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Resnick CM, Rottgers SA, Wright JM, Vyas RM, Goldstein JA, Swanson JW, Padula MA, Coghill CH, Ahmad I, Molter DW, Menezes MD, Naing KW, Cielo CM. Surgical Outcome and Treatment Trends in 1289 Infants with Micrognathia: A Multicenter Cohort. Plast Reconstr Surg 2024; 154:155e-166e. [PMID: 37184511 DOI: 10.1097/prs.0000000000010639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Studies of infants with micrognathia, especially Robin sequence, are limited by its rarity and both phenotypic and diagnostic variability. Most knowledge of this condition is sourced from small, single-institution samples. METHODS This is a cross-sectional study including infants with micrognathia admitted to 38 Children's Hospital Neonatal Consortium centers from 2010 through 2020. Predictor variables included demographic data, birth characteristics, cleft, and syndrome status. Outcome variables included length of stay, death, feeding or respiratory support, and secondary airway operations. RESULTS A total of 1289 infants with micrognathia had surgery to correct upper airway obstruction. Mean age and weight at operation were 34.8 ± 1.8 weeks and 3515.4 ± 42 g, respectively. A syndromic diagnosis was made in 150 (11.6%) patients, with Stickler (5.4%) and Treacher Collins (2.2%) syndromes being the most common. Operations included mandibular distraction osteogenesis (MDO) in 66.3%, tracheostomy in 25.4%, and tongue-lip adhesion (TLA) in 8.3%. Patients receiving a tracheostomy had lower birthweight, head circumference, gestational age, and Apgar scores. Patients undergoing MDO were less likely to need a second airway operation compared with patients undergoing TLA (3.5% versus 17.8%; P < 0.001). The proportion of infants feeding exclusively orally at hospital discharge differed significantly, from most to least: MDO, TLA, and tracheostomy. Hospital length of stay was not statistically different for patients who had MDO or TLA, but was longer for those with primary tracheostomy. The mortality rate was low for all operations (0.5%). CONCLUSIONS In this surgical patient cohort, MDO was associated with shorter hospital stay, improved oral feeding, and lower rates of secondary airway operations. Prospective multicenter studies are necessary to support these conclusions. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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Affiliation(s)
- Cory M Resnick
- From the Department of Plastic and Oral Surgery, Boston Children's Hospital
| | - S Alex Rottgers
- Division of Plastic and Reconstructive Surgery, Johns Hopkins All Children's Hospital
| | - Joshua M Wright
- Division of Plastic and Reconstructive Surgery, Johns Hopkins All Children's Hospital
| | - Raj M Vyas
- Department of Aesthetic and Plastic Surgery, University of California, Irvine
| | | | | | | | | | - Irfan Ahmad
- Division of Neonatology, Children's Hospital of Orange County
| | - David W Molter
- Department of Otolaryngology, St. Louis Children's Hospital
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Barrero CE, Wietlisbach LE, Pontell ME, Salinero LK, Wagner CS, Swanson JW, Bartlett SP, Taylor JA. Severity of Mandibular Dysmorphology in Treacher Collins Syndrome for Stratification of Perioperative Airway Risk. J Craniofac Surg 2024; 35:18-22. [PMID: 37646339 DOI: 10.1097/scs.0000000000009700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/12/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Patients with Treacher Collins syndrome (TCS) and attendant airway dysmorphology may be predisposed to airway complications in the perioperative period. However, limited data correlates severity of mandibular hypoplasia and airway status. This study aims to improve risk stratification for perioperative airway insufficiency in TCS by using a previously proposed mandibular severity index. METHODS Patient demographics, perioperative airway status, difficulty of intubation, and Cormack Lehane grade were collected and compared using a TCS mandibular hypoplasia severity grading scale in patients with TCS treated between 2000 and 2022. RESULTS Twenty-six patients underwent 222 procedures with institutional mandibular severity gradings as follows: 23% Grade I, 31% Grade II, 39% Grade III, 8% Grade IV. Our severity index was associated with intubation difficulty ( P <0.001) and difficult airway status ( P <0.001), with 72% of difficult airways found in grade III and grade IV patients. Mandibular retrusion and ramal hypoplasia subscores were positively correlated with measures of airway severity ( P <0.001), whereas the gonial angle was negatively correlated ( P <0.001). Age was negatively correlated with difficult visualization for endotracheal intubation ( P =0.02) but had no association with difficult airway status ( P =0.2). CONCLUSIONS This study found a positive correlation between severity of maxillomandibular dysmorphology and perioperative airway difficulty in TCS patients. Our findings suggest that severely affected patients require heightened vigilance throughout life, as difficult airways may not completely resolve with aging. Given the risk of morbidity and mortality associated with airway complications, proper identification and preparation for challenging airways is critical for TCS patients.
