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Combined soft and skeletal tissue modelling of normal and dysmorphic midface postnatal development.

This paper is available in a repository.
This paper is available in a repository.

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Preprint: policy unknown
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Postprint: policy unknown
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Abstract

Midface hypoplasia as exemplified by Treacher Collins Syndrome (TCS) can impair appearance and function. Reconstruction involves multiple invasive surgeries with variable long-term outcomes. This study aims to describe normal and dysmorphic midface postnatal development through combined modeling of skeletal and soft tissues and develop a surgical evaluation tool. Midface skeletal and soft tissue surfaces were extracted from computed tomography scans of 52 control and 14 TCS children then analysed using dense surface modeling. The model was used to describe midface growth, morphology and asymmetry then evaluate postoperative outcomes. Parameters responsible for the greatest variation in midface size and shape showed differences between TCS and controls with close alignment between skeletal and soft tissue models. TCS children exhibited midface dysmorphology and hypoplasia when compared with controls. Asymmetry was also significantly higher in TCS midfaces. Combined modeling was used to evaluate the impact of surgery in one TCS individual who showed normalisation immediately after surgery but reversion towards TCS dysmorpology after 1 year. This is the first quantitative analysis of postnatal midface development using combined modeling of skeletal and soft tissues. We also provide an approach for evaluation of surgical outcomes laying the foundations for future development of a preoperative planning tool.