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- Title
Spatially Detailed 3D Quantification of Improved Facial Symmetry After Surgery in Children With Unicoronal Synostosis.
- Authors
Öwall, Louise; Darvann, Tron A.; Hove, Hanne B.; Bøgeskov, Lars; Kreiborg, Sven; Hermann, Nuno V.
- Abstract
Objective: To assess improvement of soft-tissue facial symmetry in children surgically treated for unicoronal synostosis (UCS) in infancy, to correlate pre- and postsurgical facial asymmetry and to evaluate whether the improvement was visually recognizable. Design: Case–controlled follow-up. Patients/Settings: Eleven Danish children diagnosed with UCS were included, 3 of whom had tested positive for Muenke mutation. Preoperative computed tomography scans and postoperative 3dMD surfaces were available for measurements. A control group of healthy children matched for age and sex was employed. Main Outcome Measures: Pre- and postsurgical facial asymmetry was analyzed using a computerized method capable of objective and spatially detailed quantification in 3-dimension (transverse, vertical, and sagittal directions). Asymmetry was evaluated in the facial region and 6 subregions (forehead, mouth, eyes, nose, cheek, and chin). Results: The largest significant improvement was seen in the sagittal direction of the facial (1.9 mm), forehead (2.0 mm), and cheek (3.4 mm) regions. Small but significant improvements were also seen in the mouth, chin, and eye regions. No significant improvement was seen in the nose region. Significant correlations were found between the pre- and postsurgically calculated facial asymmetry and between calculated asymmetry and clinical validation scores. Conclusions: All patients presented with improved facial symmetry after surgery and the improvements were visually recognizable. However, only 1 (9.1%) of the 11 patients reached a level of facial asymmetry as low as that seen in the control group. The best outcome was, in general, seen in cases with mild facial asymmetry presurgically.
- Subjects
DENMARK; EYE anatomy; NASAL anatomy; MOUTH anatomy; FACIAL anatomy; CHEEK; CHIN; COMPUTED tomography; CRANIOSYNOSTOSES; GENETIC mutation; POSTOPERATIVE period; THREE-dimensional imaging; TREATMENT effectiveness; SEVERITY of illness index; CASE-control method; PREOPERATIVE period; CHILDREN
- Publication
Cleft Palate Craniofacial Journal, 2019, Vol 56, Issue 7, p918
- ISSN
1055-6656
- Publication type
Article
- DOI
10.1177/1055665618821821