title: Perception of children's faces with unilateral coronal synostosis--an eye-tracking investigation.
abstract: OBJECTIVE
  Premature unilateral coronal craniosynostosis results in distinctive cranial and facial abnormalities of varying severity, including orbital dystopia and an abnormal head shape. As the face is affected, these children may encounter stigmatization. To avoid this scenario, many parents elect for their child to undergo surgical correction. Laypeople's perception of children with either untreated or treated unilateral coronal craniosynostosis (UCS) has not yet been objectively evaluated.
  
  
  METHODS
  This study introduces eye tracking as an objective instrument in order to evaluate the perception of 14 children with coronal synostosis, both pre- and postoperatively. Age-matched healthy children served as a control group. Using standardized photos, the involuntary eye movements and the fixations of 30 unaffected laypeople were evaluated.
  
  
  RESULTS
  In the untreated children, whose faces were characterized by striking orbital dystopia, the eyes drew more attention than those of the healthy children. The results of our study demonstrate that the operative correction of unilateral coronal synostosis results in the normalization of the asymmetry of the fronto-orbital region, whereas the C-shaped deformity of the midface, which is not addressed via surgery, subsequently attracts more attention.
  
  
  CONCLUSIONS
  Eye tracking objectively evaluates both the perception of craniofacial abnormalities and the extent of the approximation of normality after surgical correction. We introduce eye tracking as an objective measurement tool for craniofacial abnormalities for the first time.
authors.affiliation: Department of Oral and Maxillofacial Plastic Surgery, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany. linz_c@ukw.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Linz
authors.affiliation: Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany.
authors.forename: Antje B M
authors.initials: AB
authors.lastname: Gerdes
authors.affiliation: Department of Orthodontics, University Hospital of Würzburg, Würzburg, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Meyer-Marcotty
authors.affiliation: Department of Oral and Maxillofacial Plastic Surgery, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
authors.forename: Urs
authors.initials: U
authors.lastname: Müller-Richter
authors.affiliation: Department of Oral and Maxillofacial Plastic Surgery, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Böhm
authors.affiliation: Department of Neurosurgery, University Hospital of Würzburg, Würzburg, Germany.
authors.forename: Ralf-Ingo
authors.initials: RI
authors.lastname: Ernestus
authors.affiliation: Department of Oral and Maxillofacial Plastic Surgery, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kübler
authors.affiliation: Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany.
authors.forename: Georg W
authors.initials: GW
authors.lastname: Alpers
authors.affiliation: Department of Neurosurgery, Section of Pediatric Neurosurgery, University Hospital of Würzburg, Würzburg, Germany.
authors.forename: Tilmann
authors.initials: T
authors.lastname: Schweitzer
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001288:Attention / Q000502:physiology; D016022:Case-Control Studies; D019465:Craniofacial Abnormalities / Q000209:etiology*; D003398:Craniosynostoses / Q000150:complications* / Q000601:surgery*; D005133:Eye Movements / Q000502:physiology; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D010364:Pattern Recognition, Visual / Q000502:physiology*; D010468:Perceptual Disorders / Q000209:etiology*; D010775:Photic Stimulation; D055815:Young Adult
keywords: Anterior plagiocephaly; Coronal synostosis; Eyetracking; Perception; Surgical correction