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Affiliation(s)
- Carlos E Barrero
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, PA
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Tonello C, Dias GB, Nunes RB, Fussuma CY, Sousa LR, Feitosa LB, Flores RL, Alonso N. Mandibular Dysmorphology and Clinical Presentation in Treacher Collins Syndrome. Cleft Palate Craniofac J 2023:10556656231184967. [PMID: 37437901 DOI: 10.1177/10556656231184967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION Treacher Collins syndrome is a rare congenital disease characterized by the multiple craniofacial malformations. Although the deformities affecting patients with Treacher Collins syndrome have been well characterized, the effects of these malformations to clinical severity of the syndrome are not well understood. OBJECTIVE To determine the association of specific Treacher Collins mandibular malformations with clinical severity. DESIGN A retrospective radiographic observational study. SETTING Study conducted at a single institution, a quaternary craniofacial care center. PATIENTS 54 patients with Treacher Collins syndrome. INTERVENTIONS Computed tomography (CT), clinical photographs and medical history were included in this analysis. Mandibles were isolated from CT data and reconstructed in three dimensions using Mimics software. Cephalometric measurements were performed on CT data. Clinical severity was determined by Teber and Vincent scores. Association of craniofacial dysmorphology to clinical severity was determined by Spearman rank coefficient. MAIN OUTCOME MEASURES The main results obtained were the measurements of the mandibles and the quantification of the malformations of the evaluated patients. RESULTS Among the most frequent findings in the sample are hypoplasia of the zygomatic complex, descending palpebral cleft and mandibular hypoplasia. Patients with a lower ramus/corpus ratio had a higher (more severe) Teber and Vincent classification. CONCLUSION Patients with the most compromised mandible are also the patients with the highest number of malformations, thus, the most severe patients.
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Affiliation(s)
- C Tonello
- Craniofacial Surgeon of Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - G B Dias
- Bauru School Dentistry, University of São Paulo, São Paulo, Brazil
| | - R B Nunes
- Craniofacial Surgeon of Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - C Y Fussuma
- Craniofacial Surgeon of Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - L R Sousa
- Bauru School Dentistry, University of São Paulo, São Paulo, Brazil
| | - L B Feitosa
- Craniofacial Surgeon of Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - R L Flores
- Craniofacial Surgeon of The Hansjörg Department of Plastic Surgery, New York University Langone Health, New York City, NY, USA
| | - N Alonso
- Craniofacial Surgeon of Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
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Ulhaq ZS, Nurputra DK, Soraya GV, Kurniawati S, Istifiani LA, Pamungkas SA, Tse WKF. A systematic review on Treacher Collins syndrome: Correlation between molecular genetic findings and clinical severity. Clin Genet 2023; 103:146-155. [PMID: 36203321 DOI: 10.1111/cge.14243] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 01/20/2023]
Abstract
Treacher Collins syndrome (TCS, OMIM: 154500) is a rare congenital craniofacial disorder that is caused by variants in the genes TCOF1, POLR1D, POLR1C, and POLR1B. Studies on the association between phenotypic variability and their relative variants are very limited. This systematic review summarized the 53 literatures from PubMed and Scopus to explore the potential TCS genotype-phenotype correlations with statistical analysis. Studies reporting both complete molecular genetics and clinical data were included. We identified that the molecular anomaly within TCOF1 (88.71%) accounted for most TCS cases. The only true hot spot for TCOF1 was detected in exon 24, with recurrent c.4369_4373delAAGAA variant is identified. While the hot spot for POLR1D, POLR1C, and POLR1B were identified in exons 3, 8, and 15, respectively. Our result suggested that the higher severity level was likely to be observed in Asian patients harboring TCOF1 variants rather than POLR1. Moreover, common 5-bp deletions tended to have a higher severity degree in comparison to any variants within exon 24 of TCOF1. In summary, this report suggested the relationship between genetic and clinical data in TCS. Our findings could be used as a reference for clinical diagnosis and further biological studies.
