\r\n\tWe are living in a particularly challenging historical moment. People have learned that no matter how much they control their lives, their environment, and their relationships, everything can be changed instantly, at the fancy of a virus that does not respect age, nationality, ancestry, intelligence, or skills. People learned that the limitless power of science and technology was purely illusory, in the face of an absolute and overwhelming force of nature that was almost no longer recognized. After all, the balance of forces between Nature and science and technology was inevitably shaken and the certainties with which people built their lives were jeopardized by an unpredictable and constantly changing reality. Uncertainty is one of the biggest challenges we face today. Never, as today, people management can make such a difference in their future, both personally and professionally.
\r\n
\r\n\t \r\n\tCHROs need to decide where to focus their resources and attention, select their action priorities. This book will aim to provide the reader with a comprehensive overview of the new challenges of people management and provide keys to (re)think about the new/renewed challenges that the new times, the new “normals” place on those who manage people. From the strategic management of HR to people analytics and HR IT architecture and operation, through the new practices of remote work, this book aims to reflect on the future(s) of people management, illuminating trends and reflecting on potential risks or promising achievements.
",isbn:"978-1-80355-043-5",printIsbn:"978-1-80355-042-8",pdfIsbn:"978-1-80355-044-2",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,hash:"982c56a5fb4684d966f8f5e76b2638f5",bookSignature:"Prof. Diana Dias and Dr. Carla Magalhães",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11603.jpg",keywords:"HR Strategy, Strategic Workforce Planning, Employer Branding, Talent Ecosystem Management, Upskilling and Reskilling, Learning and Development, Performance Management, Rewards and Recognition, HR IT Architecture and Operation, Remote and Hybrid, HR Organization and Governance, HR Shared Services",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 22nd 2022",dateEndSecondStepPublish:"March 22nd 2022",dateEndThirdStepPublish:"May 21st 2022",dateEndFourthStepPublish:"August 9th 2022",dateEndFifthStepPublish:"October 8th 2022",remainingDaysToSecondStep:"2 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Combining Psychology and Management Sciences, Dr. Dias chooses People Management as her field of teaching, learning, work, and research. She was Vice-rector for research, quality, and academic development in Laureate International Universities and also the European Representative in Laureate Research Council (Miami, FL-USA)As a consultant for higher education quality, she works with A3ES, EUA, UNESCO, and OECD. Nowadays she is Dean of two Faculties of Economic, Social and Business Sciences.",coeditorOneBiosketch:"Dr. Magalhães has more than 20 years of international experience in the Human Resources Management scientific field as a teacher, researcher, and consultor. An active member of several international projects, she took along her career several positions of academic, scientific, and pedagogical coordination.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"450553",title:"Prof.",name:"Diana",middleName:null,surname:"Dias",slug:"diana-dias",fullName:"Diana Dias",profilePictureURL:"https://mts.intechopen.com/storage/users/450553/images/system/450553.jpg",biography:"Diana Dias, graduated in Psychology, specializing in career management at the University of Porto. Her PhD in Educational Sciences dealing with the theme of academic integration in Higher Education culminated entirely in her experience and field work, not only as a teacher, but also as a researcher in the field of Academic Management in Higher Education. She is recognized by the Portuguese Psychologist Board as a specialist in Work and Organizational Psychology.\r\nIn 2022, she will present Aggregation Exams in Management and in 2017, it accumulates as the aggregation title already atributed at the University of Minho in the specialty of Learning Psychology.\r\nOver the course of his career, she has taken on various academic management positions, directing two Higher Schools and coordinating scientifically and pedagogically several Undergraduate, Masters and Postgraduate Degrees, with emphasis on the scientific design and coordination of the Degree and Doctorate Degree in Psychology, as well. as a Licentiate and Master's Degree in Human Resources Management. She was part of the Executive Committee of a Doctorate in Management and scientifically coordinated the Doctorate in Psychology. She was Pedagogical Director at ESAI – Higher School of Real Estate Activities, where she is also President of the Council for Quality Assurance. She was Dean for Research and Academic Innovation at the European University, after 5 years as Vice-Dean.\r\nFull professor at Universidade Lusófona, she is Dean of FCESE - Faculty of Economic, Social and Business Sciences at Universidade Lusófona do Porto and Strategic Director of the School of Economic Sciences and Organizations at Universidade Lusófona de Humanidades e Tecnologia (Lisbon).\r\nShe is also a researcher and member of the Scientific Council of CIPES-Center for Research on Higher Education Policies, classified as Excellent by the FCT.\r\nShe has a vast scientific work published in indexed scientific journals and is the author of several books in the areas of Management, Psychology and Education.\r\nConsultant in Higher Education policies, she has been working with several relevant national and international entities, namely, POCH, DGEEC, A3ES, CNE, USA, UNESCO and OECD.",institutionString:"Lusofona University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null}],coeditorOne:{id:"452431",title:"Dr.",name:"Carla",middleName:null,surname:"Magalhães",slug:"carla-magalhaes",fullName:"Carla Magalhães",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003LeuV6QAJ/Profile_Picture_1643029510060",biography:"PhD in Business Sciences (specialization in Human Resources), by Minho University (Braga/Portugal), in partnership with Getúlio Vargas Foundation (Rio de Janeiro/Brazil). Master in Public Administration (specialization in Human Resources and Marketing), by Brazilian School of Public and Business Administration of Getulio Vargas Foundation (Rio de Janeiro). Associate Professor at Faculty of Social and Business Economic Sciences of Lusófona University (Porto/Portugal), where coordinates the 1st study cycle of Human Resources Management and Development and directs the Lifelong Training Unit. Invited Professor at the School of Economics and Management of Minho University. Researcher at the Center for Population, Economy and Society Studies (CEPESE) and an associate member of Transdisciplinary Research Center for Innovation & Entrepreneurship Ecosystems (TRIE), both in Portugal.",institutionString:"Lusofona University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"7",title:"Business, Management and Economics",slug:"business-management-and-economics"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"429339",firstName:"Jelena",lastName:"Vrdoljak",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/429339/images/20012_n.jpg",email:"jelena.v@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. 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\n
1. Introduction
\n
There is an increasing demand for facial plastic surgery with more awareness of the procedure and its outcome. Many patients who seek surgery for their nasal aesthetics also have complaints of nasal obstruction and snoring [1, 2]. Severe gross septal deviations present big surgical challenges for the operating surgeon. The role of functional rhinoplasty in the management of internal nasal valve has been discussed by numerous authors (Figure 1).
\n
Figure 1.
A close-up view showing the anatomical relationship of the left internal nasal valve to the septum anteromedially and the inferior turbinate laterally.
\n
A complete evaluation of these groups of patients with nasal endoscopy and CT scan of paranasal sinuses will often reveal concurrent chronic rhinosinusitis (CRS).
\n
Procedures of endoscopic sinus surgery (ESS), septoplasty (SP), and rhinoplasty (RP) were initially meant for functional improvement to which today an aesthetic aim is added. The functional aim of rhinoplasty is meant for recovery of normal sinonasal physiology and ventilatory function.
\n
CRS is an inflammation of the nose and paranasal sinuses manifesting with two or more significant symptoms for 12 weeks with endoscopic and/or CT scan signs of disease. The symptoms include nasal obstruction, thick nasal discharge, and/or facial pain/pressure and/or reduction or loss of sense of smell [3]. Diagnosis of CRS is primarily based on symptoms that are confirmed by nasal endoscopy and CT scans in coronal and axial views (Figures 2 and 3).
\n
Figure 2.
Coronal (A1) and axial (A2) CT scan serial cuts of paranasal sinuses showing a markedly deviated nasal septum with pneumatized diseased right middle turbinate and evidence of sinusitis.
