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[PMID]: | 28468148 | [Au] Autor: | Ligh CA; Swanson J; Yu JW; Samra F; Bartlett SP; Taylor JA |
[Ad] Address: | *Division of Plastic and Reconstructive Surgery, Department of Surgery, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA †Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Southern California, Los Angeles, CA. | [Ti] Title: | A Morphological Classification Scheme for the Mandibular Hypoplasia in Treacher Collins Syndrome. | [So] Source: | J Craniofac Surg;28(3):683-687, 2017 May. | [Is] ISSN: | 1536-3732 | [Cp] Country of publication: | United States | [La] Language: | eng | [Ab] Abstract: | BACKGROUND: Mandibular hypoplasia is a hallmark of Treacher Collins syndrome (TCS), and its severity accounts for significant functional morbidity. The purpose of this study is to develop a mandibular classification scheme. METHODS: A classification scheme was designed based on three-dimensional computed tomography (3D-CT) scans to assess 3 characteristic features: degree of condylar hypoplasia, mandibular plane angle (condylion-gonion-menton), and degree of retrognathia (sella-nasion-B point angle). Each category was graded from I to IV and a composite mandible classification was determined by the median value among the 3 component grades. RESULTS: Twenty patients with TCS, aged 1 month to 20 years, with at least one 3D-CT prior to mandibular surgery were studied. Overall, 33 3D-CTs were evaluated and ordered from least to most severe phenotype with 10 (30%) Grade 1 (least severe), 14 (42%) Grade 2, 7 (21%) Grade 3, and 2 (7%) Grade 4 (most severe). Seven patients had at least 2 longitudinal scans encompassing an average 5.7 (range 5-11) years of growth. Despite increasing age, mandibular classification (both components and composite) remained stable in those patients over time (P = 0.2182). CONCLUSION: The authors present a classification scheme for the TCS mandible based on degree of condylar hypoplasia, mandibular plane angle (Co-Go-Me angle), and retrognathia (SNB angle). While there is a natural progression of the mandibular morphology with age, patients followed longitudinally demonstrate consistency in their classification. Further work is needed to determine the classification scheme's validity, generalizability, and overall utility. |
[Mh] MeSH terms primary: |
Malocclusion/surgery Mandibulofacial Dysostosis/classification Mandibulofacial Dysostosis/surgery
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[Mh] MeSH terms secundary: |
Adolescent Cephalometry/methods Child Child, Preschool Female Humans Imaging, Three-Dimensional Infant Male Malocclusion/classification Malocclusion/diagnosis Mandible/abnormalities Mandibulofacial Dysostosis/diagnosis Retrognathia/classification Retrognathia/diagnosis Retrognathia/surgery Retrospective Studies Tomography, X-Ray Computed/methods Tooth Abnormalities/classification Tooth Abnormalities/diagnosis Tooth Abnormalities/surgery Young Adult
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[Pt] Publication type: | JOURNAL ARTICLE | [Em] Entry month: | 1801 | [Cu] Class update date: |
180126 | [Lr] Last revision date: | 180126 | [Js] Journal subset: | D | [Da] Date of entry for processing: | 170505 | [St] Status: | MEDLINE |
[do] DOI: | 10.1097/SCS.0000000000003470 |
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