THE EFFECT OF SURGERY ON THE FACIAL MORPHOLOGY OF PATIENTS WITH HEMIFACIAL MICROSOMIA


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P.M.Goodwin,J.P.Moss,A.D.Linney, D.R.James, M.Calvert.
Dept. of Medical Physics
University College, London,
The Royal London Hospital,
Great Ormond Street Hospital Trust, London, UK.

Aim
To investigate the changes in facial morphology as a result of the treatment of patients with Craniofacial Microsomia.
MATERIAL

72 Patients with Hemifacial Microsomia.
168 Controls of similar ages.
METHOD

Each of the patients were optically surface scanned using a scanner developed in the Department. The patient sits in a chair which is rotated under computer control and a camera records the distortion in a fanned beam of light as it passes over the face.
The 3D coordinates of 300 points along the line are recorded every 1 degree of rotation of the chair.
The 60,000 points are filed and registration and averaging 60,000 points are filed and registration and averaging programmes have been written to allow analysis of the data.
The patients were divided by sex and age into four groups. 4 - 8, 9 - 12, 13 - 16 and 17+ years. In order to increase the numbers of patients in each group the Hemifacial Microsomia patients were all mirror imaged so that they were all left sided anomalies.
Each of the age groups were averaged to give an average face for that age. The average scans for each age group were then compared with the average scan of the control patients. The differences in the two groups were then displayed using a registration programme. The differences between the two groups are displayed in colour, warm colours representing a positive change and cold colours a negative change.
Fig 1. (Scanner.)
Scanner
Results

Although the facial morphology of the patients was diverse, in the 4 - 8 years female group* the faces were on average 3 - 7 mm smaller in the cheek and chin regions on the affected side compared to the controls. In the male group of the same age there was a deficiency of 3 - 5 mm on the affected side.
Although costochondral bone grafts were used, at the age of 9 - 12 years the cheek and chin regions were still 3 - 7 mm smaller in the cheek region and 3 - 9 mm in the chin region than the control group in both the males and the females.
However in the 13 - 16 year group the males were more deficient than the females in the cheek and chin regions. At this age the males were deficient by 9+ mm in the cheek and chin regions whilst the females were deficient by 3 - 7 mm. At the age of 17+ the female hemifacial microsomia group were deficient on the affected side by 3 - 5 mm when compared with the controls, and the males were even more deficient by 3 - 9 mm when compared with the male controls.
Conclusion

The deficiency of the soft tissues was more severe in males than in females after puberty. Both groups were deficient when compared to the control groups.
Acknowledgement

We would like to thank the Charity Action Research for their continued sponsorship and support of this project.

Image Quality:

The following images have been significantly reduced in size (and thus quality) for compactness of transmission on the WWW. The coloured difference images look particularly bad with this treatment. If you would like to have copies of better quality, please get in touch (See below).

Image format:

All images show: Left: Craniofacial Microsomia ; Right Normal Control
Left of page: Registered Scans ; Right of page: Coded Difference image for this pair.

Female Age 17+

Craniofacial Microsomia/ Control
Difference image Registered scans
Registered Scans
Female Age 13-16

Craniofacial Microsomia/ Control
Difference image Registered scans
Registered Scans
Female Age 9-12

Craniofacial Microsomia/ Control
Difference image Registered scans
Registered Scans
Female Age 4-8

Craniofacial Microsomia/Control
Difference image Registered scans
Registered Scans
Male Age 4-8

Craniofacial Microsomia/ Control
Difference image Registered scans
Registered Scans
Male Age 9-12

Craniofacial Microsomia/ Control
Difference image Registered scans
Registered Scans
Male Age 13-16

Craniofacial Microsomia/ Control
Difference image Registered scans
Registered Scans
Male Age 17+

Craniofacial Microsomia/ Control
Difference image Registered scans
Registered Scans
**** End of PhD Poster. ****


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Poster created by Tricia Goodwin. , E-mail: pmg@medphys.ucl.ac.uk, Web page version edited by John Gardener, E-mail: jeg@medphys.ucl.ac.uk
Last update 22/1/97.