Evaluation of Mandibular Hypoplasia in Patients With Hemifacial Microsomia: A Comparison Between Panoramic Radiography and Three-Dimensional Computed Tomography

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Abstract

Objective:

To compare the accuracy of three-dimensional computed tomography (3D-CT) and panoramic radiography in the evaluation of mandibular hypoplasia in patients with hemifacial microsomia (HFM).

Design:

Retrospective study of imaging data.

Setting:

Images selected from the archives of the University of Tokyo Hospital.

Subjects:

Twenty patients with unilateral HFM who had undergone both panoramic radiography and 3D-CT in the same period.

Method:

Mandibular deformities were classified according to the Pruzansky classification; eight patients had Grade I deformity and 12 patients had Grade II deformity. Ramus heights were measured on both panoramic radiographs and 3D-CT.

Main outcome measures:

Magnification in panoramic radiographs and extent of mandibular asymmetry as estimated by the affected/unaffected side ratio based on two methods were examined. The Pearson product-moment correlation coefficient was used to estimate correlations between parameters.

Results:

The magnification of ramus heights on panoramic radiographs showed large variations in Grade II patients. The affected/unaffected side ratio estimated by the two methods showed a strong correlation in Grade I patients (correlation coefficient 0.99;p< .0001). Conversely, a weak correlation was seen in Grade II patients (correlation coefficient 0.77;p= .0036), and affected/unaffected side ratios from panoramic radiographs were both over- and underestimated.

Conclusions:

The accuracy of evaluation using panoramic radiography was fairly reliable in Grade I patients. Conversely, accuracy was poor in Grade II patients, and evaluation using 3D-CT seems preferable. The combination of two methods with careful consideration is recommended for clinical applications.

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