bone that also called the helix - the mastoid bone angle - The angle created by the concha auricularis and the outer surface of the mastoid that called the concha auricularis-mastoid ear angle - The angle created by concha auricularis, and scaphoid fossa is called the concha auricularis-scaphoid fossa angle 1.3 Some research methods of ear anthropology Among many research methods of human ear anthropometry, the two most widely used methods are direct clinical measurement and indirect measurement on imaging 1.3.1 Measure directly in clinical practice The method of assessment through direct measurement on the ear, clamp is a popular tool in this technique In which, the technicians observe and determines the anatomical markers directly on the ear, then they use a ruler to measure directly on the research object, recording the results in the result sheet 1.3.2 Standardized image measurement method Analysis on photographs was performed on images taken in a straight and tilted position 1.3.3 Combination method between direct measurement and measurement on image This is a method that researchers perform both directly measurement on research subjects and indirectly on images at the same time CHAPTER SUBJECTS AND METHODS 2.1.The subjects Selecting study subjects: samples were selected by single random method We contacted to the Fatherland Front Committee of District st and bringed the data collection plan to the Fatherland Front Committee of District 1st We also cooperated with the People's Committee of 10 th wards, then the Fatherland Front Committee of District st in Ho Chi Minh city distributed invitations for each ward based on the list of permanent resident households, each households chose only household, in the household selected qualified person to participate in the study, until there were 50 households for each ward Location: Head office of District 1st Ho Chi Minh City's Fatherland Front Committee 51 Nguyen Binh Khiem, District 1st, Ho Chi Minh Time research: during October 2018 to October 2020 2.1.1 Selection criteria - Vietnamese adults (≥ 18 years old) who live in Ho Chi Minh City - The two ears have normal shape, not deformed, not have tear injuries, nether burns, ear tumors, birth defects nor have been operated by surgery - Person agrees to participate in research 2.1.2 Exclusive criteria - Inflammation of the ear - Diseases affects ear morphology: facial paralysis, cerebrovascular accident - People get congenital syndrome affects ear morphology: Down syndrome… - People wear earrings often cause deformation of the earlobes Research Methods 2.2.1 Research Methods: We used descriptive studies cross-section and analysis in this research 2.2.2 Sample size Applying formula: The sample size was determined by a formula that estimates the sample size for an average value in a population + n: Minimum sample size required + : Error type I α: Choose α = 0.05, respectively have less than 5% chance of drawing a false positive conclusion Then, Zα = 1.96 + : Error type II β or sample force (power is 1-β: Select β = 0.1 or Sample force = 0.9 respectively has 90% chance of avoiding a false negative conclusion Then, Zβ = 1.28 + : standard deviation Select = 2.33 + d: desired error in units with Select d = 0.38 (mm) 2.3 Content of study 2.3.1 Evaluation parameters Morphological Anthropometric size characteristics Ear length Located of éar Ear width Change the ear Earlobe length individually Earlobe width Ear type Concha auricularis length Earlobe type Concha auricularis width Tubers Tragus length Tragus width Darwin Morphological width Crooked / pressed ear 10 Distance helix-mastoid Face classification - Level with tragus - Level with crus helix 11 The distance from the helix to the slit outside the eyelid - From crus helix to slit outside the eyelid - From where the earlobe is attached to the scalp to slit outside the eyelid 12 Nose length 13 Above side width 14 Face length In addition to year of birth, gender, height, weight, BMI, each object was surveyed 21 characteristics including 07 morphological features, 14 anthropometric dimensions, of which dimensions are measured at different positions 2.3.2 Indexs Ear index (AI) = Ear width / Ear length x 100 Concha auricularis index (CI) = Concha auricularis width/Concha auricularis length x 100 10 Lobe index (LI) = Earlobe width / Earlobe length x 100 2.4 Data analysis - Data were processed by SPSS22 software - Verification of data: by the intraclass correlation system - Reduce data: classify variables when necessary - Data analysis and descriptive statistics processing + If the quantitative variable has an abnormal distribution, use the median and the quartile + Table presentation form: the binomial variable represents typical value; the nominal variable present values sorted follow frequency; ordinal variable uses cumulative percentages - Analyze data and process statistical analysis + We used T-test (with normal distribution variables) to compare the mean of each index for two groups of male and female, or compare with data of other authors (if any); + We utilised Pearson test (normal distribution variable) to assesse the degree of correlation between two or more research variables through correlation coefficients between quantitative variables + Using the chi square test or Fisher (when more than 20% of the plots have an expected value less than or there is a cell with a expected value less than 1); with threshold statistical significance was 0.05 (pvalue
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