探索颅面微小症和小耳症中颅外异常与面部形态的关系
Exploring extracraniofacial anomalies in relation to facial morphology in craniofacial microsomia and microtia.
文献信息
| PMID | 42983716 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Elsa M Ronde |
| 作者单位 | Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. e.m.ronde@amsterdamumc.nl. |
| 期刊 | BMC pediatrics |
| SCI 分区 | Q2 |
| IF | 2.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 颅面微小症（CFM）与颅外异常、阻塞性呼吸和喂养困难相关。本研究旨在探讨能否根据面部形态将伴有颅外异常、阻塞性呼吸或喂养困难的患者与无这些异常或困难的患者区分开来。
方法： 这项横断面研究使用三维照片和不对称指数（ASI）、面部特征（FS）评分以及由FS评分得出的主成分（PC）来测量面部形态。进行单变量分析，以评估伴有颅外异常或喂养和/或呼吸困难的患者与无这些异常或困难的患者在ASI、FS和PC评分以及患者特征方面的显著差异。对两种结局均进行了多变量logistic回归分析。
结果： 179例患者中有84例（47%）发现颅外异常。在多变量分析中，相关颅面异常组数（OR 2.62 [95% CI 1.72-4.15]）和较高的PC30评分（描绘下巴、上颌骨和下眶缘周围FS评分越来越负，OR 1.06 [95% CI 1.01-1.11]）是颅外异常的显著独立预测因素。对于喂养和/或呼吸困难，独立预测因素为裂隙（OR 6.45 [95% CI 2.72-16.05]）、呼吸道或胃肠道异常（OR 7.63 [95% CI 2.33-28.06]）和较低的PC34评分（OR 0.91 [95% CI 0.84-0.97]），后者对应于下眶缘FS评分越来越正以及前额FS评分越来越负。
结论： 伴有颅外异常的患者和伴有呼吸或喂养困难的患者具有更严重的面部表型。颅外异常与可能对应于双侧眶部受累和下巴后缩的形态模式以及其他相关颅面异常显著且独立相关。
英文摘要
BACKGROUND: Craniofacial microsomia (CFM) is associated with extracraniofacial anomalies, obstructive breathing, and feeding difficulties. This study aimed to explore whether patients with extracraniofacial anomalies, obstructive breathing, or feeding difficulties can be distinguished from patients without these anomalies or difficulties, based on their facial morphology.
METHODS: This cross-sectional study used three-dimensional photographs and asymmetry index (ASI), facial signature (FS) scores, and principal components (PC) derived from FS scores to measure facial morphology. Univariate analyses were performed to assess significant differences in ASI, FS, and PC scores, as well as patient characteristics between patients with extracraniofacial anomalies, or feeding and/or breathing difficulties, and patients without these anomalies or difficulties. Multivariate logistic regression analyses were performed for both outcomes.
RESULTS: Extracraniofacial anomalies were found in 84 (47%) out of 179 patients. In the multivariate analysis, the number of associated groups of craniofacial anomalies (OR 2.62 [95% CI 1.72-4.15]) and higher PC30 scores, depicting increasingly negative FS scores around the chin, maxilla, and inferior orbital rims (OR 1.06 [95% CI 1.01-1.11]) were significant independent predictors of extracraniofacial anomalies. For feeding and/or breathing difficulties, independent predictors were clefting (OR 6.45 [95% CI 2.72-16.05]), anomalies of the respiratory or gastrointestinal tracts (OR 7.63 [95% CI 2.33-28.06]), and lower PC34 scores (OR 0.91 [95% CI 0.84-0.97]), corresponding to increasingly positive FS scores of the inferior orbital rims and increasingly negative FS scores of the forehead.
CONCLUSIONS: Patients with extracraniofacial anomalies and patients with breathing or feeding difficulties had more severe facial phenotypes. Extracraniofacial anomalies were significantly and independently associated with morphological patterns possibly corresponding to bilateral orbital involvement and chin retrusion, as well as other associated craniofacial anomalies.