Assessment of soft tissue facial asymmetry in medically normal and syndrome-affected individuals by analysis of landmarks and measurements

Fractures of mandibular condyle may be overlooked because attention is often focused on readily apparent soft tissue injury such as lacerations and abrasions. Clinical and radiographic signs are often subtle, but the injuries caused by rapid deceleration and listed in Table 2 will serve to alert the pediatrician to the possibility of such fractures. All children in these circumstances should be carefully examined for dental occlusion and the preauricular area palpated to help formulate a clinical diagnosis. Additional evidence is gained from the finding of deviation or limitation of the jaw upon opening or edema in the preauricular area. If any of these yield abnormal findings, a good quality series of mandibular radiographs will be needed to confirm the diagnosis. Overlooking a condylar fracture may commit a child to unsightly facial asymmetry, marked malocclusion, or ankylosis requiring invasive surgery for correction. Consultation with an oral and maxillofacial surgeon or other interested specialist should be sought while the patient is still in the emergency room.

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Three-dimensional cone beam computed tomographic image reorientation using soft tissues as reference for facial asymmetry diagnosis

The Angle Orthodontist ◽

10.2319/112112-890.1 ◽

2013 ◽

Vol 84 (1) ◽

pp. 38-47 ◽

Cited By ~ 12

Author(s):

Jae-Kyu Lee ◽

Pil-Kyo Jung ◽

Cheol-Hyun Moon

Keyword(s):

Soft Tissue ◽

Soft Tissues ◽

Three Dimensional ◽

Facial Asymmetry ◽

Cone Beam ◽

Expert Group ◽

Computed Tomographic ◽

Asymmetry Analysis ◽

Cbct Image ◽

Facial Midline

ABSTRACT Objective: To investigate discrepancies in results of facial asymmetry analysis using different cone beam computed tomography (CBCT) image reorientation methods and the effectiveness of soft tissue as a reorientation reference for analysis of facial asymmetry. Materials and Methods: An asymmetric group of 30 patients with 4 mm or more of chin point (menton [Me]) deviation and a symmetric group of 30 patients with less than 4 mm of deviation of Me were chosen as study subjects. Three orientation methods were used to calculate and compare Me deviation values of the 60 subjects. Two methods used only skeletal landmarks for reference, and one method included the soft tissue landmarks around the eye. Preferences of an expert group for the facial midline as determined by each reorientation method were also examined. Results: The examinations showed significant discrepancies in Me deviation values between the three reorientation methods. The expert group showed the greatest preference for the facial midline reorientation method that incorporated soft tissue landmarks of the eye. Conclusions: These study findings suggest that the inclusion of soft tissue landmarks, especially those around the eyes, is effective for three-dimensional CBCT image reorientation for facial asymmetry analysis.

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Three-dimensional analysis of hard and soft tissue changes in patients with facial asymmetry undergoing 2-jaw surgery

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2015.05.020 ◽

2015 ◽

Vol 120 (3) ◽

pp. 299-306 ◽

Cited By ~ 16

Author(s):

Erika Suzuki-Okamura ◽

Norihisa Higashihori ◽

Tatsuo Kawamoto ◽

Keiji Moriyama

Keyword(s):

Soft Tissue ◽

Dimensional Analysis ◽

Three Dimensional ◽

Facial Asymmetry ◽

Tissue Changes ◽

Soft Tissue Changes ◽

Jaw Surgery

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Assessing soft-tissue characteristics of facial asymmetry with photographs

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1016/j.ajodo.2008.08.029 ◽

2010 ◽

Vol 138 (1) ◽

pp. 23-31 ◽

Cited By ~ 30

Author(s):

Mi-song Lee ◽

Dong Hwa Chung ◽

Jin-woo Lee ◽

Kyung-suk Cha

Keyword(s):

Soft Tissue ◽

Facial Asymmetry ◽

Tissue Characteristics

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Facial contouring with soft tissue augmentation in facial asymmetry

Plastic & Reconstructive Surgery ◽

10.1097/00006534-199001000-00065 ◽

1990 ◽

Vol 85 (1) ◽

pp. 157

Author(s):

Se-Min Baek

Keyword(s):

Soft Tissue ◽

Facial Asymmetry ◽

Soft Tissue Augmentation ◽

Tissue Augmentation

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CAD/CAM splint based on soft tissue 3D simulation for treatment of facial asymmetry

Maxillofacial Plastic and Reconstructive Surgery ◽

10.1186/s40902-016-0050-8 ◽

2016 ◽

Vol 38 (1) ◽

Cited By ~ 7

Author(s):

Kazuhiro Tominaga ◽

Manabu Habu ◽

Hiroki Tsurushima ◽

Osamu Takahashi ◽

Izumi Yoshioka

Keyword(s):

Soft Tissue ◽

Facial Asymmetry ◽

3D Simulation ◽

Cad Cam

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The Effect of Orthognathic Surgery on Soft-Tissue Facial Asymmetry

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000006403 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Filippo Da Pozzo ◽

Daniele Gibelli ◽

Giada A. Beltramini ◽

Claudia Dolci ◽

Aldo Bruno Giannì ◽

...

Keyword(s):

Soft Tissue ◽

Orthognathic Surgery ◽

Facial Asymmetry

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Facial contouring with parascapular free flap: A case series of 22 cases

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.122020 ◽

2013 ◽

Vol 46 (03) ◽

pp. 561-567 ◽

Cited By ~ 2

Author(s):

Guru Dayal Singh Kalra ◽

Ram Krishna Gupta

Keyword(s):

Soft Tissue ◽

Free Flap ◽

Donor Site ◽

Case Series ◽

Facial Asymmetry ◽

Free Flaps ◽

Soft Tissue Augmentation ◽

Facial Soft Tissue ◽

Skin Paddle ◽

Hemifacial Atrophy

ABSTRACT Background: The facial asymmetry correction in complex craniofacial malformations presents a challenging problem for reconstructive surgeons. Progressive hemifacial atrophy (HFA) and hemifacial microsomia (HFM) can manifest in different grades of severity. Most patients require only soft-tissue augmentation. Free flaps are the best option for correction of severe facial soft-tissue deficiency. Materials and Methods: Twenty-two patients of HFM and HFA were included in this study from January 2006 to March 2009 in the Department of Plastic and Reconstructive Surgery, SMS Medical College and Hospital. In all cases, atrophy correction was done using de-epithelialised parascapular free flap with the de-epithelialised surface was placed under the skin. A small skin paddle was taken for monitoring. Results: All cases were reconstructed with de-epithelialised parascapular free flap. There was no flap loss in this series. Hematoma was noted in five cases. Debulking and removal of skin paddle were done in all cases after 6 months. Atrophy recurrence was not observed in any of the cases on follow-up. Conclusion: Contouring of face in cases of HMF and HFA is satisfactorily done with the parascapular free flap. It gives better cosmetic results with minimal donor site morbidity. Facial vessels are better recipient vessels for anastomosis. Keeping de-epithelialised surface of flap under the skin helped in preventing sagging.

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