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Affiliation(s)
- Zulvikar Syambani Ulhaq
- Laboratory of Developmental Disorders and Toxicology, Center for Promotion of International Education and Research, Faculty of Agriculture, Kyushu University, Fukuoka, Japan
- Research Center for Pre-clinical and Clinical Medicine, National Research and Innovation Agency Republic of Indonesia, Cibinong, Indonesia
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Maulana Malik Ibrahim State Islamic University, Batu, Indonesia
| | | | - Gita Vita Soraya
- Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
- Department of Neurology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Siti Kurniawati
- Department of Clinical Microbiology, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Lola Ayu Istifiani
- Department of Nutrition, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | | | - William Ka Fai Tse
- Laboratory of Developmental Disorders and Toxicology, Center for Promotion of International Education and Research, Faculty of Agriculture, Kyushu University, Fukuoka, Japan
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Characterization of Phenotypes and Treatment Modalities in Patients With Treacher-Collins Syndrome. J Craniofac Surg 2021; 32:e773-e778. [PMID: 34727453 DOI: 10.1097/scs.0000000000007769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The purpose of this study was to investigate the phenotypes and treatment modalities (Tx-Mod) in patients with Treacher-Collins syndrome (TCS) using a TCS severity index (TSI). The sample consisted of 14 Korean TCS patients treated at the Department of Orthodontics, Seoul National University Dental Hospital during 1998 to 2019. The TSI was calculated by adding the scores from the number of deformity-involved midface structures (eye, ear, zygoma) and the degree of mandibular hypoplasia (Pruzansky-Kaban type, gonial angle, Sella-Nasion-B point angle). The deformity-involved midface structure, degree of mandibular hypoplasia, oral manifestations, dental phenotypes, and Tx-Mod types were investigated using descriptive statistics. The TSI classified the subjects into 2 mild, 6 moderate, and 6 severe cases. The severity of ear and zygoma deformities, degree of condylar hypoplasia (Pruzansky-Kaban type), clockwise-rotated morphology (gonial angle) and retrusive position (Sella-Nasion-B point angle) of the mandible, and frequency of oral/craniofacial cleft, openbite, congenitally missing tooth and impacted tooth showed a tendency of increase from mild to severe TCS cases. After growth observation (78.6%), diverse combinations of Tx-Mods were applied except for functional appliance therapy. Surgical procedures for eye, ear, and zygoma reconstruction were performed on all patients (100%), whereas fixed orthodontic treatment, mandibular distraction osteogenesis, and orthognathic surgery were performed on 50% of patients. Surgical procedure for hearing improvement was the most frequent Tx-Mod (78.6%). The main desires of TCS patients were to obtain the facial esthetics in the midface and to improve hearing function. The TSI might provide a primary data for individualized diagnosis and treatment planning.
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Abstract
Treacher Collins syndrome (TCS) is a genetic disorder that presents with a variety of craniofacial deformities. One classic feature of TCS is a steep, counterclockwise rotation of the occlusal plane, and microretrognathia with bony deficiencies in both the body and ramus of the mandible. This morphology commonly necessitates reconstruction by the craniofacial surgeon. This article discusses strategies and considerations for surgically correcting the mandibular deformity associated with TCS using mandibular distraction osteogenesis and other related techniques. The proper implementation of these techniques can yield excellent results that greatly improve quality of life in this challenging patient population.