\n
Figure 3.
Coronal (B1) and axial (B2) CT scan serial cuts of paranasal sinuses showing a grossly deviated nasal septum post-trauma with evidence of paranasal sinus mucosal thickening.
\n
In functional rhinoplasty, the role of the spreader graft [4], columellar extension graft [5], shield graft [6, 7], onlay conchal graft [8], nasal valve suture suspension [9], and flaring sutures [10] has been advocated by numerous authors. Endoscopic sinus surgery (ESS) has also been accepted as a safe and efficient modality for the treatment of CRS. The combination of both these procedures would offer great benefit to the indicated patient group.
\n
Concurrent ESS, SP, and RP are affordable, reliable, and safe procedures when performed as a single surgical procedure to reduce operative time, general anesthetic, and recovery period [11]. The additional RP leads to an increase in postoperative complications but when analyzed separately is considered minor in the literature [12, 13]. Thus, the result of surgery and the patient’s quality of life are not exceedingly compromised and therefore considered acceptable. Traditional surgeons have been concerned of combining rhinoplasty and ESS to avoid the possibility of increased postoperative complications. Recent publications have reported initial success with this combined technique [14].
\n
Therefore, a larger sample study like this can better define how RP affects outcomes of concurrent ESS and SP.
\n
We present a novel one surgeon combined endoscopic sinus surgery and rhinoplasty technique to evaluate patient satisfaction, efficacy, safety, and clinical outcomes of them undergoing concurrent surgery.
\n
\n
\n
2. Methods and materials
\n
\n
2.1 Patients
\n
A retrospective clinical chart review was performed on all of the author’s patients who had nasal surgery from January 2016 through December 2018 at the ENT unit of Pantai Hospital Kuala Lumpur (PHKL). All patients had severe nasal obstruction with chronic rhinosinusitis and were followed up for a minimum of 6 months post-surgery. The data revealed that 53 patients out of the 116 patients (45.6%) underwent concurrent open rhinoplasty and ESS by the same surgeon at PHKL. Patients who underwent rhinoplasty and ESS at different sittings (54.4%) were excluded from the study because the SNOT 22 subjective scoring system which was used only for the evaluation of patient symptoms in the concurrent group before and after surgery was sufficient, and therefore the need to compare with patients who underwent rhinoplasty and ESS at different sittings was not necessary. A history of nasal trauma and snoring was documented.
\n
Patients with primary nasal dysfunction and sinus complaints were seen by the same surgeon. All the patients underwent ENT workup which included history, head and neck examination, nasal endoscopy, and CT scans of paranasal sinuses and were treated with oral antibiotics and topical nasal steroids prior to the CT scan and a full facial analysis including standardized photography.
\n
\n
\n
2.2 Evaluation
\n
The main complaints of the patients prior to surgery were chronic nasal obstruction, postnasal drip, headaches with occasional voice changes, and snoring. External nasal examination was performed to detect a twisted/crooked/saddled nose.
\n
Nasal endoscopy revealed that all these patients had significant anterior septal deviation involving the internal nasal valve, in addition to posterior septal deviation. Nasal endoscopic examination was performed to detect the grading of septal deviations, namely, I, II, III, IV, and V (Figure 4), and diseased mucosal or polypoidal tissue (grade 1, 2, 3) involving the paranasal sinuses. If there was evidence of mucopurulent discharge from the paranasal sinuses on nasal endoscopy on admission, the patients were commenced on systemic antibiotics prior to surgery.
\n
Figure 4.
The five areas of the internal nose most commonly involved in nasal septal deviations. Open approach rhinoplasty is indicated in anterior deviations of nasal septum involving areas I, II, and III along with significant internal nasal valve involvement, whereas closed approach is indicated for posterior septal deviations restricted to areas IV and V only.
\n
\n
\n
2.3 Surgical technique
\n
All the cases were performed as an inpatient procedure by a one surgeon and two procedure approach under general anesthesia at Pantai Hospital Kuala Lumpur. At the time of induction, all patients received IV antibiotics (ceftriaxone 1 gm) and steroids (dexamethasone 8 mg). The CT scans of the paranasal sinuses were reviewed again in OR prior to performing the surgery. A throat pack was inserted, and the nasal cavity was packed with soaked spacers for vasoconstriction. Infiltration was performed at the nasal dorsum, alar rim, septum, and greater palatine fossa transorally with levobupivacaine (20 cc), adrenaline (0.2 mg), and aqua (1.8 cc). Surgery was initiated with ESS procedure followed by open rhinoplasty approach, but in gross septal deviations, the septoplasty was performed prior to the ESS.
\n
For the open rhinoplasty approach, an inverted transcolumellar V-shaped incision was made, and the SMAS elevated all the way to the dorsum of the nose (Figure 5). The domes are divided in the midline, and the upper lateral cartilages released laterally, creating excellent exposure of the septum. Bilateral submucoperichondrial flaps are elevated, exposing the entire cartilaginous and anterior bony septum. The cartilaginous and bony septum is then resected by paramedian osteotomy, separating cartilaginous septum from maxillary crest and fracturing bony septum as posterior as possible leaving behind the cribriform plate and sphenoid rostrum. Extracorporeal approach was performed on all patients with gross high septal deviation, which requires complete removal of the entire cartilaginous septum, which is then straightened and returned to the nose. In revision rhinoplasty cases where adequate quadrangular cartilage and septal bone grafts were not available, conchal cartilage graft was harvested. Bilateral spreader grafts are then placed on the dorsal part of the septum. K-wire drill was used to drill multiple holes on the septal bone graft for use as spreader/ columella strut/columella extension graft. Straight 4/0 Monosyn mattress sutures were used to secure the spreader graft. Then lateral osteotomies are performed by external subcutaneous method if required. Nasal spine if deviated more than 30° is gauged out or drilled. Neo-septum with spreader graft is inserted in the nose. Areas of fixation are the caudal end of the nasal bones, upper lateral cartilage, and maxillary crest. A hole is drilled through the nasal bones and the nasal spine and suturing the neo-septum with Monosyn 4/0 sutures. Other required steps like columellar strut, rim grafts, and tip grafts are performed. Soft silicon splints are placed along either side of septum and sutured in place with through-and through 3/0 Monosyn sutures. Curve Monosyn 4/0 and 5/0 were used for tip plasty (transcrural, intercrural, shield graft), dorsal augmentation, caudal augmentation, septum augmentation, and alar rim suturing. Ethicon 6/0 sutures were used for the skin.
\n
Figure 5.
Close-up view of open rhinoplasty via a transcolumellar incision and elevation of SMAS all the way to the nasal dorsum.
\n
For the ESS, the mucosa on the lateral wall of the nose and the anterior face of the sphenoid was infiltrated and the diseased sinuses addressed by performing ethmoidectomy, middle meatal antrostomy, sphenoidotomy or frontal sinusotomy. Prior to performing middle meatal antrostomy, an uncinectomy was performed using thru-cut instruments along with a microdebrider.
\n
The nasal and sinus cavities were packed with Nasapore. Steri-Strip was applied externally on the nasal dorsum along with Denver splints which were removed between 7 and 10 days postoperatively. Nasal cavity suction was performed on the third postoperative day along with the removal of the nasal septal splints and patient sent home the same day. The ESS was performed using a technique adapted from Stammberger [12] and Kennedy [13]. The ESS instruments included high-definition Spice monitor, 4 mm endoscopes (0, 30 and 70°), and powered instruments (debrider by Medtronic). IGS was used in revision sinus surgery cases. All patients received postoperative antibiotics and nasal rinse. The one surgeon team performed the postoperative endoscopic debridement and nasal function and documented aesthetic alterations with standardized postoperative photography.
