Quantitative Assessment of Facial Asymmetry Using Three-Dimensional Surface Imaging in Adults: Validating the Precision and Repeatability of a Global Approach

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Objective:Comparison of global versus landmark analyses of facial asymmetry using three-dimensional photogrammetry to establish a precise method for evaluating facial asymmetry.Design:The landmark-based approach utilized anthropometric data points. Our global approach involved registration of mirror images, independent of a midplane, to calculate a root mean square (RMS) value. We analyzed precision and technical and operator error of both methods.Participants:Three hundred fifty adults participated in this study.Results:We found that the global method has better precision and repeatability with a significantly lower error rate than the landmark-based method. In adults, the average RMS was 0.6253 mm with a standard deviation of 0.16.Conclusions:Our facial asymmetry measurement is more accurate than landmark-based measurements. This method is quick, reliable, and results in generation of a RMS score and a corresponding color-coded facial map that highlights regions of higher and lower asymmetry. This method may be used as a screening tool for asymmetry in both the clinical and research settings.

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