Department of Cranio-Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China.
Department of Gastrointestinal Surgery, Ningbo Municipal Hospital of T.C.M, China.
J Plast Reconstr Aesthet Surg. 2024 Dec;99:256-262. doi: 10.1016/j.bjps.2024.09.052. Epub 2024 Sep 19.
The Pruzansky-Kaban and OMENS classifications do not provide additional details on temporomandibular joint deformities. The aim of this study was to classify and quantitatively define severe forms of craniofacial microsomia based on three-dimensional maxillofacial measurements, focusing on deformities in the zygomatic, temporal, and mandibular bones.
Maxillofacial computed tomography (CT) scans of children with severe types of craniofacial microsomia (CFM) from 2010 to 2020 were collected. Three-dimensional measurements of zygomatic arch length, height of mandibular ramus, height of maxilla, and occlusal cant were performed. A two-step cluster analysis was conducted based on zygomatic arch continuity, occlusal cant, and the ratio of the affected side to the unaffected side (A/U ratio) for zygomatic arch length, mandibular ramus height, and maxillary height.
Fifty patients (32 male, 18 female) were included in the study. They were classified into 2 clusters through cluster analysis. Cluster 1 comprised subjects (44% of patients) with continuous zygomatic arches. Cluster 2 comprised subjects (39% of patients) with discontinuous zygomatic arches. The zygomatic arch A/U ratio in cluster 1 was greater than that in cluster 2, with statistical significance observed. Additionally, the maxilla height A/U ratio in cluster 1 was lower than in cluster 2, also with statistical significance. There was no statistically significant difference observed in the ramus height A/U ratio and occlusal cant between clusters 1 and 2.
Based on craniofacial measurements, severe CFM can be categorized into two types: continuous zygomatic arch and discontinuous zygomatic arch. This cluster analysis complemented the OMENS classification and could assist in the selection and design of prosthetic joints for patients with CFM.
普鲁赞斯基-卡班（Pruzansky-Kaban）和 OMENS 分类法并没有提供关于颞下颌关节畸形的更多细节。本研究旨在基于三维颌面测量结果对颅面发育不全症（Craniofacial microsomia，CFM）的严重形式进行分类和定量定义，重点关注颧骨、颞骨和下颌骨的畸形。
收集了 2010 年至 2020 年患有严重 CFM 儿童的颌面计算机断层扫描（CT）图像。对颧骨弓长度、下颌支高度、上颌高度和咬合倾斜度进行三维测量。基于颧骨弓连续性、咬合倾斜度和患侧与健侧的比值（A/U 比值），对颧骨弓长度、下颌支高度和上颌高度进行了两步聚类分析。
本研究共纳入 50 例患者（男 32 例，女 18 例）。聚类分析将他们分为 2 组。组 1包括颧骨弓连续的患者（44%），组 2包括颧骨弓不连续的患者（39%）。组 1的颧骨弓 A/U 比值大于组 2，差异有统计学意义。此外，组 1的上颌高度 A/U 比值小于组 2，差异也有统计学意义。组 1和组 2的下颌支高度 A/U 比值和咬合倾斜度差异无统计学意义。
基于颌面测量结果，严重 CFM 可分为颧骨弓连续和不连续两种类型。本聚类分析补充了 OMENS 分类法，有助于为 CFM 患者选择和设计义颌关节。