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顾 伟, 樊 悦, 霍 红, 陈 晓. [Obstructive sleep apnea in microtia children with maxillofacial dysostosis]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:371-379. [PMID: 33794641 PMCID: PMC10128449 DOI: 10.13201/j.issn.2096-7993.2021.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Indexed: 06/12/2023]
Abstract
Children with microtia are often associated with maxillofacial dysostosis, such as Treacher Collins syndrome, Goldenhar syndrome, and Nager syndrome, and they are prone to suffer from obstructive sleep apnea(OSA). Obstruction widely occurred in the upper airway is the main mechanism of OSA in these children, and dysplasia of the pharynx and neurodevelopmental abnormalities may also participate. Early diagnosis requires symptom screening and polysomnography. Imaging techniques and endoscopy can be adopted to fully assess the upper airway status to guide further treatment. According to the child's condition and the main obstruction site, treatment methods include maxillofacial deformity correction, continuous positive pressure ventilation and tracheotomy. OSA in microtia children with maxillofacial dysostosis needs to be identified and treated in time to reduce the adverse effects on the growth and development of children.
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Affiliation(s)
- 伟 顾
- 中国医学科学院 北京协和医学院 北京协和医院耳鼻咽喉头颈外科(北京,100730)
| | - 悦 樊
- 中国医学科学院 北京协和医学院 北京协和医院耳鼻咽喉头颈外科(北京,100730)
| | - 红 霍
- 中国医学科学院 北京协和医学院 北京协和医院耳鼻咽喉头颈外科(北京,100730)
| | - 晓巍 陈
- 中国医学科学院 北京协和医学院 北京协和医院耳鼻咽喉头颈外科(北京,100730)
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Kato RM, Moura PP, Zechi-Ceide RM, Tonello C, Peixoto AP, Garib D. Comparison Between Treacher Collins Syndrome and Pierre Robin Sequence: A Cephalometric Study. Cleft Palate Craniofac J 2020; 58:78-83. [PMID: 32613853 DOI: 10.1177/1055665620937499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the dentoskeletal pattern of Treacher Collins syndrome (TCS) and nonsyndromic Pierre Robin sequence (PRS). DESIGN Retrospective. SETTING Single center. PATIENTS Eighteen patients diagnosed with TCS (Group TCS) or PRS (Group PRS) in rehabilitation treatment at a single center. Group TCS was composed of 9 patients (4 male, 5 female) with a mean age of 12.9 years (standard deviation = 4.8). Group PRS was composed of 9 patients paired by age and sex with group TCS. MAIN OUTCOME MEASURE(S) Cone beam computed tomography-derived cephalometric images taken before the orthodontic or the orthodontic-surgical treatment were analyzed using Dolphin Imaging (Dolphin Imaging 11.0 & Management Solutions). Variables evaluating the cranial base, the maxillary and mandibular skeletal components, maxillomandibular relationship, the vertical components and the dentoalveolar region were measured. Intergroup comparisons were performed using t tests. The significance level considered was 5%. RESULTS Intergroup differences in the mandible size and growth pattern were observed. Group TCS showed a smaller mandibular length (Co-Go, Co-Gn) and a higher palatal plane (SN-Palatal Plane) and mandibular plane angles (SN-Go.Gn) compared to group PRS. No differences between TCS and PRS were observed for the sagittal position of the maxilla, maxillomandibular relationship, and dental components. CONCLUSIONS Treacher Collins syndrome presented a decreased mandible and a more severe vertical growth pattern compared to PRS.
