Tuin A Jorien, Tahiri Youssef, Paine Kaitlyn M, Paliga J Thomas, Taylor Jesse A, Bartlett Scott P
Philadelphia, Pa. From the Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, The Children's Hospital of Philadelphia.
Plast Reconstr Surg. 2015 Jan;135(1):149e-156e. doi: 10.1097/PRS.0000000000000843.
The OMENS+ classification is commonly used to describe the phenotypically diverse craniofacial features of craniofacial microsomia. The purpose of this study was to evaluate associations among the individual components of the OMENS+ criteria.
An institutional review board-approved retrospective chart review was performed for patients who presented with a diagnosis of unilateral or bilateral craniofacial microsomia to the craniofacial clinic from January of 1990 to December of 2012. Demographic, diagnosis, classification, treatment, and radiographic data were abstracted for all patients who met inclusion criteria. Associations and correlations were evaluated using the Spearman rank test and a logistic regression model.
One hundred five patients (61 male and 44 female) with craniofacial microsomia met inclusion criteria. Eighty-one patients (77.1 percent) had unilateral microsomia and 24 (22.9 percent) had bilateral microsomia. Twenty-eight patients (26.7 percent) had macrostomia. Correlations were all significantly interrelated (p = 0.000 to p = 00.018) between the degree of orbital, mandibular, and soft-tissue deformities. Moreover, the severity of ear deformity and facial nerve involvement were also significantly correlated (p = 0.008). Between these two groupings, there was a significant correlation between soft-tissue deficiency and nerve involvement (p = 0.010). Macrostomia was associated with the individual components of the group orbit (p = 0.008), mandible (p = 0.000), and soft tissue (p = 0.005).
The association between structures using the OMENS+ classification may be caused by their branchial arch origin. Structures mainly developed from the first branchial arch (orbit, mandible, and soft tissue) are associated in degree of severity, as are the structures mainly derived from the second branchial arch (facial nerve and ear).
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
OMENS+分类常用于描述颅面短小畸形的多种表型颅面特征。本研究的目的是评估OMENS+标准各组成部分之间的关联。
对1990年1月至2012年12月在颅面诊所诊断为单侧或双侧颅面短小畸形的患者进行了机构审查委员会批准的回顾性病历审查。提取了所有符合纳入标准患者的人口统计学、诊断、分类、治疗和影像学数据。使用Spearman秩检验和逻辑回归模型评估关联和相关性。
105例颅面短小畸形患者（61例男性和44例女性）符合纳入标准。81例患者（77.1%）为单侧短小畸形，24例（22.9%）为双侧短小畸形。28例患者（26.7%）有大口畸形。眼眶、下颌骨和软组织畸形程度之间的相关性均显著相关（p = 0.000至p = 00.018）。此外，耳部畸形的严重程度与面神经受累也显著相关（p = 0.008）。在这两组之间，软组织缺损与神经受累之间存在显著相关性（p = 0.010）。大口畸形与眼眶组（p = 0.008）、下颌骨组（p = 0.000）和软组织组（p = 0.005）的各个组成部分相关。
使用OMENS+分类的结构之间的关联可能是由于它们的鳃弓起源。主要由第一鳃弓发育而来的结构（眼眶、下颌骨和软组织）在严重程度上相关，主要由第二鳃弓衍生而来的结构（面神经和耳朵）也是如此。
临床问题/证据水平：风险，III级。
