Maxilla–nasion–mandible angle: a new method to assess profile anomalies in pregnancy

Jong-Pleij, E. A. P. de; Ribbert, L. S. M.; Manten, G. T. R.; Tromp, Ellen; Bilardo, Caterina M.

doi:10.1002/uog.7768

Cited by 36 publications

(72 citation statements)

References 18 publications

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“…deviation between operators, meaning that it can be already reliably measured in the first trimester of pregnancy. The MNM angle and PFSR increase with CRL, whereas in the second and third trimesters, the MNM angle and PFSR remain constant [1,5,7]. The increase in the MNM angle in the first trimester can be explained by a more distinct growth and forward displacement of the maxilla compared to the mandible, which is only connected to the cranium through the temporomandibular joint and facial Fig.…”

Section: Discussionmentioning

confidence: 96%

“…Established second-trimester profile markers for trisomies are the nasal bone length (NBL), the prenasal thickness (PNT), the ratio between the NBL and PNT, and more recently, the prefrontal space ratio (PFSR) [1][2][3][4]. Other second-trimester profile parameters, e.g., the facial profile (FP) line and maxilla-nasion-mandible (MNM) angle, have been studied as markers for facial anomalies including profile alterations in case of aneuploidies [2,3,[5][6][7]. These are proven reproducible markers for the diagnosis of retrognathia, maxillary alveolar ridge interruption, sloping forehead, frontal bossing, and flat profile [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…Other second-trimester profile parameters, e.g., the facial profile (FP) line and maxilla-nasion-mandible (MNM) angle, have been studied as markers for facial anomalies including profile alterations in case of aneuploidies [2,3,[5][6][7]. These are proven reproducible markers for the diagnosis of retrognathia, maxillary alveolar ridge interruption, sloping forehead, frontal bossing, and flat profile [6,7]. Reference values for these markers are available for the second trimester, but normal ranges for the PNT/NBL ratio, profile line (PL) distance, MNM angle, and PFSR in the first trimester are still missing.…”

Section: Introductionmentioning

confidence: 99%

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Prenasal Thickness, Prefrontal Space Ratio and Other Facial Profile Markers in First-Trimester Fetuses with Aneuploidies, Cleft Palate, and Micrognathia

et al. 2016

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Objective: To investigate the feasibility and reproducibility of the prenasal thickness (PNT)/nasal bone length (NBL) ratio, maxilla-nasion-mandible (MNM) angle, facial profile line, profile line distance, and prefrontal space ratio (PFSR) in the first trimester of pregnancy, develop normal ranges, and evaluate these markers in abnormal fetuses. Methods: All measurements were performed on stored images by two operators. Feasibility, interoperator agreement, and prediction intervals were calculated for all measurements. Results: Feasibility was the highest for the NBL (74.3-79.7%) and the MNM angle (75.7-79.05%). Correlation was good for the NBL, the PNT, and the MNM angle (intraclass correlation coefficient 0.706-0.835). Mean difference between operators was the lowest for the PNT and PFSR (0.03-0.08). Measurements in abnormal fetuses showed that the majority of trisomy 21 fetuses had either an absent nasal bone or a shorter NBL. The PNT and PNT/NBL ratio were above the 97.5th centile in one third of the cases. Fetuses with facial clefts or micrognathia showed on average a large MNM angle (multiple of the median 0.96-5.15). Conclusion: First-trimester facial markers are feasible. The PNT and PNT/NBL ratio were increased in one third of the trisomic fetuses, and the MNM angle in the majority of fetuses with micrognathia and facial clefts.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prenasal Thickness, Prefrontal Space Ratio and Other Facial Profile Markers in First-Trimester Fetuses with Aneuploidies, Cleft Palate, and Micrognathia

et al. 2016

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“…45 Another tentative to point out an objective three-dimensional ultrasound analysis of the profile has been proposed by the construction of the maxilla-nasion-mandible angle. 46 The angle is defined as the angle between the intersection of the maxilla-nasion and the mandible-nasion lines in the exact mid sagittal plane. The mean angle seems to be 13.5 degrees and does not change during pregnancy.…”

Section: Imaging Of the Profilementioning

confidence: 99%

Radiological evaluation of the fetal face using three-dimensional ultrasound imaging

Bäumler¹,

Bigorre²,

Faure³

2012

RMI

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This paper reviews screening and three-dimensional diagnostic ultrasound imaging of the fetal face. The different techniques available for analyzing biometric and morphological items of the profile, eyes, ears, lips, and hard and soft palate are commented on and briefly compared with the respective bi-dimensional techniques. The available literature supports the use of three-dimensional ultrasound in difficult prenatal diagnostic conditions because of its diagnostic accuracy, enabling improved safety of perinatal care. Globally, a marked increase has been observed in the accuracy of three-dimensional ultrasound in comparison with the bidimensional approach. Because there is no consensus about the performance of the different three-dimensional techniques, future studies are needed in order to compare them and to find the best technique for analysis of each of the respective facial elements. Universal prenatal standards may integrate these potential new findings in the future. At this time, the existing guidelines for prenatal facial screening should not be changed.

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“…Numerous studies using more standardized objective methods for measuring fetal jaw size and micrognathia have been performed [11,12,13,14,15,16,17,18,19,20]. Paladini et al [14] introduced the concept of a jaw index by defining growth curves and biometry in order to establish normal fetal jaw size and dimensions in utero.…”

Section: Micrognathiamentioning

confidence: 99%

Prenatal Identification of Pierre Robin Sequence: A Review of the Literature and Look towards the Future

Kaufman¹,

Cassady

Hyman³

et al. 2015

Fetal Diagn Ther

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Fetal ultrasonography is an important tool used to prenatally diagnose many craniofacial conditions. Pierre Robin sequence (PRS) is a rare congenital deformation characterized by micrognathia, glossoptosis, and airway obstruction. PRS can present as a perinatal emergency when the retropositioned tongue obstructs the airway leading to respiratory compromise. More predictable and reliable diagnostic studies could help the treating medical team as well as families prepare for these early airway emergencies. The medical literature was reviewed for different techniques used to prenatally diagnose PRS radiologically. We have reviewed these techniques and suggested a possible diagnostic pathway to consistently identify patients with PRS prenatally.

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Maxilla–nasion–mandible angle: a new method to assess profile anomalies in pregnancy

Abstract: Objectives

Cited by 36 publications

References 18 publications

Prenasal Thickness, Prefrontal Space Ratio and Other Facial Profile Markers in First-Trimester Fetuses with Aneuploidies, Cleft Palate, and Micrognathia

Prenasal Thickness, Prefrontal Space Ratio and Other Facial Profile Markers in First-Trimester Fetuses with Aneuploidies, Cleft Palate, and Micrognathia

Radiological evaluation of the fetal face using three-dimensional ultrasound imaging

Prenatal Identification of Pierre Robin Sequence: A Review of the Literature and Look towards the Future

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