Gribova Maria N, Pluijmers Britt I, Resnick Cory M, Caron Cornelia J J M, Borghi Alessandro, Koudstaal Maarten J, Padwa Bonnie L
Medical Student, Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Rotterdam, The Netherlands; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.
Attending Surgeon, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.
J Oral Maxillofac Surg. 2018 Dec;76(12):2625-2629. doi: 10.1016/j.joms.2018.04.038. Epub 2018 May 31.
Craniofacial microsomia (CFM) is characterized by malformations of structures derived from the first and second pharyngeal arches. The orbit is variably affected. The purpose of this study was to determine whether there is a difference in orbital volume between affected and unaffected sides in patients with unilateral CFM. The specific aims were to 1) measure orbital volume, 2) compare affected and unaffected sides, 3) evaluate the correlation between clinical evaluation of orbital size and volumetric measurement, and 4) determine whether there is a correlation between orbital volume and severity of mandibular deformity.
This study is a retrospective case series of patients with unilateral CFM from Boston Children's Hospital (Boston, MA) who had a computed tomographic (CT) scan. Manual segmentation of the orbit using Mimics software (Materialise, Leuven, Belgium) was performed on CT images of the 2 orbits. The predictor variable was laterality (affected vs unaffected side) and the primary outcome variable was orbital volume. Wilcoxon signed rank test was used to compare these measurements and determine whether the affected side differed from the unaffected side. The correlation between orbital volume and Pruzansky-Kaban type of mandibular deformity, as documented in the medical record, was determined using the Spearman rank correlation coefficient.
Thirty-nine patients were included. Orbital volume was 10% smaller on the affected side (P = .001) in 80% of patients. There was no correlation between orbital size and severity of mandibular involvement.
The results of this study showed a marked difference in orbital volume between affected and unaffected sides in patients with unilateral CFM. These differences were small and might not be clinically relevant. Orbital volume did not correlate with severity of mandibular deformity.
颅面短小畸形（CFM）的特征是源于第一和第二咽弓的结构畸形。眼眶受到不同程度的影响。本研究的目的是确定单侧CFM患者患侧和未患侧眼眶容积是否存在差异。具体目标为：1）测量眼眶容积；2）比较患侧和未患侧；3）评估眼眶大小的临床评估与容积测量之间的相关性；4）确定眼眶容积与下颌骨畸形严重程度之间是否存在相关性。
本研究是对来自波士顿儿童医院（马萨诸塞州波士顿）的单侧CFM患者进行的回顾性病例系列研究，这些患者均进行了计算机断层扫描（CT）。使用Mimics软件（Materialise，比利时鲁汶）对两个眼眶的CT图像进行眼眶手动分割。预测变量为左右侧别（患侧与未患侧），主要结局变量为眼眶容积。采用Wilcoxon符号秩检验比较这些测量值，并确定患侧与未患侧是否存在差异。根据病历记录，使用Spearman秩相关系数确定眼眶容积与Pruzansky-Kaban下颌骨畸形类型之间的相关性。
纳入39例患者。80%的患者患侧眼眶容积小10%（P = 0.001）。眼眶大小与下颌受累严重程度之间无相关性。
本研究结果显示，单侧CFM患者患侧和未患侧眼眶容积存在显著差异。这些差异较小，可能与临床无关。眼眶容积与下颌骨畸形严重程度无关。