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Affiliation(s)
- Renata Mayumi Kato
- 344933Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil
| | - Priscila Padilha Moura
- Department of Genetic, 344933Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil
| | - Roseli Maria Zechi-Ceide
- Department of Genetic, 344933Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil
| | - Cristiano Tonello
- Hospital Department, 344933Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil
| | - Adriano Porto Peixoto
- Department of Orthodontics, 344933Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil
| | - Daniela Garib
- Department of Orthodontics, 344933Hospital for Rehabilitation of Craniofacial Anomalies and Bauru Dental School, University of São Paulo, Bauru-SP, Brazil
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Kalabalık F, Şahin O. Evaluation of stylohyoid complex in subjects with different types of malocclusions using cone-beam computed tomography: a retrospective study in a Turkish subpopulation. Surg Radiol Anat 2020; 42:1095-1100. [PMID: 32394117 DOI: 10.1007/s00276-020-02486-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/29/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE According to the functional matrix theory, the development of maxillomandibular complex may be affected by the surrounding tissues. The aim of this study was to evaluate the length and angulation of the styloid process in different types of malocclusions using cone-beam computed tomography (CBCT). METHODS Angulations and length of the styloid process were evaluated in CBCT images of 97 individuals retrospectively. The patients were classified as class I, II, and III groups according to sagittal skeletal classes. The mean length, anterior angulation, and medial angulation of the styloid process were analyzed. Statistical significance was evaluated at p < 0.05. RESULTS The mean styloid process length in group class III was found to be significantly longer than class I (p: 0.035). Anterior angle was significantly higher in class III group than in other groups (p < 0.05). No statistically significant difference was found in medial angle between the groups (p: 0.506). CONCLUSION According to present findings, class III malocclusion is associated with the stylohyoid complex morphology due to longer styloid process lengths and higher anterior angle values.
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Affiliation(s)
- Fahrettin Kalabalık
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Onur Şahin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Izmir Katip Celebi University, Aydinlik Evler Mahallesi, Cemil Meric Caddesi, 6780 Sokak No: 48, 35640, Cigli, Izmir, Turkey.
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Ribeiro ADA, Smith FJ, Nary Filho H, Trindade IEK, Tonello C, Trindade-Suedam IK. Three-Dimensional Upper Airway Assessment in Treacher Collins Syndrome. Cleft Palate Craniofac J 2019; 57:371-377. [DOI: 10.1177/1055665619885555] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objectives: The purpose of this investigation was to assess the pharyngeal dimensions and the craniofacial morphology of individuals with Treacher Collins syndrome (TCS) when compared to vertical skeletal class II individuals. It is our hypothesis that the upper airways of individuals with TCS are reduced in view of the skeletal pattern and the maxillomandibular dysmorphologies. Materials and Methods: Cone-beam computed tomography scans of 26 individuals had the pharyngeal volume (V) and minimal cross-sectional area (mCSA) evaluated. Study group (TCS) was formed by 13 scans of patients with TCS (7 males and 6 females; 20.2 ± 4.7 years). Control group (CG) assembled 13 scans of nonaffected individuals with the same type of skeletal pattern (2 males and 11 females; 26.6 ± 5.4 years). Cephalometric data of maxillomandibular position, maxillomandibular dimensions, and growth pattern were assessed. Statistical analysis ( P ≤ .05) included Student t test and Pearson correlation coefficient. Results: Although reduced, pharyngeal V and mCSA of TCS were not statistically different from the CG. On both groups, mCSA was mostly at the oropharyngeal level. Individuals with TCS presented retrognathic chin, reduced maxillomandibular dimensions, and increased clockwise rotation of the palatal plane. Maxillary and mandibular lengths were correlated with pharyngeal V and mCSA. Conclusions: The pharyngeal dimensions of individuals with TCS are impacted by the micrognathia and retrognathia. In association with the skeletal pattern, the reduction of the airways, although not statistically significant, may explain the increased prevalence of airways disorder in this syndrome.