\n
\n
\n
2.4 Data collection
\n
The medical charts of included patients were retrieved for analysis and demographic data obtained (Table 1). The medical and surgical history, presenting complaints and physical and endoscopic examination results, was documented. The details of the rhinoplasty and sinus surgery subtype procedures are listed in Tables 2 and 3, respectively. Patient follow-ups were obtained with standardized questionnaires (SNOT 22) of presenting complaints, satisfaction with surgical experience, and self-evaluation of aesthetic outcome.
Summary of endoscopic sinus subtype procedures performed on 53 patients who underwent concurrent two procedural approaches.
\n
\n
\n
\n\n
\n
Spreader graft (SprG)
\n
53 (100%)
\n
\n
\n
Shield graft (SG)
\n
53 (100%)
\n
\n
\n
Columella extension graft (CEG)
\n
29 (54.7%)
\n
\n
\n
Osteotomy (O)
\n
13 (24.5%)
\n
\n
\n
Columella strut (CS)
\n
9 (16.9%)
\n
\n
\n
Hump reduction (HR)
\n
4 (7.5%)
\n
\n
\n
Caudal septal resection (CSR)
\n
3 (5.6)
\n
\n
\n
Conchal cartilage graft (CCG)
\n
3 (5.6)
\n
\n\n
Table 3.
Summary of rhinoplasty subtype procedures performed on 53 patients who underwent concurrent two procedural approaches.
\n
\n
\n
\n
3. Results
\n
Between January 2016 and December 2018, 53 patients underwent rhinoplasty combined with endoscopic sinus surgery (ESS). The demography of the patients is listed in Table 1. There were 31 females and 22 males with age ranging from 16 to 55 years with a mean of 31.8 years. There were three referred revision cases where rhinoplasty [1] and septoplasty [2] were performed elsewhere. All patients had open approach rhinoplasty. The average operative time was 45 minutes for endoscopic sinus surgery and 141.20 minutes for rhinoplasty. The average operating time for the concurrent procedure was 186.20 minutes, and average blood loss was 121.4 ml. Out of the 53 patients, there were 15 Malays, 11 Chinese, and 21 Indians, and the remaining 6 were foreigners (one each from Australia, Canada, Iran, and the United Kingdom and two from Indonesia). Thirty-eight (71,6%) of the 53 patients had a history of chronic snoring and 27 (50.9%) history of nasal trauma.
\n
Regarding the ESS, the most common procedure performed was septoplasty and turbinate reduction in all patients, followed by ethmoidectomy (71.7%), middle meatal antrostomy (67.9%), sphenoidotomy (16.9%), and frontal sinusotomy (15.1%). Majority of the patients had extensive mucosal disease requiring sinus surgery.
\n
Regarding the rhinoplasty procedures, the most common aesthetic procedure was spreader graft and shield graft in all patients followed by columella extension graft (54.7%), osteotomy (24.5%), columella strut (11.9%), hump reduction (7.5%) caudal septal resection, and conchal cartilage graft (5.6%). It is of interest to note that 53 patients had some type of cartilage graft performed (spreader graft, shield graft, columellar extension graft, caudal septal resection, columella strut, and conchal cartilage graft). Pictures of spreader and shield grafts are illustrated in Figures 6 and 7. All patients were followed up for a minimum of 6 months of post-surgery at the time of this report. All patients reported an improvement in their sinus symptoms and were adequately satisfied with their nasal appearance. No revision rhinoplasty or ESS was performed on this group at the time of reporting.
\n
Figure 6.
Picture showing spreader graft sandwiched between the septum just before mattress sutures are applied in a case of twisted nose.
\n
Figure 7.
Close-up view of shield graft augmentation tip plasty.
\n
There were no major complications noted in this study. There were minor complications reported which were mainly delayed wound healing [2], minor irregularities of the nasal dorsal skin lining [2], alar asymmetry [2], and pinching of the nose [1]. None of the patients were interested in further surgical intervention at that moment in time.
\n
\n
\n
4. Discussion
\n
In the population, there are patients with cosmetic nasal concerns who will also have functional problems (nasal obstruction and/or sinus problems) which should be fully evaluated. Moreover, patients with functional nasal problems would like a cosmetic nasal improvement (Figures 8,9, and 10). It is meaningful that patients who would benefit from rhinoplasty and ESS would wish to combine the two procedures which would save patients time, money, and inconvenience. Advances in powered sinus instrumentation have made combining rhinoplasty and ESS more attractive. In 1991, Sheman and Matarasso [15] first reported combining rhinoplasty and ESS, and since then various authors have reported a bigger series demonstrating the safety and efficacy of combining these two procedures [16, 17, 18, 19, 20, 21].
\n
Figure 8.
Pre (A1 and A2) and postoperative (A3 and A4) pictures of patient no. 38 who presented with twisted nose, prominent nasal hump, and CRS.
\n
Figure 9.
Pre- (B1 and B2) and postoperative (B3 and B4) pictures of patient no. 13 who presented with crooked nose, pseudo-hump nasal hump, and CRS.
\n
Figure 10.
Pre- (C1 and C2) and postoperative (C3 and C4) pictures of patient no. 26 who presented with twisted nose, pseudo-nasal hump, and CRS post-trauma.
\n
Since the main complaint on presentation was chronic nasal obstruction (DNS with enlarged turbinates) with rhinosinusitis, all the patients had septal surgery with turbinate reduction. The CT scan of the paranasal sinuses performed on all the patients showed evidence of involvement of more than one paranasal sinus; the ESS was performed on more than one sinus. The most common sinuses involved were the ethmoid and the maxillary sinuses, with less incidence of involvement of sphenoid and frontal sinuses. Since all the patients presented with internal nasal valve problems, all the patients had spreader with shield graft performed.
\n
Since all patients had caudal septal deviation with narrow nasal valve, spreader graft was performed on all patients. Only 24.5% of patients had mid-vault deformity which required osteotomy.
\n
Powered instrumentation combining suction, irrigation, debridement, and cautery reduces surgical steps, operative time, and blood loss. IGS is a valuable instrument used for anatomic confirmation especially in revision cases. Absorbable sinus packing has increased patient comfort. Advances in ESS instrumentation have made the procedure faster, safer, precise, and comfortable.
\n
This addition of 53 cases of rhinoplasty with ESS to the literature by one surgeon technique illustrates the overall safety and efficacy of combining the two procedures. This study shows that the ESS using powered instrumentation is not too time-consuming, on average taking about 45 minutes in this study compared to 50 minutes in other reported cases [13]. Total blood loss for the combined procedure was about three times more (121 cc) in our study compared to blood loss in other studies (40 cc) [21] which could likely be due to the more extensive paranasal sinus mucosal disease involvement. The average operating time for the concurrent procedure was 186.20 minutes compared to 110 minutes in other reports [22] which could likely be due to time-consuming remodeling utilizing autografts. All the patients had some type of cartilage grafting with no evidence of infection, extrusion, malposition, or resorption since autologous grafts were used in all 53 patients. Minor complications like erythematous columellar incisions were treated aggressively with a course of oral antibiotics.
\n
A review of 268 rhinoplasties between 1997 and 2001 demonstrated 11 cases with concurrent surgery, and there were no complications noted in this study [17]. Furthermore, the authors mention a case report of a 22-year-old patient who underwent a septorhinoplasty and ESS on an outpatient basis at another institution and developed edema over the nose, cheek, glabella, and forehead regions with fever. A CT scan of paranasal sinuses showed evidence of opacification of the frontal sinuses with dehiscence of nasal bones which responded to intravenous medication and frontal trephination. Herzon in 1971 reported a 12% incidence of bacteremia in patients undergoing nasal septal surgery requiring nasal packing [23]. In 1978, Todd et al. reported the first case of toxic shock syndrome (TSS) [24].Four years later the first case of TSS after septorhinoplasty was reported [25].
