Quantitative Evaluation of Cephalometric Radiographs of Patients With Hemifacial Microsomia

Abstract

Objective: To clarify the morphological characteristics of hemifacial microsomia (HFM) by quantitative analysis of cephalometric radiographs. Design: Retrospective study of imaging data. Setting: Imaging data were obtained from the records of Sapporo Medical University Hospital. Patients: A total of 183 patients with HFM. Main Outcome Measures: We used linear and angular measurements and analyzed the middle face and lower face. Results: The ratios of the affected side to the unaffected (A/U) side of the lateral distance of the mandibular condyle, the mandibular ramus height, and the length of the body of the mandible in the HFM group were significantly lower than in the control group. The inclination of the body of the mandible was significantly larger in the side with HFM than in the unaffected side, and the extent of the mandibular ramus was significantly lower than in the unaffected side. The A/U ratios of the extent of the angle of the mandible and the inclination of the body of the mandible in the HFM group were larger than in the control group. Moreover, the length and the inclination of the body of the mandible had significant correlations with the distance of the shift of the menton. Conclusions: It is suggested that improving the hypoplasia of the length of the body of the mandible and the extent of the angle of the mandible on the affected side will lead to more effective treatment of jaw deformity in patients with HFM.

Quantitative structural analysis of hemifacial microsomia mandibles in different age groups

“…The findings of a significant reduction in body size on the affected side are generally consistent with the previous studies ( 6 – 8 , 10 ). We further found that the degree of asymmetry of the body was generally smaller than that of the ipsilateral ramus, and no significant shortening of the body was observed in infancy.…”

“…Particularly, quantitative studies on the affected mandibular body in hemifacial microsomia are inconclusive (6)(7)(8)(9)(10)(11). Some studies considered it smaller than the contralateral side, causing clinical difference; while compensatory body growth was also found, with an incidence of up to 14.1% in the study population (6)(7)(8)(9)(10).…”

“…This classification system is clinically significant for diagnosis and treatment guidance; however, it does not address morphological analysis of the mandibular ramus or body (4). Particularly, quantitative studies on the affected mandibular body in hemifacial microsomia are inconclusive (6)(7)(8)(9)(10)(11). Some studies considered it smaller than the contralateral side, causing clinical difference; while compensatory body growth was also found, with an incidence of up to 14.1% in the study population (6)(7)(8)(9)(10).…”

A decade of clinical research on clinical characteristics, medical treatments, and surgical treatments for individuals with craniofacial microsomia: What have we learned?

“…This difference was also seen comparing the affected to the unaffected side, and comparing patients that were severely and mildly affected (43). Another cephalometric study by Tokura et al showed that mandibular body hypoplasia on the affected side was unrelated to the severity of hypoplasia of the mandibular ramus and TMJ, and was stronger correlated to the degree of chin point deviation than the ramus hypoplasia in patients with CFM (44). Functional difficulties due to hypoplasia of the mandible and maxilla are common in patients with CFM and can have adverse impacts on breathing, feeding, speech and/or occlusion.…”

Discrepancy in Mandibular Medullary Cavity on Different Sides: More Hints Towards Understanding Hemifacial Microsomia

“…Their attempts to approach HFM with new measurement techniques have made progress on macroscopically understanding this disease. Tokura et al’s 8 evaluated multiple parameters of mandibular morphology based on HFM patients’ cephalometric radiographs; Elnaghy et al’s 9 found the difference between mandibular ramus bone mineral density on the affected and nonaffected side of HFM patients by cone beam computerized tomography assessments; Chen et al’s 10 investigated the cranial base involvements in HFM patients by 3-dimensional analysis, and Peng et al’s 11 characterized airway changes in HFM adolescents.…”