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Evaluating 3D Morphometrics for Assessing Micrognathia in Neonates with Severe Pierre Robin Sequence: A Case-Control
Sahejbir S Bhatia1, Paul W Hung1, Alexander E Velazquez1
1Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Summary
Neonates with Pierre Robin sequence (PRS) have wider, shorter mandibles compared to controls, impacting airway obstruction. These 3D morphometric differences in PRS mandibles offer insights for surgical planning.
Area of Science:
- Craniofacial Surgery
- Pediatric Dentistry
- Medical Imaging
Background:
- Pierre Robin sequence (PRS) is a congenital condition characterized by mandibular hypoplasia, glossoptosis, and airway obstruction.
- Understanding the precise 3D mandibular morphology in neonates with PRS is crucial for effective management and surgical planning.
Purpose of the Study:
- To compare 3D mandibular morphometrics between neonates with non-syndromic PRS and age-matched controls.
- To establish normative 3D mandibular data for PRS neonates.
- To elucidate the specific anatomical differences contributing to PRS.
Main Methods:
- Retrospective case-control study involving 25 neonates with PRS and 25 age-matched controls.
- Computed tomography (CT) scans of the head were utilized for 3D mandibular reconstructions.
- Standardized morphometric measurements (linear distances, angles, ratios) were analyzed.
Main Results:
- Mandibles in neonates with PRS exhibited significantly higher asymmetry in body length compared to controls (p=0.006).
- PRS mandibles were wider (increased intercondylar and intergonial distances) and shorter antero-posteriorly (decreased body length, effective mandibular length) relative to their height.
- Intercondylar angle was significantly smaller in PRS mandibles (p<0.001).
Conclusions:
- Neonates with PRS requiring mandibular distraction osteogenesis (MDO) present with a uniquely wide and antero-posteriorly short mandible for its height.
- Except for body length, PRS and control mandibles show similar asymmetry in other dimensions.
- These findings provide a detailed understanding of the structural abnormalities in PRS, informing surgical strategies for glossoptosis and airway issues.