\n
Most authors agree that performing the sinus surgery first allows the surgeon to determine if there is ongoing rhinosinusitis. Millman B who performs combination rhinoplasty with ESS recommends not proceeding with rhinoplasty if there are signs of infection [17].
\n
There have been only 4 reported cases of MRSA associated postoperative complications following septorhinoplasty reported in the literature across all specialities [26]. Patients who are susceptible to MRSA infections may also be at higher risk for nasal colonization, and this includes elderly patients, patients recently hospitalized or treated in a rehabilitation center, and health-care workers. Few cases of MRSA infection following septorhinoplasty have been reported in the literature. Elimination of nasal colonization is a major step in preventing these infections, and preoperative systemic antibiotic use should be considered, especially in revision cases [27].
\n
Most of the sinus symptoms resolved postoperatively with 47 (88.6%) of 53 patients describing their improvement as significant. Fifty (94.3%) of 53 patients stated that they would recommend the concurrent procedure.
\n
\n
\n
5. Conclusion
\n
The author has reasonably good results combining rhinoplasty and ESS, and the benefits of these advances are illustrated by a review of the literature with good results (functional and cosmetic) and minimal complications. Extracorporeal approach was performed on all patients with gross high septal deviation. All the patients had some type of cartilage grafting with no evidence of infection, extrusion, malposition, or resorption since all the patients had autologous grafts inserted. Minor complications like erythematous columellar incisions were treated aggressively with a course of oral antibiotics. Advances in rhinoplasty and sinus surgery technique and equipment have made this one surgeon combined procedure safe and cost-effective with good results in selected patients.
\n
\n\n',keywords:"rhinoplasty, open, concurrent, endoscopic sinus surgery, one team approach",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/69430.pdf",chapterXML:"https://mts.intechopen.com/source/xml/69430.xml",downloadPdfUrl:"/chapter/pdf-download/69430",previewPdfUrl:"/chapter/pdf-preview/69430",totalDownloads:1159,totalViews:0,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:0,impactScore:0,impactScorePercentile:38,impactScoreQuartile:2,hasAltmetrics:0,dateSubmitted:"September 29th 2018",dateReviewed:"August 29th 2019",datePrePublished:"October 8th 2019",datePublished:"December 4th 2019",dateFinished:"October 8th 2019",readingETA:"0",abstract:"Combining rhinoplasty and endoscopic sinus surgery (ESS) was first reported in 1991 by Sheman and Matarasso. Since then, many authors have documented a large series showing the overall efficacy of combining the two procedures. The focus of this manuscript is to document the author’s recent experience with combining rhinoplasty and endoscopic sinus surgery and highlight the changes that have occurred during the author’s 2-years experience. A retrospective data review was performed on 53 (31 females and 22 men, age range 16–55 years) patients who underwent combined rhinoplasty and ESS between January 2016 and December 2018 at Pantai Hospital Kuala Lumpur by the same surgeon. The mean age was 31.8 years. All patients had severe nasal obstruction with chronic rhinosinusitis and were followed up for a minimum of 6 months post-surgery and underwent ENT workup, which included history, office rigid endoscopy, CT scans of paranasal sinuses and preoperative photography. Initially, the ESS was performed followed by the open rhinoplasty with or without osteotomy. The ESS consisted of middle turbinate reduction [15/53 (28.3%)], maxillary antrostomy [36/53 (67.9%)], ethmoidectomy [38/53 (71.6%)], frontal sinusotomy [7/53 (13.2%)], and sphenoidotomy [9/53 (16.9%)]. Most of the sinus symptoms resolved postoperatively with 47 (88.6%) of 53 patients describing their improvement as significant. Fifty (94.3%) of 53 patients stated that they would recommend the concurrent procedure. The benefits of these advances are illustrated by a review of the literature with good results (functional and cosmetic) and minimal complications.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/69430",risUrl:"/chapter/ris/69430",book:{id:"7062",slug:"rhinosinusitis"},signatures:"Balwant Singh Gendeh",authors:[{id:"67669",title:null,name:"Balwant Singh",middleName:null,surname:"Gendeh",fullName:"Balwant Singh Gendeh",slug:"balwant-singh-gendeh",email:"bsgendeh@gmail.com",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/67669/images/system/67669.png",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Methods and materials",level:"1"},{id:"sec_2_2",title:"2.1 Patients",level:"2"},{id:"sec_3_2",title:"2.2 Evaluation",level:"2"},{id:"sec_4_2",title:"2.3 Surgical technique",level:"2"},{id:"sec_5_2",title:"2.4 Data collection",level:"2"},{id:"sec_7",title:"3. Results",level:"1"},{id:"sec_8",title:"4. Discussion",level:"1"},{id:"sec_9",title:"5. Conclusion",level:"1"}],chapterReferences:[{id:"B1",body:'Murakami C. Nasal valve collapse. Ear, Nose, & Throat Journal. 2004;83:163-164'},{id:"B2",body:'Beekhuis GJ. Nasal obstruction after rhinoplasty: Etiology and techniques for correction. The Laryngoscope. 1976;86:540-548'},{id:"B3",body:'Scadding GK, Durham SR, Mirakian R, et al. BSACI guidelines for the management of rhinosinusitis and nasal polyposis. Clinical and Experimental Allergy. 2008;38(2):260-275'},{id:"B4",body:'Sheen JH. Spreader graft: A method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plastic and Reconstructive Surgery. 1984;73(2):230-239'},{id:"B5",body:'Byrd HS, Andochick S, Copit S, et al. Septal extension grafts: A method of controlling tip projection shape. Plastic and Reconstructive Surgery. 1997;100:999-1010'},{id:"B6",body:'Whitaker EG, Johnson CM Jr. The evolution of open structure rhinoplasty. Archives of Facial Plastic Surgery. 2003;5:291-300. DOI: 10.1001/archfaci.5.4.291'},{id:"B7",body:'Toriumi DM. New concepts in nasal tip contouring. Archives of Facial Plastic Surgery. 2006;8:156-185. DOI: 10.1001/archfaci.8.3.156'},{id:"B8",body:'Clark JM, Cook TA. The “butterfly” graft in functional secondary rhinoplasty. Laryngoscope. 2002;112:1917-1925'},{id:"B9",body:'Lee DS, Glasgold AI. Correction of nasal valve stenosis with lateral suture suspension. Archives of Facial Plastic Surgery. 2001;3:237-240'},{id:"B10",body:'Schlosser RJ, Park SS. Surgery of the dysfunctional nasal valve: Cadaveric analysis and clinical outcomes. Archives of Facial Plastic Surgery. 