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Craniofacial Asymmetry in Adults With Neglected Congenital Muscular Torticollis.

Jeong KY, Min KJ, Woo J, Yim SY - Ann Rehabil Med (2015)

Bottom Line: The frontal and the zygomatic length ratio (i.e., the anteroposterior length asymmetry on the axial plane) was 1.06±0.03 and 1.07±0.03, respectively, which was increased significantly with age in the linear regression analysis (r(2)=0.176, p=0.019 and r(2)=0.188, p=0.015, respectively).The vertical or lateral displacement of the facial landmarks and rotation of the mandibular axis did not significantly correlate with age (p>0.05).This finding may enhance the understanding of therapeutic strategies for craniofacial asymmetry in adults with neglected CMT.

View Article: PubMed Central - PubMed

Affiliation: The Clinic for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT

Objective: To evaluate the craniofacial asymmetry in adults with neglected congenital muscular torticollis (CMT) by quantitative assessment based on craniofacial three-dimensional computed tomography (3D-CT).

Methods: Preoperative craniofacial asymmetry was measured by 3D-CT for 31 CMT subjects ≥18 years of age who visited a tertiary medical center and underwent 3D-CT between January 2009 and December 2013. The relationship between the age and the severity of craniofacial asymmetry was analyzed in reference to anteroposterior length asymmetry of the frontal bone and zygomatic arch, vertical and lateral displacements of the facial landmarks, and mandibular axis rotation.

Results: The age at CT was 27.71±7.02 years (range, 18-44 years). All intra-class correlation coefficients were higher than 0.7, suggesting good inter-rater reliability (p<0.05) of all the measurements. The frontal and the zygomatic length ratio (i.e., the anteroposterior length asymmetry on the axial plane) was 1.06±0.03 and 1.07±0.03, respectively, which was increased significantly with age in the linear regression analysis (r(2)=0.176, p=0.019 and r(2)=0.188, p=0.015, respectively). The vertical or lateral displacement of the facial landmarks and rotation of the mandibular axis did not significantly correlate with age (p>0.05).

Conclusion: Craniofacial asymmetry of neglected CMT became more severe with age in terms of anteroposterior length asymmetry of the ipsilateral frontal bone and zygomatic arch on the axial plane even after growth cessation. This finding may enhance the understanding of therapeutic strategies for craniofacial asymmetry in adults with neglected CMT.

No MeSH data available.


Related in: MedlinePlus

Measurement of the vertical length asymmetry on the coronal plane. (A) A mid-sagittal line was constructed by joining the landmarks, namely the glabella 'G', nasion 'N', and top of the nasal spine 'TNS', to form the y1-axis and perpendicular line with origins at G, defined as the x-axis on the frontal view. The xULR, e/f, represents the vertical length asymmetry of the LO from the x-axis on the CMT side in comparison with that on the non-CMT side. The xMLR, g/h, represents the vertical length asymmetry of the ZY. The xLLR, i/j, represents the vertical length asymmetry of the GO on the CMT side in comparison with that on the non-CMT side. (B) Linear regression analyses between xULR, xMLR, xLLR, and the subjects' ages. LO, latero-orbitale; CMT, congenital muscular torticollis; ZY, zygonion; GO, gonion.
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Figure 2: Measurement of the vertical length asymmetry on the coronal plane. (A) A mid-sagittal line was constructed by joining the landmarks, namely the glabella 'G', nasion 'N', and top of the nasal spine 'TNS', to form the y1-axis and perpendicular line with origins at G, defined as the x-axis on the frontal view. The xULR, e/f, represents the vertical length asymmetry of the LO from the x-axis on the CMT side in comparison with that on the non-CMT side. The xMLR, g/h, represents the vertical length asymmetry of the ZY. The xLLR, i/j, represents the vertical length asymmetry of the GO on the CMT side in comparison with that on the non-CMT side. (B) Linear regression analyses between xULR, xMLR, xLLR, and the subjects' ages. LO, latero-orbitale; CMT, congenital muscular torticollis; ZY, zygonion; GO, gonion.

Mentions: The vertical length asymmetry of the anterior facial landmarks was measured as shown in Fig. 2A. A mid-sagittal line was constructed by joining the landmarks, namely the glabella (G), nasion (N), and top of the nasal spine (TNS) to form the y1-axis, and the perpendicular line with origins at the G was defined as the x-axis in the frontal view. The x-upper landmark length ratio (xULR), e/f, represents the vertical length asymmetry of the latero-orbitale (LO), the intersection of the temporal line of the frontal bone and internal orbital margin from the x-axis on the CMT side in comparison with that on the non-CMT side. The x-middle landmark length ratio (xMLR), g/h, represents the vertical length asymmetry of the zygonion (ZY) on the CMT side in comparison with that on the non-CMT side. The x-lower landmark length ratio (xLLR), i/j, represents the vertical length asymmetry of the gonion (GO) on the CMT side in comparison with that on the non-CMT side. ZY is the most lateral point on the outline of each zygomatic arch, and GO is the mid-point on the curvature at the angle of the mandible.


