Asymmetry of glenoid fossa as differential diagnosis for hemimandibular elongation

Abstract

La asimetría facial es uno de los principales hallazgos durante la práctica clínica con una prevalencia entre el 21-85%; ésta causa problemas tanto funcionales como estéticos, y se manifi esta por la inconsistencia en tamaño, forma o disposición de las estructuras craneofaciales en ambos lados del plano medio sagital. Su etiología se atribuye a factores hereditarios y/o ambientales que se pueden expresar durante el periodo fetal, infantil y/o puberal, incluyendo la hiperactividad condilar unilateral, desarmonía funcional de los músculos de la masticación, dominancia de algún hemisferio cerebral, plagiocefalia, craneosinostosis unilateral, entre otros. Donde el tiempo de evolución previo a su detección contribuye con el nivel de expresión de la asimetría. Por medio de la revisión de literatura, la propuesta de un diagrama diferencial y la presentación de un caso clínico que incluye análisis facial, análisis cefalométrico, reconstrucción tomográfi ca 3D y hallazgos de medicina nuclear. Se sugieren diagramas diferenciales y una nueva clasifi cación de asimetría facial. Estableciendo el diagnóstico diferencial entre asimetría de la fosa glenoidea y elongación hemimandibular, que exige una cuidadosa correlación de los hallazgos clínicos e imagenológicos, ya que ambos presentan características clínicas similares, pero difi eren en su enfoque terapéutico.

Three-dimensional computed tomography evaluation of craniofacial characteristics according to lateral deviation of chin

“…In the lower facial thirds, chin deviation is correlated with mandibular length and mandibular body length asymmetry, coincident with the findings of previous studies [12, 21, 28]. Moreover, in our study, chin deviation was also correlated with the upper and middle facial third asymmetry, especially vertical asymmetry of the glenoid fossa and zygomatic arch, coincident with the findings of another stud y[7]. In a previous study, asymmetry of the glenoid cavity, a type of upper and middle facial third asymmetry, was reported [7].…”

“…The glenoid fossa is a depression in the temporal bone that articulates with the mandible to form the temporomandibular joint [25]. Positional changes in the glenoid fossa during growth can lead to facial asymmetry and malocclusion [7]. The location of the orbit and zygomatic bone plays an important role in facial symmetry and esthetics [26, 27].…”

“…Facial asymmetry often involves varying degrees of upper (5%) and middle (36%) facial third asymmetries [3]. In a previous study, asymmetry of the glenoid cavity, a type of upper and middle facial third asymmetry, was reported [7]. Asymmetry of the glenoid cavity is caused by defects in generation, proliferation, migration, and differentiation of cranial neural crest cells [8] or craniofacial structure modeling from the cerebrum [9–11].…”

“…Asymmetry of the glenoid cavity is caused by defects in generation, proliferation, migration, and differentiation of cranial neural crest cells [8] or craniofacial structure modeling from the cerebrum [9–11]. As a result, asymmetry of the glenoid cavity causes lateral deviation of the chin [7].…”

“…The relationship between the lateral deviation of chin and the upper and middle facial third asymmetry is still controversial. López Buitrago et al reported lateral deviation of chin is associated with upper and middle facial third asymmetry, while Kwon et al reported lateral deviation of chin is not closely related with upper and middle facial third asymmetry [7, 12]. The purpose of this study was to evaluate the correlation of upper and middle facial third asymmetry with lateral deviation of chin using 3-dimensional computed tomography (3-D CT).…”