1999;1:105-110'},{id:"B11",body:'Marchica P, Bassetto F, Vindigni V, Galici R, Dispenza F, Gallina S, et al. Endoscopic sinus surgery associated with rhinoseptoplasty: A case-control study. Plastic and Reconstructive Surgery Global Open. 2018;10:1-5'},{id:"B12",body:'Terrel JE. Primary sinus surgery. In: Cummings CW, Friedrickson JM, Harker LA, et al, editors. Otolaryngology Head Neck Surgery. Vol. 2. St Louis: Mosby; 1998. pp. 1160-1162'},{id:"B13",body:'Levine HL, May M, Schaitkin B, Mester SJ. Results of surgery. In: Levine H, May M, editors. Endoscopic Sinus Surgery. New York: Thieme Medical Publishes Inc; 1993. pp. 176-192'},{id:"B14",body:'Rizk SS, Edelstein DR, Matarasso A. Concurrent functional endoscopic sinus surgery and rhinoplasty. Annals of Plastic Surgery. 1997;38:323-329'},{id:"B15",body:'Sheman LJ, Matarasso A. Combined endoscopic sinus surgery and aesthetic rhinoplasty: A pilot study. American Journal of Rhinology. 1991;5:131-136'},{id:"B16",body:'Toffel PH. Simultaneous secure endoscopic sinus surgery and rhinoplasty. Ear, Nose and Throat Journal. 1994;73(8):554-573'},{id:"B17",body:'Milman B, Smith R. The potential pitfalls of concurrent rhinoplasty and endoscopic sinus surgery. Laryngoscope. 2002;112(71):1193-1196'},{id:"B18",body:'Mazzola RF, Felisati G. Rhinoplasty and endoscopic surgery for functional and inflammatory nasal/sinus disorders. Plastic and Reconstructive Surgery. 2005;115(3):705-710'},{id:"B19",body:'Lee JH, Sherris DA, Moore EJ. Combined open septorhinoplasty and functional endoscopic sinus surgery. Otolaryngology. 2005;133(3):436-440'},{id:"B20",body:'Inanli S, Sari M, Yazici MZ. The results of concurrent functional endoscopic sinus surgery and rhinoplasty. The Journal of Craniofacial Surgery. 2008;19(3):701-704'},{id:"B21",body:'Marcus B, Patel Z, Busquets J, Hwang PH, Cook TA. The utility of concurrent rhinoplasty and sinus surgery: A 2-team approach. Archives of Facial Plastic Surgery. 2006;8(4):260-262'},{id:"B22",body:'Murrell GL. Rhinoplasty and functional endoscopic sinus surgery. Plastic Surgery International. 2011;10:1-6. DOI: 10.155/2011/473481'},{id:"B23",body:'Herzon FS. Bacteremia and local infections with nasal packing. Archives of Otolaryngology. 1971;94:31-32'},{id:"B24",body:'Todd J, Fishaut M, Kapral F, Welch T. Toxic shock syndrome associated with phase group! Staphylococcus. Lancet. 1979;1:1116-1118'},{id:"B25",body:'Thomas SW, Baird IM, Frazier RD. Toxic shock syndrome following submucous resection and rhinoplasty. JAMA. 1982;247:2402-2403'},{id:"B26",body:'Lohr GD, Hollabaugh B, Waters P, Tiwana PS. Methicillin-resistant Staphylococcus aureus and antibiotic use in septorhinoplasty: Case report and review of literature. Journal of Oral Medicine, Oral Surgery, Oral Pathology and Oral Radiology. 2017;123(6):e 177-e 188'},{id:"B27",body:'Angelos PC, Wang TD. Methicillin-resistant Staphylococcus aureus infection in septorhinoplasty. Laryngoscope. 2010;120(7):1309-1311'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Balwant Singh Gendeh",address:"bsgendeh@gmail.com",affiliation:'
Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
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1. Introduction
Approximate methods of analytical modeling (MAM) of the wideband stochastic processes (StP) in stochastic differential systems with unsolved derivatives (SDS USD) based on normal approximate method (NAM), orthogonal expansions method, and quasi moment methods are developed in [1, 2]. For stochastic integrodifferential systems with unsolved derivatives reducible to SDS corresponding equations for MAM are given in [3, 4]. In [3, 4], problems of mean square (m.s.) synthesis of normal (Gaussian) estimators (filters, extrapolators, etc.) were firstly stated and solved in [1, 2, 3, 4]. Results presented in [1, 2, 3, 4] are valid for smooth (in m.s. sense) functions in SDS USD. For unsmooth functions in SDS USD theory of normal filtering and extrapolation is developed in [5].
Let us present an overview and generalization of [1, 2, 3, 4, 5] for linear and nonlinear regression models. Section 2 is developed to normal analytical modeling algorithms. Normal linear filtering and extrapolation algorithms are given in Sections 3 and 4. Linear modeling and estimation algorithms for SDS USD with multiplicated (parametric) noises are presented in Section 5. Normal nonlinear algorithms for filtering and extrapolation are described in Section 6. Section 7 contains two illustrative examples. In Section 8, main conclusions and some generalizations are given.
2. Normal modeling
Different types of SDS USD arise in problems of analytical modeling and estimator design for stochastic nonlinear dynamical systems when it is possible to neglect higher-order time derivatives [1, 2, 3].
First-order SDS USD is described by the following scalar equation:
φ=φtXtẊtUt=0,E1
where Xt and Ẋt are scalar state variable and its time derivative; Ut is noise vector StP dimUt=nU; nonlinear function φ admits regression approximation [6, 7, 8].
For vector SDS USD, we have the following vector equation:
φ¯=φ¯tXtX¯tUt=0.E2
Here X¯t being vector of derivatives till l order
X¯t=ẊtT…Xtl−1TT;E3
Ut being autocorrelated noise vector defined by linear vector equation:
U̇t=a0tU+a1tUt+btUVt,E4
where dimXt=nX;dimUt=nU; Vt is white noise, dimVt=nV;dima0tU=nU×1;dimatU=nU×nU;dimbtU=nU×nV. Further, we consider the Wiener white noise W0t with matrix intensity v0=v0t and the mixed Wiener-Poisson white noise [9, 10, 11, 12, 13]:
Vt=Ẇt,Wt=W0t+∫R0qcρP0tdρ,E5
vt=v0tW+∫R0qcρcρTvPtρdρ.E6
Here, dimcρ=dimW0t=nV; stochastic Ito integrals are taken in R0q (R0q with pricked origin).
As it is known [6, 7, 8], a deterministic model for real StP defined by Y=φZ at Z=XTX¯TUTT in (2) is given by the formula
ŷz=EYz,ŷz∈ΨE7
at accuracy criterion
εz=∑p=1nYEŷp−Yp2z,p=1…nY.E8
Class of functions ψ∈Ψ represents linear functional space satisfying the following necessary and sufficient conditions:
trE[ŷz−Y]ψzT=0.E9
For linear shifted and unshifted regression models, we have two known models:
where Ez,Γz,Kz being first and second moments for given one-dimensional distribution.
For Eq. (2), linear regression model takes the Booton form
φ̂=φ̂0+k1φXt+k2φX¯t+k3φUt=0,E12
where φ̂0, k1,2,3φ being regressors depending on φ and joint distribution of StP Xt,X¯t,Ut. After Eq. (12) differentiation till the l−1 order, we get the following set of l−1 equations:
φ̂̇t=0,…,φ̂tl−1=0.E13
At algebraic solvability condition of linear Eqs. (12) and (13), we reduce SDS USD to SDS of the following form:
Ẋt=A0+A1Xt+A2Ut,E14
where A0,A1,A2 are expressed in terms φ̂0, k1,2,3φdetk2φ−1≠0 and indirectly depends on statistical characteristics of Xt, its derivatives and noise Ut. For combined vector XtTUtT=Y˜t we have equation:
Y˜̇t=B0+B1Y˜t+B2Vt,Yt0=Y0,E15
Its one and second probabilistic moments satisfy the following equations [12, 13, 14]:
Y˜̇t=B0+B1Y˜t+B2Vt,Yt0=Y0,E16
ĖtY˜=B0+B1EtY˜,Et0Y˜=E0Y˜,E17
K̇tY˜=B1KtY˜+KtY˜B1T+B2vB2T,K̇t0Y˜=K0Y˜,E18
∂KY˜t1t2∂t2=KY˜t1t2B1t2T,KY˜t1t1=Kt1Y˜E19
where EtY˜=EY˜t, KtY˜=EY˜t−E˜tYY˜t−E˜tYT, t1>t2. So, we get two proposals.