Craniofacial Asymmetry in Adults With Neglected Congenital Muscular Torticollis.

Jeong KY, Min KJ, Woo J, Yim SY - Ann Rehabil Med (2015)

Measurement of the vertical length asymmetry on the coronal plane. (A) A mid-sagittal line was constructed by joining the landmarks, namely the glabella 'G', nasion 'N', and top of the nasal spine 'TNS', to form the y1-axis and perpendicular line with origins at G, defined as the x-axis on the frontal view. The xULR, e/f, represents the vertical length asymmetry of the LO from the x-axis on the CMT side in comparison with that on the non-CMT side. The xMLR, g/h, represents the vertical length asymmetry of the ZY. The xLLR, i/j, represents the vertical length asymmetry of the GO on the CMT side in comparison with that on the non-CMT side. (B) Linear regression analyses between xULR, xMLR, xLLR, and the subjects' ages. LO, latero-orbitale; CMT, congenital muscular torticollis; ZY, zygonion; GO, gonion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496516&req=5

Figure 2: Measurement of the vertical length asymmetry on the coronal plane. (A) A mid-sagittal line was constructed by joining the landmarks, namely the glabella 'G', nasion 'N', and top of the nasal spine 'TNS', to form the y1-axis and perpendicular line with origins at G, defined as the x-axis on the frontal view. The xULR, e/f, represents the vertical length asymmetry of the LO from the x-axis on the CMT side in comparison with that on the non-CMT side. The xMLR, g/h, represents the vertical length asymmetry of the ZY. The xLLR, i/j, represents the vertical length asymmetry of the GO on the CMT side in comparison with that on the non-CMT side. (B) Linear regression analyses between xULR, xMLR, xLLR, and the subjects' ages. LO, latero-orbitale; CMT, congenital muscular torticollis; ZY, zygonion; GO, gonion.
Mentions: The vertical length asymmetry of the anterior facial landmarks was measured as shown in Fig. 2A. A mid-sagittal line was constructed by joining the landmarks, namely the glabella (G), nasion (N), and top of the nasal spine (TNS) to form the y1-axis, and the perpendicular line with origins at the G was defined as the x-axis in the frontal view. The x-upper landmark length ratio (xULR), e/f, represents the vertical length asymmetry of the latero-orbitale (LO), the intersection of the temporal line of the frontal bone and internal orbital margin from the x-axis on the CMT side in comparison with that on the non-CMT side. The x-middle landmark length ratio (xMLR), g/h, represents the vertical length asymmetry of the zygonion (ZY) on the CMT side in comparison with that on the non-CMT side. The x-lower landmark length ratio (xLLR), i/j, represents the vertical length asymmetry of the gonion (GO) on the CMT side in comparison with that on the non-CMT side. ZY is the most lateral point on the outline of each zygomatic arch, and GO is the mid-point on the curvature at the angle of the mandible.

Bottom Line: The frontal and the zygomatic length ratio (i.e., the anteroposterior length asymmetry on the axial plane) was 1.06±0.03 and 1.07±0.03, respectively, which was increased significantly with age in the linear regression analysis (r(2)=0.176, p=0.019 and r(2)=0.188, p=0.015, respectively).The vertical or lateral displacement of the facial landmarks and rotation of the mandibular axis did not significantly correlate with age (p>0.05).This finding may enhance the understanding of therapeutic strategies for craniofacial asymmetry in adults with neglected CMT.

View Article: PubMed Central - PubMed

Affiliation: The Clinic for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT

Objective: To evaluate the craniofacial asymmetry in adults with neglected congenital muscular torticollis (CMT) by quantitative assessment based on craniofacial three-dimensional computed tomography (3D-CT).

Methods: Preoperative craniofacial asymmetry was measured by 3D-CT for 31 CMT subjects ≥18 years of age who visited a tertiary medical center and underwent 3D-CT between January 2009 and December 2013. The relationship between the age and the severity of craniofacial asymmetry was analyzed in reference to anteroposterior length asymmetry of the frontal bone and zygomatic arch, vertical and lateral displacements of the facial landmarks, and mandibular axis rotation.

Results: The age at CT was 27.71±7.02 years (range, 18-44 years). All intra-class correlation coefficients were higher than 0.7, suggesting good inter-rater reliability (p<0.05) of all the measurements. The frontal and the zygomatic length ratio (i.e., the anteroposterior length asymmetry on the axial plane) was 1.06±0.03 and 1.07±0.03, respectively, which was increased significantly with age in the linear regression analysis (r(2)=0.176, p=0.019 and r(2)=0.188, p=0.015, respectively). The vertical or lateral displacement of the facial landmarks and rotation of the mandibular axis did not significantly correlate with age (p>0.05).

Conclusion: Craniofacial asymmetry of neglected CMT became more severe with age in terms of anteroposterior length asymmetry of the ipsilateral frontal bone and zygomatic arch on the axial plane even after growth cessation. This finding may enhance the understanding of therapeutic strategies for craniofacial asymmetry in adults with neglected CMT.

No MeSH data available.


Related in: MedlinePlus