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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 mandibular axis rotation. (A) The FAD is the angle formed by the intersection of the y1-axis and line δ, which represents the frontal mandibular axis, defined by a line connecting the nasal spine (ANS) and M on the frontal view. (B) The CAD is the angle between the y2-axis and line ε, which represents the caudal mandibular axis. The y2-axis was defined by joining the landmarks OP and O. The caudal mandibular axis was constructed by joining the landmarks M, PM in the inferior cranial view. (C) Linear regression analysis between FAD and the subjects' ages. (D) Linear regression analysis between CAD and the subjects' ages. ANS, anterior nasal spine; TNS, top of the nasal spine; M, mentum; OP, occipital protuberance; O, opisthion; PM, palatine midpoint; G, glabella; N, nasion.
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Figure 5: Measurement of the mandibular axis rotation. (A) The FAD is the angle formed by the intersection of the y1-axis and line δ, which represents the frontal mandibular axis, defined by a line connecting the nasal spine (ANS) and M on the frontal view. (B) The CAD is the angle between the y2-axis and line ε, which represents the caudal mandibular axis. The y2-axis was defined by joining the landmarks OP and O. The caudal mandibular axis was constructed by joining the landmarks M, PM in the inferior cranial view. (C) Linear regression analysis between FAD and the subjects' ages. (D) Linear regression analysis between CAD and the subjects' ages. ANS, anterior nasal spine; TNS, top of the nasal spine; M, mentum; OP, occipital protuberance; O, opisthion; PM, palatine midpoint; G, glabella; N, nasion.

Mentions: To measure the degree of mandibular rotation, the frontal axis deviation (FAD) and caudal axis deviation (CAD) were measured as shown in Fig. 5A and B. FAD is the angle formed by the intersection of the y1-axis and line δ, which represents the frontal mandibular axis defined by a line connecting the anterior nasal spine (ANS) and mentum (M) in the frontal view. CAD is the angle between the y2-axis and line ε, which represents the caudal mandibular axis. The y2-axis was defined by joining the landmarks occipital protuberance (OP), opisthion (O). The caudal mandibular axis was constructed by joining the landmarks M, and palatine midpoint (PM) in the inferior cranial view.


Craniofacial Asymmetry in Adults With Neglected Congenital Muscular Torticollis.

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

Measurement of the mandibular axis rotation. (A) The FAD is the angle formed by the intersection of the y1-axis and line δ, which represents the frontal mandibular axis, defined by a line connecting the nasal spine (ANS) and M on the frontal view. (B) The CAD is the angle between the y2-axis and line ε, which represents the caudal mandibular axis. The y2-axis was defined by joining the landmarks OP and O. The caudal mandibular axis was constructed by joining the landmarks M, PM in the inferior cranial view. (C) Linear regression analysis between FAD and the subjects' ages. (D) Linear regression analysis between CAD and the subjects' ages. ANS, anterior nasal spine; TNS, top of the nasal spine; M, mentum; OP, occipital protuberance; O, opisthion; PM, palatine midpoint; G, glabella; N, nasion.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Measurement of the mandibular axis rotation. (A) The FAD is the angle formed by the intersection of the y1-axis and line δ, which represents the frontal mandibular axis, defined by a line connecting the nasal spine (ANS) and M on the frontal view. (B) The CAD is the angle between the y2-axis and line ε, which represents the caudal mandibular axis. The y2-axis was defined by joining the landmarks OP and O. The caudal mandibular axis was constructed by joining the landmarks M, PM in the inferior cranial view. (C) Linear regression analysis between FAD and the subjects' ages. (D) Linear regression analysis between CAD and the subjects' ages. ANS, anterior nasal spine; TNS, top of the nasal spine; M, mentum; OP, occipital protuberance; O, opisthion; PM, palatine midpoint; G, glabella; N, nasion.
Mentions: To measure the degree of mandibular rotation, the frontal axis deviation (FAD) and caudal axis deviation (CAD) were measured as shown in Fig. 5A and B. FAD is the angle formed by the intersection of the y1-axis and line δ, which represents the frontal mandibular axis defined by a line connecting the anterior nasal spine (ANS) and mentum (M) in the frontal view. CAD is the angle between the y2-axis and line ε, which represents the caudal mandibular axis. The y2-axis was defined by joining the landmarks occipital protuberance (OP), opisthion (O). The caudal mandibular axis was constructed by joining the landmarks M, and palatine midpoint (PM) in the inferior cranial view.

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