Proposal 1. Let vector non-Gaussian SDS USD(2)satisfy conditions:
vector functionsφinEq. (2)admit m.s. regression of linear classΨ;
linearEqs. (12)and(13)are solvable regards all derivatives tilll−1order.
Then SDS USD may be reduced to parametrized SDE. First and second moments of joint vectorY˜t=XtTUtTTsatisfyEqs. (16)–(19).
Proposal 2. For normal joint distributionN=NEtYKtYof vector variables inEqs. (16)–(19)it is necessary in equations of Theorem 1 to put
So for Kazakov regression, Eqs. (21)–(24) are the basis of Proposal 3.
The regression Eyz and its m.s. estimator ŷz represent deterministic regression model. So to obtain a stochastic regression model, it is sufficient to represent Y in the form Y=Eyz+Y\' or Y=ŷz+Y\'\', where Y\',Y\'\' being some random variables. For finding a deterministic linear regression model, it is sufficient to know the mathematical expectations Ez,Ey and covariance matrices Kz,Kyz. In the case of a stochastic linear regression model, it is necessary to know the distribution of Y for any z or at list its regression ŷz and covariance matrix Kyz (coinciding with the covariance matrices KY\'z or KY\'\'z). A more general problem of the best m.s. approximation of the regression by a finite linear combination of given functions χ1z,…,χNz is reduced to the problem of the best approximation to the regression, as any linear combination of the functions χ1z,…,χNz represents a linear function of variables z1=χ1z,…,zNz=χNz. Corresponding models based on m.s. optimal regression are given in [7].
In the general case, we have the following vector equation:
Żt=azZtt+bzZttVt,E30
where Vt being defined by Eqs. (5) and (6). Functions az=azZtt and bz=bzZtt are composed on the basis of Eq. (2) after nonlinear regression approximation φ̂t=∑jcjχZt and Eq. (13).
According to normal approximation method (NAM), we have for Eq. (30) the following equations for normal modeling [9, 10, 11, 12]:
where EN being symbol of normal mathematical expectation.
3. Normal linear filtering
In filtering SDS USD problems, we use two types of equations: reduced SDE USD for vector state variables Xt and equation for vector observation variables Yt and Ẏt≡Zt.
Consider SDS USD Eq. (2) reducible to SDE Eq. (3.9) at conditions of Theorem 1. We introduce new variables putting Xt≡Y˜t,
Ẋt=A0t+A1tXt+A2tV1t.E39
Let the observation vector variable Yt satisfy the following linear equations:
Zt=Ẏt=B0t+B1tXt+B2tV2t.E40
where V1t and V2t are normal white noises with matrix v1t=v01 and v2t=v02 intensities.
Equations of Kalman-Bucy filter in case of Eqs. (39) and (40) for the Gaussian white noises are as follows [12, 13, 14]:
X̂̇t=A0+A1X̂t+βtZt−B0+B1X̂t.E41
βt=RtB1tTv2t−1,detv2t≠0.E42
Ṙt=A1tRt+RtA1tT+v1t−βtv2tβtTE43
at corresponding initial conditions. Rt being m.s. covariance matrix error, βt being gain coefficient. So, we have the following result.
Proposal 4. Let:
USD are reducible to SDS according to Proposal 2 or Proposal 3;
Then equations for m.s. normal filtering have the generalized Kalman-Bucy filter of the form(41)–(43).
4. Normal linear extrapolation
Using equations of linear m.s. extrapolation for time interval Δ [12, 13, 14] we get the following equations for the generalized Kalman–Bucy extrapolator:
X̂̇t+Δt∣t=A1X̂t+Δt∣tΔ>0E44
with initial condition
X̂t+Δt∣tΔ=0=X̂t.E45
For the initial time moment t and for the final time moment t+Δ according to Eq. (44), we get
where utτ being the fundamental solution of equation u̇t=A1tut at condition utt=I. For conditional mathematical expectation relatively Yt0t in Eq. (46), we get m.s. estimate future state Xt+Δ
In this case, error covariance matrix Rt+Δt∣t satisfies the following equation:
Ṙt+Δt∣t=a1Rt+Δ∣t+Rt+Δ∣ta1T+ψv0ψT.E48
At initial condition
Rt+Δ∣tΔ=0=Rt.E49
Hence, the error matrix Rt is known from Proposal 4. So, we have the following proposition.
Proposal 5. At conditions of Proposal 4 m.s. normal extrapolationX̂t+Δt∣tis defined byEqs. (47)–(49).
This extrapolator presents a sequel connection m.s. filter with gain ut+Δt, summator ut+ΔtX̂t∣t and integral term ∫tt+Δut+ΔτA0τdτ. The accuracy of extrapolation is estimated according to Eqs. (48) and (49).
5. Linear modeling and estimation in SDS USD with multiplicated noises
Let us consider vector Eqs. (2)–(6) for the multiplicative Gaussian noises:
φ=φẊtXtVt=φ1Ẋtt+φ20t∑h=1nXφ2htXhVt=0.E50
Here, dimXt=dimẊt=nX, dimφ=nX, φ1 being nonlinear vector function of vector argument Ẋt admitting linear regression
φ1Ẋtt≈φ11Ẋt,φ11=φ11EtẊKtẊt.E51
Here, φ11 being matrix of regressors; V1t being vector Gaussian white noise, dimVt=nV with matrix intensity v=v0t. In this case, Eqs. (50) and (51) at condition detφ11≠0 may be resolved relatively Ẋt
Ẋt=B0+B1Xt+B2+∑r=1nXB3rXrtVt,E52
where B0,B1,B2,B3r depend upon regressors φ11. Using [9, 10, 11, 12], we get equations for mathematical expectations. EtX, covariance matrix KtX, and matrix of covariance functions KXt1t2:
Here KtX=KrstX; KXt1t2=KrsXt1t2. So for MAM in nonstationary regimes, we have Eqs. (54) and (55) Proposal 6. In stationary case Eqs. (54) and (55) we get the following finite set of equations for E∗ and K∗ (Proposal 7):
For calculating (62) we need to find mathematical expectation EtQ, covariance matrix KtQ of combined vector Qt=X1…XnXY1…YnYT and error X˜t,X˜t=X˜t−Xt covariance matrix Rt using equations
Equations (70)–(72) define normal linear Pugachev extrapolator for SDS USD reduced to SDS (Proposal 9).
6. Normal nonlinear filtering and extrapolation
Let us consider SDS (2) reducible to SDS and fully observable measuring system described by the following equations:
Ẋt=aXtYtαt+bXtYtαtV0,E73
Zt=Ẏt=a1XtYtt+b1XtYttV0.E74
Here, a,a1,b,b1 being known functions of mentioned variable; α being vector of parameters in Eq. (73); V0 being normal white noise with intensity matrix v0=v0t.
Using the theory of normal nonlinear suboptimal filtering [10, 11, 12], we get the following equations for X̂t and Rt:
where ar being r th element of line-matrix a1T−â1Tb1ν0b1T−1; bkr being element of k th line and r th column of the matrix b1ν0b1T; br being the rth column of the matrix b1ν0b1Tb1ν0b1T−1, br=b1r…bprr=1,n1¯.
Hence, if the function a1 is linear in Xt and function b does not depend on Xt all matrices ρr=0 and Eq. (76) does not contain Ẏt (Section 3).
Analogously Section 6 we get from [12] corresponding equations of normal conditionally optimal (Pugachev) extrapolator for reduced equations
Ẋt=aXtYtt+bXttV1,E84
Zt=Ẏt=a1XtYtt+b1XtYttV2,E85
where V1 and V2 are normal independent white noises.
