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Method for accessing zygomatic-maxillary complex symmetry: Mirroring, transposing, and calculating Hausdorff distance
Tien-Hsiang Wang1,2,3, Yu-Chung Shih1,2, Wen-Chan Yu4,5
1Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Journal of the Chinese Medical Association : JCMA
|December 2, 2025
Summary
A new method objectively measures facial symmetry after zygomaticomaxillary complex (ZMC) fracture repair. This approach uses 3D CT scans and Hausdorff distance to quantify deviations, aiding surgical planning and outcome assessment.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic and Reconstructive Surgery
- Medical Imaging Analysis
Background:
- Facial fracture treatment aims to restore function and aesthetics.
- Assessing outcomes objectively is challenging due to complex anatomy.
- A novel method was developed to evaluate facial symmetry without a midsagittal plane.
Purpose of the Study:
- To assess a novel methodology for evaluating zygomaticomaxillary complex (ZMC) symmetry.
- To provide an objective means of outcome assessment in facial fracture treatment.
Main Methods:
- Utilized postoperative facial CT scans from ZMC fracture patients and controls.
- Created 3D models, mirrored, transposed, and analyzed using Hausdorff distance (HD).
- Calculated 95th percentile HD (HD95) to quantify deviations between mirrored and contralateral ZMCs.
Main Results:
- The study included 21 ZMC fracture patients and 22 controls.
- Mean HD95 was significantly higher in the ZMC fracture group (3.48±1.50mm) vs. control (2.00±0.76mm).
- Statistical significance was found (p=0.0002).
Conclusions:
- Bilateral ZMC symmetry can be effectively and objectively assessed using the novel mirroring, transposing, and HD analysis approach.
- This quantitative tool can improve preoperative planning and postoperative evaluation.
- The method offers an objective measure for facial symmetry in ZMC fractures.
