Correlation between maxillary defect and facial asymmetry

The aim of this study was to evaluate the correlation between maxillary defects and facial asymmetry, and to establish categories for visual perception of facial asymmetry. The facial data of 47 patients who underwent maxillary resection due to tumors were captured using stereophotogrammetry. Facial asymmetry was measured using a landmark-independent method and assessed with a Likert scale. Facial asymmetry was classified into three grades (I-III) based on visual perception. Statistically significant differences (P < 0.001) were found in the asymmetry of the suborbital, zygomatic, buccal, and superolabial areas among the different visual perception categories, and the symmetry of these areas significantly influenced the visual perception (P < 0.001). The maxillary defect magnitude significantly influenced facial asymmetry perception (P < 0.001). Substantial statistical variations (P < 0.001) in the asymmetry of four facial areas, excluding the masseteric and nasal areas, across the different classes of maxillary defect were noted. Maxillary defects significantly affect the midface soft tissue symmetry. Reconstruction should focus on sufficient soft tissue support in the zygomatic, buccal, suborbital, and superolabial areas. Corrective measures are generally unnecessary for grade I asymmetry. For grade II asymmetry, reconstruction can be decided individually. For grade III asymmetry, reconstruction is essential.