Hofmann Elisabeth, Schmid Matthias, Steinhäuser-Andresen Stefanie, Hirschfelder Ursula
Department of Orthodontics and Orofacial Orthopedics, Zahnklinik 3-Kieferorthopädie, Universitätsklinikum Erlangen, Glückstrasse 11, 91054, Erlangen, Germany.
Department of Medical Biometry, Informatics and Epidemiology, Rheinische Friedrichs-Wilhelms University, Bonn, Germany.
J Orofac Orthop. 2016 May;77(3):176-84. doi: 10.1007/s00056-016-0022-8. Epub 2016 Apr 21.
To evaluate patients with oculoauriculovertebral spectrum (OAVS) malformations based on Katsumata's asymmetry index and to assess the usefulness of the scores thus obtained in identifying degrees and sites of asymmetry.
Multislice spiral computed tomography (MSCT) datasets of 8 female and 12 male OAVS patients aged 5.7-23.9 years were retrospectively analyzed. After three-dimensional reconstruction, central and bilateral anatomical landmarks were identified within a coordinate system defined by the sella, nasion, and dens axis. MSCT datasets of 20 clinically symmetrical patients were used to define the cutoff values for asymmetry. Based on the mean asymmetry scores and their standard deviations, the severities and sites of asymmetry were evaluated and processed for visual presentation in charts.
Both interrater (ICC 0.7070-0.9984) and intrarater (FVU 0.0014-0.2930) reliability was very high. The calculated asymmetry scores added up to mean values and standard deviations that were higher by factors of around 1.5-2.5 than reported by Katsumata et al. More anatomical landmarks were rated as asymmetric in OAVS patients showing unilateral agenesis of an external acoustic pore than in OAVS patients without such agenesis: in the former patients, statistically significant asymmetries compared to the control group were present at the L1M (coronal pulp cavity of the lower first molar), CoP (coronoid process), and Co (condylion superius) landmarks, whereas the latter group showed such significant asymmetries at the CoP and Co landmarks. Likewise, more patients with unilateral agenesis showed asymmetries at the level of the maxilla. Highly variable severities of asymmetry were found in both subgroups of OAVS patients.
Katsumata's asymmetry index can yield well-structured and illustrative views of landmark distribution, thus, suitably allowing for qualitative asymmetry evaluation of OAVS cases and identification of the skeletal regions involved.
基于胜俣不对称指数评估眼耳脊椎综合征（OAVS）畸形患者，并评估由此获得的分数在识别不对称程度和部位方面的有用性。
回顾性分析8名女性和12名男性OAVS患者的多层螺旋计算机断层扫描（MSCT）数据集，这些患者年龄在5.7至23.9岁之间。三维重建后，在由蝶鞍、鼻根和齿状突轴定义的坐标系内确定中央和双侧解剖标志。使用20名临床对称患者的MSCT数据集来定义不对称的临界值。基于平均不对称分数及其标准差，评估不对称的严重程度和部位，并进行处理以便在图表中直观呈现。
评分者间（组内相关系数ICC为0.7070 - 0.9984）和评分者内（FVU为0.0014 - 0.2930）的可靠性都非常高。计算得到的不对称分数的总和及其平均值和标准差比胜俣等人报告的高约1.5 - 2.5倍。与无外耳道单侧发育不全的OAVS患者相比，有外耳道单侧发育不全的OAVS患者中更多的解剖标志被评为不对称：在前一组患者中，与对照组相比，在L1M（下颌第一磨牙冠髓腔）、CoP（冠状突）和Co（髁上点）标志处存在统计学显著的不对称，而在后一组中，在CoP和Co标志处显示出这种显著的不对称。同样，更多有单侧发育不全的患者在上颌水平显示出不对称。在OAVS患者的两个亚组中都发现了高度可变的不对称严重程度。
胜俣不对称指数可以产生结构良好且具有说明性的标志分布视图，因此，适合对OAVS病例进行定性不对称评估并识别受累的骨骼区域。
