Ronde Md Elsa M, de Jong PhD Guido A, Nolte Md Dmd PhD Jitske W, Nienhuijs Md Dmd PhD Marloes E L, Bulstrode Frcs Plast Neil W, Maal PhD Thomas J J, Becking Md Dmd PhD Alfred G, Breugem Md PhD Corstiaan C
From the Departments of Plastic, Reconstructive and Hand Surgery.
Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam.
Plast Reconstr Surg. 2025 Aug 1;156(2):304-315. doi: 10.1097/PRS.0000000000011831. Epub 2024 Oct 28.
Craniofacial microsomia (CFM) is classified using the subjective orbit, mandible, ear, nerve, and soft tissue (OMENS) tool. Digital stereophotogrammetry (ie, 3-dimensional [3D] photography) can be used to capture facial shape objectively. This case-control study assessed the applicability of 3D photography in distinguishing between patients with CFM and individuals without a craniofacial condition, as well as classifying the severity of facial involvement.
The 3D photographs of patients with CFM or microtia from Amsterdam UMC, Radboudumc, or Great Ormond Street Hospital, and of individuals without craniofacial conditions, were assessed. Differences between patients and controls were explored through asymmetry index (ASI) and facial signature (FS) scores, as well as principal components analysis of FS scores and logistic regression. Correlations between OMENS scores and ASI, FS, and principal components scores were evaluated.
A total of 179 patients and 210 controls were analyzed. ASI and FS scores differed significantly between patients and controls ( P < 0.001), and were correlated with several OMENS subscales. The logistic regression model distinguishing between patients and controls showed increasing asymmetry of the mandible and orbits with increasing Pruzansky-Kaban score. Patients with isolated microtia deviated from controls in the midface.
Clinically significant differences in the facial morphology of patients with CFM and microtia were found compared with controls, suggesting that 3D photography can be used to assess the severity of facial involvement in a novel, objective, and safe way in these patients.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, IV.
颅面短小畸形（CFM）采用主观的眼眶、下颌骨、耳朵、神经和软组织（OMENS）工具进行分类。数字立体摄影测量法（即三维[3D]摄影）可用于客观地捕捉面部形状。本病例对照研究评估了3D摄影在区分CFM患者和无颅面疾病个体以及对面部受累严重程度进行分类方面的适用性。
对来自阿姆斯特丹大学医学中心、拉德堡德大学医学中心或大奥蒙德街医院的CFM或小耳畸形患者以及无颅面疾病个体的3D照片进行评估。通过不对称指数（ASI）和面部特征（FS）评分，以及FS评分的主成分分析和逻辑回归来探索患者与对照组之间的差异。评估OMENS评分与ASI、FS及主成分评分之间的相关性。
共分析了179例患者和210例对照。患者与对照组之间的ASI和FS评分存在显著差异（P<0.001），且与几个OMENS子量表相关。区分患者与对照组的逻辑回归模型显示，随着普鲁赞斯基 - 卡班评分增加，下颌骨和眼眶的不对称性增加。孤立性小耳畸形患者在中面部与对照组存在差异。
与对照组相比，发现CFM和小耳畸形患者的面部形态存在临床上的显著差异，这表明3D摄影可用于以一种新颖、客观且安全的方式评估这些患者面部受累的严重程度。
临床问题/证据水平：诊断性，IV级。