7. Examples
Let us consider scalar system
φẊtXt≡φ1Ẋt+φ2Xt+U1t=0E86
U̇1t=α10+α11U1t+β1V1t.E87
Here, Xt,Ẋt being state variable and its time derivative; U1t being scalar stochastic disturbance; V1t being scalar normal white noise with intensity v1t; φ1 and φ2 being nonlinear functions; α10,α11,β1 being constant parameters. After regression linearization of nonlinear functions, we have
φ1≈φ10+kẊφ1Ẋt0,φ2≈φ20+kXφ2Xt0.E88
At condition kẊφ≠0 we get from (86) and (88) equations for mathematical expectation mtX=EXt and centered Xt0=Xt−mtX:
Coefficients of statistical linearization for typical nonlinear functions [12, 13, 14].
Let us consider normal scalar system
F≡ΦẊt+atXt+ut=0.E104
Нere random function admits Pugachev normalization
ΦẊt≈Φ0+kΦẊt0+ΔΦt0,E105
where ΔΦt0 being normal StP satisfying equation of forming filter
Δ̇Φt0=atΔΦΔΦt0+btΔΦVt.E106
Note that functions Φt0 and kΦ depend on EtΦ̇ and DtΦ̇. Equations (104) and (105) are decomposing on two equations. First equation at condition kΦ≠0 is as follows:
Φ0+atEtX+ut=0,Φ0=kΦ0EtẊ.E107
Second equation at condition kΦ≠0 is as follows: kΦẊt0+ΔΦt0+atXt0=0 may be presented as
Ẋt0=atkΦ−1Xt0−kΦ−1ΔΦt0.E108
Equations (106) and (108) for Zt0=Xt0ΔΦt0T leads to the following vector equation for covariance matrix
K̇tZ=AKtZ+KtZAT+BνVBT,E109
where A=−atkΦ−1−kΦ−10aΔΦ,B=0bΔΦ. Eqs. (107) and (109) give the following final relations:
Models of various types of SDS USD arise in problems of analytical modeling and estimation (filtering, extrapolation, etc.) for control stochastic systems, when it is possible to neglect higher-order time derivatives. Linear and nonlinear methodological and algorithmic support of analytical modeling, filtering, and extrapolation for SDS USD is developed. The methodology is based on the reduction of SDS USD to SDS by means of linear and nonlinear regression models. Special attention is paid to SDS USD with multiplicative (parametric) noises. Examples illustrating methodology are presented. The described results may be generalized for systems with stochastically unsolved derivatives and stochastic integrodifferential systems reducible to the differential.
Acknowledgments
The author is grateful to experts for their appropriate and constructive suggestions to improve this template. Research is supported by the Russian Academy of Sciences (Project-AAAA-A19-119001990037-5). Also, the author is much obliged to Mrs. Irina Sinitsyna and Mrs. Helen Fedotova for translation and manuscript preparation.
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Methodological and algorithmic support of analytical modeling, filtering, and extrapolation for SDS USD is developed. The methodology is based on the reduction of SDS USD to SDS by means of linear and nonlinear regression models. Two examples that are illustrating stochastic aspects of methodology are presented. Special attention is paid to SDS USD with multiplicative (parametric) noises.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/79114",risUrl:"/chapter/ris/79114",signatures:"Igor N. Sinitsyn",book:{id:"10821",type:"book",title:"Automation and Control - Theories and Applications",subtitle:null,fullTitle:"Automation and Control - Theories and Applications",slug:null,publishedDate:null,bookSignature:"Prof. Elmer P. Dadios",coverURL:"https://cdn.intechopen.com/books/images_new/10821.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-83969-174-4",printIsbn:"978-1-83969-173-7",pdfIsbn:"978-1-83969-211-6",isAvailableForWebshopOrdering:!0,editors:[{id:"111683",title:"Prof.",name:"Elmer P.",middleName:"P.",surname:"Dadios",slug:"elmer-p.-dadios",fullName:"Elmer P. Dadios"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"301200",title:"Dr.",name:"Igor N.",middleName:null,surname:"Sinitsyn",fullName:"Igor N. Sinitsyn",slug:"igor-n.-sinitsyn",email:"efedotova@ipiran.ru",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Normal modeling",level:"1"},{id:"sec_3",title:"3. Normal linear filtering",level:"1"},{id:"sec_4",title:"4. Normal linear extrapolation",level:"1"},{id:"sec_5",title:"5. Linear modeling and estimation in SDS USD with multiplicated noises",level:"1"},{id:"sec_6",title:"6. Normal nonlinear filtering and extrapolation",level:"1"},{id:"sec_7",title:"7. Examples",level:"1"},{id:"sec_8",title:"8. Conclusion",level:"1"},{id:"sec_9",title:"Acknowledgments",level:"1"}],chapterReferences:[{id:"B1",body:'Sinitsyn IN. Analytical modeling of wide band processes in stochastic systems with unsolved derivatives. Informatics and its Applications. 2017;11(1):2-12. (in Russian)'},{id:"B2",body:'Sinitsyn IN. Parametric analytical modeling of processes in stochastic systems with unsolved derivatives. Systems and Means of Informatics. 2017;27(1):21-45. (in Russian)'},{id:"B3",body:'Sinitsyn IN. Normal suboptimal filters for stochastic systems with unsolved derivatives. Informatics and its Applications. 2021;15(1):3-10. (in Russian)'},{id:"B4",body:'Sinitsyn IN. Analytical modeling and filtering in integrodifferential systems with unsolved derivatives. Systems and Means of Informatics. 2021;31(1):37-56. (in Russian)'},{id:"B5",body:'Sinitsyn IN. Analytical modeling and estimation of normal processes defined by stochastic differential equations with unsolved derivatives. Mathematics and Statistics Research. 2021. (in print)'},{id:"B6",body:'Pugachev VS. Theory of Random Functions and its Application to Control Problems. Pergamon Press; 1965. p. 833'},{id:"B7",body:'Pugachev VS. Probability Theory and Mathematical Statistics for Engineers. Pergamon Press; 1984. p. 450'},{id:"B8",body:'Pugachev VS, Sinitsyn IN. Lectures on Functional Analysis and Applications. Singapore: World Scientific; 1999. p. 730'},{id:"B9",body:'Pugachev VS, Sinitsyn IN. Stochastic Differential Systems. Analysis and Filtering. Chichester: John Wiley & Sons; 1987. p. 549'},{id:"B10",body:'Pugachev VS, Sinitsyn IN. Theory of Stochastic Systems. 2nd ed. Moscow: TORUS Press; 2001. p. 1000. (in Russian)'},{id:"B11",body:'Pugachev VS, Sinitsyn IN. Stochastic Systems. Theory and Applications. Singapore: World Scientific; 2001. p. 908'},{id:"B12",body:'Sinitsyn IN. Kalman and Pugachev Filters. 2nd ed. Logos: Moscow; 2007. p. 772. (in Russian)'},{id:"B13",body:'Socha L. Linearization Methods for Stochastic Dynamic Systems, Lect Notes Phys. 730. Springer; 2008. p. 383'},{id:"B14",body:'Sinitsyn IN. Normalization of systems with stochastically unsolved derivatives. Informatics and its Applications. 2021. (in print, in Russian)'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Igor N. Sinitsyn",address:"sinitsin@dol.ru",affiliation:'
Federal Research Center “Computer Science and Control” of Russian Academy of Sciences, Russia
Moscow Aviation Institute (Technical University), Russia
