title: Facial asymmetry quantitative evaluation in oculoauriculovertebral spectrum.
abstract: OBJECTIVE
  Facial asymmetries in oculoauriculovertebral spectrum (OAVS) patients might require surgical corrections that are mostly based on qualitative approach and surgeon's experience. The present study aimed to develop a quantitative 3D CT imaging-based procedure suitable for maxillo-facial surgery planning in OAVS patients.
  
  
  METHODS
  Thirteen OAVS patients (mean age 3.5 ± 4.0 years; range 0.2-14.2, 6 females) and 13 controls (mean age 7.1 ± 5.3 years; range 0.6-15.7, 5 females) who underwent head CT examination were retrospectively enrolled. Eight bilateral anatomical facial landmarks were defined on 3D CT images (porion, orbitale, most anterior point of frontozygomatic suture, most superior point of temporozygomatic suture, most posterior-lateral point of the maxilla, gonion, condylion, mental foramen) and distance from orthogonal planes (in millimeters) was used to evaluate the asymmetry on each axis and to calculate a global asymmetry index of each anatomical landmark. Mean asymmetry values and relative confidence intervals were obtained from the control group.
  
  
  RESULTS
  OAVS patients showed 2.5 ± 1.8 landmarks above the confidence interval while considering the global asymmetry values; 12 patients (92%) showed at least one pathologically asymmetric landmark. Considering each axis, the mean number of pathologically asymmetric landmarks increased to 5.5 ± 2.6 (p = 0.002) and all patients presented at least one significant landmark asymmetry.
  
  
  CONCLUSIONS
  Modern CT-based 3D reconstructions allow accurate assessment of facial bone asymmetries in patients affected by OAVS. The evaluation as a global score and in different orthogonal axes provides precise quantitative data suitable for maxillo-facial surgical planning.
  
  
  CONCLUSIONS
  CT-based 3D reconstruction might allow a quantitative approach for planning and following-up maxillo-facial surgery in OAVS patients.
authors.affiliation: Neuroradiologic Unit, Sezione di Neuroscienze, University of Salerno, Via S Allende 1, 89081, Salerno, Italy. rmanara@unisa.it.
authors.forename: Renzo
authors.initials: R
authors.lastname: Manara
authors.affiliation: Department of Neurosciences, University of Padova, Padua, Italy. schifanognn@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Schifano
authors.affiliation: Department of Neurosciences, University of Padova, Padua, Italy. davidebrotto@hotmail.it.
authors.forename: Davide
authors.initials: D
authors.lastname: Brotto
authors.affiliation: Department of Neuroradiology, University Hospital of Padova, Padua, Italy. rodica.mardari@sanita.padova.it.
authors.forename: Rodica
authors.initials: R
authors.lastname: Mardari
authors.affiliation: Department of Neurosciences, University of Padova, Padua, Italy. saraghiselli@alice.it.
authors.forename: Sara
authors.initials: S
authors.lastname: Ghiselli
authors.affiliation: Department of Neurosurgery, University Hospital of Padova, Padua, Italy. antonio.gerunda@sanita.padova.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gerunda
authors.affiliation: Department of Maxillo-Facial Surgery, University Hospital of Padova, Padua, Italy. cristina.ghirotto@sanita.padova.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ghirotto
authors.affiliation: Department of Maxillo-Facial Surgery, University Hospital of Padova, Padua, Italy. stefano.fusetti@unipd.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Fusetti
authors.affiliation: Department of Maxillo-Facial Surgery, University Hospital of Padova, Padua, Italy. kpiacentile@hotmail.com.
authors.forename: Katherine
authors.initials: K
authors.lastname: Piacentile
authors.affiliation: Department of Neurosurgery, University Hospital of Padova, Padua, Italy. renato.scienza@sanita.padova.it.
authors.forename: Renato
authors.initials: R
authors.lastname: Scienza
authors.affiliation: Department of Neurosciences, University of Padova, Padua, Italy. mario.ermani@unipd.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Ermani
authors.affiliation: Department of Neurosciences, University of Padova, Padua, Italy. alessandromartini@unipd.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Martini
mesh_terms: D000293:Adolescent; D059925:Anatomic Landmarks; D002648:Child; D002675:Child, Preschool; D005260:Female; D006053:Goldenhar Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D008297:Male; D010347:Patient Care Planning; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Facial asymmetry; Goldenhar syndrome; Image reconstruction; Oculoauriculovertebral spectrum