Akbari Mohamad Reza, Khorrami-Nejad Masoud, Kangari Haleh, Akbarzadeh Baghban Alireza, Ranjbar Pazouki Mehdi
Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Optom Vis Sci. 2021 Nov 1;98(11):1248-1254. doi: 10.1097/OPX.0000000000001793.
This study was conducted to evaluate facial asymmetry in unilateral congenital superior oblique muscle palsy (SOP). The results showed that all facial asymmetry parameters had a higher frequency in SOP patients compared with orthotropic individuals.
This study aimed to evaluate the characteristics of facial asymmetry in unilateral congenital SOP and compare with orthotropic individuals.
This cross-sectional comparative case series was conducted in 58 patients with ocular torticollis caused by SOP (mean ± standard deviation age, 18 ± 12 years) and 58 orthotropic individuals (mean ± standard deviation age, 19 ± 13 years). The exact form of torticollis was determined by direct observation from yaw, roll, and pitch axes. Four photographs were taken from patients: (1) with torticollis to calculate the amount of head tilt; (2) with the head in the straight position to calculate the facial angle and relative facial size (RFS); and (3 and 4) with the head positioned downward (to compare the cheek size) and upward (to assess columella deviation and nostril asymmetry).
Twenty-nine patients (50%) had a head tilt, 23 (39.66%) had combined head tilt and a face turn, and 6 (10.44%) had a pure face turn. The mean ± standard deviation of head tilt, facial angle, and RFS was 10.11 ± 6.31°, 1.11 ± 1.67°, and 1.003 ± 0.126 in SOP patients, respectively, and the mean RFS and facial angle were significantly higher in SOP patients compared with orthotropic individuals (both P < .001). Facial hemihypoplasia, unilateral cheek compression, nostril asymmetry, and columella deviation were observed in 43 (74.1%), 31 (53.4%), 39 (67.2%), and 38 patients (65.5%), respectively, which were all significantly more common compared orthotropic individuals (P < .001). Facial asymmetry was seen in 52 patients (91.2%) and 17 orthotropic subjects (29.3%), respectively (P < .001).
All quantitative and qualitative facial asymmetry parameters had a higher frequency in SOP patients compared with orthotropic subjects.
本研究旨在评估单侧先天性上斜肌麻痹（SOP）患者的面部不对称情况。结果显示，与正视个体相比，SOP患者的所有面部不对称参数出现频率更高。
本研究旨在评估单侧先天性SOP患者面部不对称的特征，并与正视个体进行比较。
本横断面比较病例系列研究纳入了58例由SOP导致眼性斜颈的患者（平均年龄±标准差，18±12岁）和58例正视个体（平均年龄±标准差，19±13岁）。通过从偏航、横滚和俯仰轴直接观察来确定斜颈的具体形式。为患者拍摄四张照片：（1）有斜颈时以计算头部倾斜度；（2）头部处于直立位置时以计算面部角度和相对面部大小（RFS）；以及（3和4）头部向下（以比较脸颊大小）和向上（以评估鼻小柱偏斜和鼻孔不对称）时的照片。
29例患者（50%）有头部倾斜，23例（39.66%）有头部倾斜并伴有面部转向，6例（10.44%）有单纯面部转向。SOP患者头部倾斜度、面部角度和RFS的平均值±标准差分别为10.11±6.31°、1.11±1.67°和1.003±0.126，与正视个体相比，SOP患者的平均RFS和面部角度显著更高（均P<.001）。分别在43例（74.1%）、31例（53.4%）、39例（67.2%）和38例患者（65.5%）中观察到面部半侧发育不全、单侧脸颊受压、鼻孔不对称和鼻小柱偏斜，与正视个体相比，这些情况均明显更常见（P<.001）。分别在52例患者（91.2%）和17例正视个体（29.3%）中发现面部不对称（P<.001）。
与正视个体相比，SOP患者所有定量和定性的面部不对称参数出现频率更高。