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Affiliation(s)
- Alexandre de Almeida Ribeiro
- Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Brazil
| | - Francis Joel Smith
- Anschutz Medical Campus Bookstore, University of Colorado at Denver, CO, USA
| | | | - Inge E. K. Trindade
- Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Brazil
| | - Cristiano Tonello
- School of Dentistry, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Brazil
| | - Ivy K. Trindade-Suedam
- Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Brazil
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Mandibular Spatial Reorientation and Morphological Alteration of Crouzon and Apert Syndrome. Ann Plast Surg 2019; 83:568-582. [DOI: 10.1097/sap.0000000000001811] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Flores MRP, Machado CEP, Gallidabino MD, de Arruda GHM, da Silva RHA, de Vidal FB, Melani RFH. Comparative Assessment of a Novel Photo-Anthropometric Landmark-Positioning Approach for the Analysis of Facial Structures on Two-Dimensional Images. J Forensic Sci 2018; 64:828-838. [PMID: 30332504 DOI: 10.1111/1556-4029.13935] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/12/2018] [Accepted: 10/03/2018] [Indexed: 11/28/2022]
Abstract
Positioning landmarks in facial photo-anthropometry (FPA) applications remains today a highly variable procedure, as traditional cephalometric definitions are used as guidelines. Herein, a novel landmark-positioning approach, specifically adapted for FPA applications, is introduced and, in particular, assessed against the conventional cephalometric definitions for the analysis of 16 landmarks on ten frontal images by two groups of examiners (with and without professional knowledge of anatomy). Results showed that positioning reproducibility was significantly better using the novel method. Indeed, in contrast to the classic approach, very low landmark dispersions were observed for both groups of examiners, which were usually below the strictest clinical standards (i.e., 0.575 mm). Furthermore, the comparison between the two groups of examiners highlighted higher dispersion consistencies, which supported a higher robustness. Thus, the use of an adapted landmark-positioning approach proved to be highly advantageous in FPA analysis and future work in this field should consider adopting similar methodologies.
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Affiliation(s)
- Marta R P Flores
- Social Department of the Dentistry College, University of Sao Paulo, Avenida Professor Lineu Prestes 2227, Sao Paulo, 05508-000, Brazil
| | - Carlos E P Machado
- Brazilian Federal Police, National Institute of Criminalistics, INC Building, Brasília, 70610-200, Brazil
| | - Matteo D Gallidabino
- Centre for Forensic Science, Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Ellison Building, Newcastle Upon Tyne, NE1 8ST, U.K
| | - Gustavo H M de Arruda
- Brazilian Federal Police, Technical and Scientific Sector, Rua Annita Luiza Mello Di Lascio, Cabedelo, 58101-770, Brazil
| | - Ricardo H A da Silva
- Department of Stomatology, Public Health and Forensic Odontology, Dentistry College of Ribeirao Preto, University of Sao Paulo, Avenida do Café, Ribeirao Preto, 14040-904, Brazil
| | - Flávio B de Vidal
- Department of Computer Science, University of Brasilia, Darcy Ribeiro Campus, Asa Norte, Brasilia, 70910-900, Brazil
| | - Rodolfo F H Melani
- Social Department of the Dentistry College, University of Sao Paulo, Avenida Professor Lineu Prestes 2227, Sao Paulo, 05508-000, Brazil
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Logjes RJH, Breugem CC, Van Haaften G, Paes EC, Sperber GH, van den Boogaard MJH, Farlie PG. The ontogeny of Robin sequence. Am J Med Genet A 2018; 176:1349-1368. [PMID: 29696787 DOI: 10.1002/ajmg.a.38718] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 12/17/2017] [Accepted: 03/23/2018] [Indexed: 02/06/2023]
Abstract
The triad of micrognathia, glossoptosis, and concomitant airway obstruction defined as "Robin sequence" (RS) is caused by oropharyngeal developmental events constrained by a reduced stomadeal space. This sequence of abnormal embryonic development also results in an anatomical configuration that might predispose the fetus to a cleft palate. RS is heterogeneous and many different etiologies have been described including syndromic, RS-plus, and isolated forms. For an optimal diagnosis, subsequent treatment and prognosis, a thorough understanding of the embryology and pathogenesis is necessary. This manuscript provides an update about our current understanding of the development of the mandible, tongue, and palate and possible mechanisms involved in the development of RS. Additionally, we provide the reader with an up-to-date summary of the different etiologies of this phenotype and link this to the embryologic, developmental, and genetic mechanisms.
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Affiliation(s)
- Robrecht J H Logjes
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, Wilhelmina Children's Hospital Utrecht, Utrecht, The Netherlands
| | - Corstiaan C Breugem
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, Wilhelmina Children's Hospital Utrecht, Utrecht, The Netherlands
| | - Gijs Van Haaften
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Emma C Paes
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, Wilhelmina Children's Hospital Utrecht, Utrecht, The Netherlands
| | - Geoffrey H Sperber
- Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada
| | | | - Peter G Farlie
- Royal Children's Hospital, Murdoch Children's Research Institute, Parkville, Australia
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