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Methodological Comparison of 3 Mandibular Condylar Segmentation Planes in 3-Dimensional CT Imaging for Craniofacial
1Department of Cranio-Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Objective:
To compare the validity and reliability of 3 mandibular condylar segmentation planes-conventional Frankfort-parallel (C), adjusted global (F), and condylar long-axis-based (P) planes-in patients with unilateral craniofacial microsomia (CFM).
Methods:
This retrospective methodological study included 47 patients with unilateral type IIA CFM. Condyles were segmented from 3-dimensional CT scans using the 3 planes. Validity was assessed using a custom 4-grade integrity score (grades 1-2 were considered valid). Reliability was evaluated using intraclass correlation coefficients (ICCs) for intra- and interoperator volume measurements. Statistical analyses included the Friedman test, the Cochrane Q test, and the Bonferroni correction.
Results:
Plane P demonstrated the highest valid segmentation rate (97.9%), significantly greater than plane C (40.4%, adjusted P<0.001) but not significantly different from plane F (78.7%, adjusted P=0.069). All planes showed good to excellent reliability (ICCs: 0.939-0.998). Condylar volumes and asymmetry ratios differed significantly among planes (P<0.001).
Conclusions:
The choice of segmentation plane significantly affects condylar volumetric measurement validity in CFM. Plane P provides the most valid segmentation, but requires enhanced standardized training. Plane F is a viable alternative. The conventional plane C frequently results in incomplete segmentation, limiting its validity in this population.
