Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, USA.
Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, USA.
J Craniomaxillofac Surg. 2024 Apr;52(4):472-476. doi: 10.1016/j.jcms.2024.01.024. Epub 2024 Jan 23.
This study compares condylar volumetric asymmetry and facial asymmetry in patients with cleft lip and/or palate (CLP) and controls. The mandibular condyle is important to facial growth, but its role in facial asymmetry for those with CLP has not been described. Condylar volumes and mandibular asymmetry were retrospectively calculated using Mimics Version 23.0 (Materialise, Leuven, Belgium) from patients with CLP undergoing computed tomography (CT) imaging and a cohort of controls. A total of 101 participants, 60 with CLP and 41 controls, had mean condylar volumetric asymmetry of 16.4 ± 17.4 % (CLP) and 6.0 ± 4.0 % (controls) (p = 0.0002). Patients with CLP who had clinically significant chin deviation (>4 mm) had more asymmetric condyles than those without significant chin deviation (p = 0.003). The chin deviated toward the smaller condyle in patients with facial asymmetry more often than in patients without facial asymmetry (81 % vs. 62 %, p = 0.033). While controls had some degree of condylar asymmetry, it tended to be milder and not associated with facial asymmetry. There is a greater degree of condylar volumetric asymmetry in patients with CLP compared to individuals in the general population. Clinically significant facial asymmetry in CLP is associated with a higher degree of condylar asymmetry, with the facial midline deviating toward the smaller condyle.
本研究比较了唇腭裂(CLP)患者和对照组患者髁突体积不对称和面部不对称。下颌髁突对面部生长很重要,但它在 CLP 患者面部不对称中的作用尚未描述。使用 Mimics Version 23.0(比利时鲁汶的 Materialise)从接受计算机断层扫描(CT)成像的 CLP 患者和对照组队列中回顾性计算髁突体积和下颌不对称。共有 101 名参与者,60 名 CLP 患者和 41 名对照组,CLP 患者的平均髁突体积不对称性为 16.4±17.4%(CLP)和 6.0±4.0%(对照组)(p=0.0002)。与无明显颏偏的患者相比,临床显著颏偏(>4mm)的 CLP 患者的髁突更不对称(p=0.003)。面部不对称的患者中,颏偏向较小髁突的情况比无面部不对称的患者更常见(81%比 62%,p=0.033)。虽然对照组存在一定程度的髁突不对称,但这种不对称往往较轻,与面部不对称无关。与一般人群相比,CLP 患者的髁突体积不对称程度更大。CLP 中临床显著的面部不对称与更高程度的髁突不对称相关,面部中线偏向较小的髁突。