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This problematic is particularly relevant with medical imaging data, where linear techniques are frequently unsuitable for capturing variations in anatomical structures. In many cases, there is enough structure in the data (CT, MRI, ultrasound) so a lower dimensional object can describe the degrees of freedom, such as in a manifold structure. Still, complex, multivariate distributions tend to demonstrate highly variable structural topologies that are impossible to capture with a single manifold learning algorithm. This chapter will present recent techniques developed in manifold theory for medical imaging analysis, to allow for statistical organ shape modeling, image segmentation and registration from the concept of navigation of manifolds, classification, as well as disease prediction models based on discriminant manifolds. We will present the theoretical basis of these works, with illustrative results on their applications from various organs and pathologies, including neurodegenerative diseases and spinal deformities.",book:{id:"7342",slug:"manifolds-ii-theory-and-applications",title:"Manifolds II",fullTitle:"Manifolds II - Theory and Applications"},signatures:"Samuel Kadoury",authors:null},{id:"52886",doi:"10.5772/65903",title:"Head Pose Estimation via Manifold Learning",slug:"head-pose-estimation-via-manifold-learning",totalDownloads:1798,totalCrossrefCites:4,totalDimensionsCites:3,abstract:"For the last decades, manifold learning has shown its advantage of efficient non-linear dimensionality reduction in data analysis. 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It is proved that the angle of deformation must be harmonic, and that the differentials of many of the important variables generate a closed differential ideal. This implies that a coordinate system exists in which many of the variables satisfy particular ordinary differential equations, and these results can be used to characterize Bonnet surfaces.",book:{id:"5488",slug:"manifolds-current-research-areas",title:"Manifolds",fullTitle:"Manifolds - Current Research Areas"},signatures:"Paul Bracken",authors:[{id:"92883",title:"Prof.",name:"Paul",middleName:null,surname:"Bracken",slug:"paul-bracken",fullName:"Paul Bracken"}]},{id:"72257",doi:"10.5772/intechopen.92441",title:"Quasiconformal Reflections across Polygonal Lines",slug:"quasiconformal-reflections-across-polygonal-lines",totalDownloads:421,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"An important open problem in geometric complex analysis is to establish algorithms for explicit determination of the basic curvelinear and analytic functionals intrinsically connected with conformal and quasiconformal maps, such as their Teichmüller and Grunsky norms, Fredholm eigenvalues and the quasireflection coefficient. This has not been solved even for convex polygons. This case has intrinsic interest in view of the connection of polygons with the geometry of the universal Teichmüller space and approximation theory. This survey extends our previous survey of 2005 and presents the new approaches and recent essential progress in this field of geometric complex analysis, having various important applications. Another new topic concerns quasireflections across finite collections of quasiintervals.",book:{id:"8760",slug:"structure-topology-and-symplectic-geometry",title:"Structure Topology and Symplectic Geometry",fullTitle:"Structure Topology and Symplectic Geometry"},signatures:"Samuel L. 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Clifford algebra unifies and generalizes real number, complex, quaternion, and vector algebra and converts complicated relations and operations into intuitive matrix algebra independent of coordinate systems. By localizing the basis or frame of space-time and introducing differential and connection operators, Clifford algebra also contains Riemann geometry. Clifford algebra provides a unified, standard, elegant, and open language and tools for numerous complicated mathematical and physical theories. Clifford algebra calculus is an arithmetic-like operation that can be well understood by everyone. This feature is very useful for teaching purposes, and popularizing Clifford algebra in high schools and universities will greatly improve the efficiency of students to learn fundamental knowledge of mathematics and physics. So, Clifford algebra can be expected to complete a new big synthesis of scientific knowledge.",book:{id:"8760",slug:"structure-topology-and-symplectic-geometry",title:"Structure Topology and Symplectic Geometry",fullTitle:"Structure Topology and Symplectic Geometry"},signatures:"Ying-Qiu Gu",authors:[{id:"314607",title:"Dr.",name:"Ying-Qiu",middleName:null,surname:"Gu",slug:"ying-qiu-gu",fullName:"Ying-Qiu Gu"}]},{id:"52596",title:"Symplectic Manifolds: Gromov-Witten Invariants on Symplectic and Almost Contact Metric Manifolds",slug:"symplectic-manifolds-gromov-witten-invariants-on-symplectic-and-almost-contact-metric-manifolds",totalDownloads:1496,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"In this chapter, we introduce Gromov-Witten invariant, quantum cohomology, Gromov-Witten potential, and Floer cohomology on symplectic manifolds, and in connection with these, we describe Gromov-Witten type invariant, quantum type cohomology, Gromov-Witten type potential and Floer type cohomology on almost contact metric manifolds. 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According to the behaviour of the tangent bundle of a sub-manifold, with respect to the action of almost Riemannian product structure of the ambient manifolds, we have three typical classes of sub-manifolds such as invariant sub-manifolds, anti-invariant sub-manifolds and semi-invariant sub-manifolds. In addition, slant, semi-slant and pseudo-slant sub-manifolds are introduced by many geometers.",book:{id:"5488",slug:"manifolds-current-research-areas",title:"Manifolds",fullTitle:"Manifolds - Current Research Areas"},signatures:"Mehmet Atçeken, Ümit Yıldırım and Süleyman Dirik",authors:[{id:"191326",title:"Prof.",name:"Mehmet",middleName:null,surname:"Atceken",slug:"mehmet-atceken",fullName:"Mehmet Atceken"},{id:"196148",title:"Dr.",name:"Umit",middleName:null,surname:"Yildirim",slug:"umit-yildirim",fullName:"Umit Yildirim"}]},{id:"52886",title:"Head Pose Estimation via Manifold Learning",slug:"head-pose-estimation-via-manifold-learning",totalDownloads:1793,totalCrossrefCites:4,totalDimensionsCites:3,abstract:"For the last decades, manifold learning has shown its advantage of efficient non-linear dimensionality reduction in data analysis. Based on the assumption that informative and discriminative representation of the data lies on a low-dimensional smooth manifold which implicitly embedded in the original high-dimensional space, manifold learning aims to learn the low-dimensional representation following some geometrical protocols, such as preserving piecewise local structure of the original data. Manifold learning also plays an important role in the applications of computer vision, i.e., face image analysis. According to the observations that many face-related research is benefitted by the head pose estimation, and the continuous variation of head pose can be modelled and interpreted as a low-dimensional smooth manifold, we will focus on the head pose estimation via manifold learning in this chapter. Generally, head pose is hard to directly explore from the high-dimensional space interpreted as face images, which is, however, can be efficiently represented in low-dimensional manifold. Therefore, in this chapter, classical manifold learning algorithms are introduced and the corresponding application on head pose estimation are elaborated. Several extensions of manifold learning algorithms which are developed especially for head pose estimation are also discussed and compared.",book:{id:"5488",slug:"manifolds-current-research-areas",title:"Manifolds",fullTitle:"Manifolds - Current Research Areas"},signatures:"Chao Wang, Yuanhao Guo and Xubo Song",authors:[{id:"190308",title:"Dr.",name:"Chao",middleName:null,surname:"Wang",slug:"chao-wang",fullName:"Chao Wang"},{id:"190461",title:"Prof.",name:"Xubo",middleName:null,surname:"Song",slug:"xubo-song",fullName:"Xubo Song"},{id:"191562",title:"MSc.",name:"Yuanhao",middleName:null,surname:"Guo",slug:"yuanhao-guo",fullName:"Yuanhao Guo"}]}],onlineFirstChaptersFilter:{topicId:"165",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[],lsSeriesList:[],hsSeriesList:[],sshSeriesList:[],testimonialsList:[]},series:{item:{id:"6",title:"Infectious Diseases",doi:"10.5772/intechopen.71852",issn:"2631-6188",scope:"This series will provide a comprehensive overview of recent research trends in various Infectious Diseases (as per the most recent Baltimore classification). 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He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. 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