title: Three-Dimensional Cephalometric Analysis of Orbital Morphology Modification for Midface Correction Surgery.
abstract: OBJECTIVE
  The aim of this study was to create an evidence-based three-dimensional cephalometric analysis of orbits in order to perform time-efficient measurements of postoperative orbital morphology changes.
  
  
  METHODS
  The authors used 23 (11 bilateral and 1 unilateral) anatomical landmarks. Based on these, 6 planes, 12 angular and 16 linear measurements were determined. A three dimensional analysis was performed twice by two observers on pre and post-operative computed tomography scans of six patients who had undergone midface advancement. The mean, minimal and maximal difference, as well as standard deviation (SD) and intraclass correlation coefficient (ICC) for the inter- and intra-observer landmark selection reliability were calculated. Additionally, the mean, minimal, maximal difference and standard deviation between pre- and post-operative angular and linear measurements were calculated to examine a connection between the established measurements and any morphological change.
  
  
  RESULTS
  The inter and intra-examiner accuracy of all landmarks for three axes was >0.9 ICC. Despite excellent inter and intra-examiner agreement (<2.49 mm ± 2.05 mm SD) for the landmark selection, linear and angular measurements showed a mismatch, the mean SD for angular measurements was found to be 8.2° and the linear 3.04 mm.
  
  
  CONCLUSIONS
  The possible causes of linear and angular measurement discrepancies are discussed and the future direction for the development of three-dimensional cephalometric analysis of orbits proposed.
authors.affiliation: Department of Maxillofacial Surgery, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland ; Oral and Maxillofacial Surgery Research Lab (OMFS/CHEX/IREC/SSS/UCL, Head: Pr Olszewski R, PhD), Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium ; Private Dental Practice, Aesthetic Dent, Szczecin, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Smektala
authors.affiliation: Department of Radiology and Diagnostic Imaging, Voivodeship Specialized Hospital, Szczecin, Poland.
authors.forename: Ewelina
authors.initials: E
authors.lastname: Staniszewska
authors.affiliation: Department of Radiology and Diagnostic Imaging, Dr Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Sławińska
authors.affiliation: Department of Maxillofacial Surgery, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland ; Private Dental Practice, Aesthetic Dent, Szczecin, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Sporniak-Tutak
authors.affiliation: Private Dental Practice, Aesthetic Dent, Szczecin, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Tutak
authors.affiliation: Oral and Maxillofacial Surgery Research Lab (OMFS/CHEX/IREC/SSS/UCL, Head: Pr Olszewski R, PhD), Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium ; Department of Dental Surgery, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Jędrzejewski
authors.affiliation: Department of Prosthodontics, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Chrusciel-Nogalska
authors.affiliation: Oral and Maxillofacial Surgery Research Lab (OMFS/CHEX/IREC/SSS/UCL, Head: Pr Olszewski R, PhD), Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Raphael
authors.initials: R
authors.lastname: Olszewski
keywords: Cephalometry; Dimensional measurement accuracy; Imaging; Morphology; Reproducibility of results; Skull