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Scott P. Bartlett - One of the best experts on this subject based on the ideXlab platform.

  • An analysis of mandibular volume in Hemifacial Microsomia.
    Plastic and reconstructive surgery, 2011
    Co-Authors: Derek M Steinbacher, Alexander J. Gougoutas, Scott P. Bartlett
    Abstract:

    Background: The mandibular deformity in Hemifacial Microsomia is characterized by ramus-condyle unit deficiency. The Pruzansky score classifies the proximal mandible according to aberrant condylar-unit structure. The authors sought to volumetrically evaluate the Hemifacial mandible compared with controls, and to assess for Pruzansky score correlation. Methods: This is a retrospective analysis of children with Hemifacial Microsomia. Demographic information was obtained, and computed tomographic data were analyzed by segmentation and volumetric calculations. Age-matched controls were compared using the t test. Results: Computed tomographic scans revealed 24 Hemifacial and 13 controls: 62.5 percent right, 12.5 percent left, and 25 percent bilateral; and 34 percent type I, 28 percent type IIa, 16 percent type IIb, and 22 percent type III. Type IIb/III compared with type I/IIa were 11,100 and 17,773 mm 3 , respectively (p = 0.0029). Segmental evaluation of type IIb/III versus type I/IIa showed 3590 versus 6510 mm 3 for the proximal segments (p = 0.0022) and 7449 versus 10,829 mm 3 for the dental-bearing segments (p = 0.0221). All Hemifacial Microsomia hemimandibles (types I to III) were significantly less than controls: 14,837 versus 20,418 mm 3 (p = 0.0005). Both dentate and proximal Hemifacial Microsomia segments statistically decreased in volume with increasing Pruzansky score. The dentate segment of the unaffected Hemifacial Microsomia side was statistically less than controls. Conclusions: This study volumetrically characterized the Hemifacial Microsomia mandibular deformity. As expected, with increasing Pruzansky severity, hemimandibular and proximal segment volumes declined. Unexpectedly, the Hemifacial dentate segment also proved significantly diminished, corresponding to the degree of proximal volume loss.

  • Hemifacial Microsomia : Clinical Features and Pictographic Representations of the OMENS Classification System
    Plastic and Reconstructive Surgery, 2007
    Co-Authors: Alexander J. Gougoutas, Davinder J Singh, David W Low, Scott P. Bartlett
    Abstract:

    Learning Objectives:After reviewing this article, the participant should be able to: 1. Describe the fundamental malformations defining Hemifacial Microsomia. 2. Distinguish Hemifacial Microsomia from other congenital craniofacial anomalies sharing similar features. 3. Understand the variety of syst

  • Hemifacial Microsomia: clinical features and pictographic representations of the OMENS classification system.
    Plastic and reconstructive surgery, 2007
    Co-Authors: Alexander J. Gougoutas, Davinder J Singh, David W Low, Scott P. Bartlett
    Abstract:

    After reviewing this article, the participant should be able to: 1. Describe the fundamental malformations defining Hemifacial Microsomia. 2. Distinguish Hemifacial Microsomia from other congenital craniofacial anomalies sharing similar features. 3. Understand the variety of systems developed to clinically classify the features of this disorder. 4. Describe the format of the OMENS clinical classification system and appreciate its possible advantages and limitations. The clinical manifestations of Hemifacial Microsomia comprise a spectrum that is both broad and complex. The fundamental features include unilateral hypoplasia of the craniofacial skeleton and its overlying soft tissue. Numerous schemes have been developed to classify this spectrum. One of the most recent classification systems, the OMENS system, scores five clinical manifestations of Hemifacial Microsomia according to dysmorphic severity on a scale from 0 to 3: orbital asymmetry, mandibular hypoplasia, ear deformity, nerve dysfunction, and soft-tissue deficiency. The authors describe the diverse features of Hemifacial Microsomia and the numerous attempts at its clinical classification, with particular emphasis on the OMENS system. With the possible exception of the OMENS scheme, the various systems developed to classify the clinical features of Hemifacial Microsomia fail to possess the flexibility and versatility needed to categorize all potential phenotypes of this complex disorder. The OMENS system represents the most comprehensive, versatile, objective, and easily adaptable attempt at clinical classification of Hemifacial Microsomia to date. The authors propose a concise clinical evaluation form using a modified version of the system to promote the use of the OMENS system, to aid in the evaluation of Hemifacial Microsomia patients, and to assist in data sharing among academic institutions.

Alexander J. Gougoutas - One of the best experts on this subject based on the ideXlab platform.

  • An analysis of mandibular volume in Hemifacial Microsomia.
    Plastic and reconstructive surgery, 2011
    Co-Authors: Derek M Steinbacher, Alexander J. Gougoutas, Scott P. Bartlett
    Abstract:

    Background: The mandibular deformity in Hemifacial Microsomia is characterized by ramus-condyle unit deficiency. The Pruzansky score classifies the proximal mandible according to aberrant condylar-unit structure. The authors sought to volumetrically evaluate the Hemifacial mandible compared with controls, and to assess for Pruzansky score correlation. Methods: This is a retrospective analysis of children with Hemifacial Microsomia. Demographic information was obtained, and computed tomographic data were analyzed by segmentation and volumetric calculations. Age-matched controls were compared using the t test. Results: Computed tomographic scans revealed 24 Hemifacial and 13 controls: 62.5 percent right, 12.5 percent left, and 25 percent bilateral; and 34 percent type I, 28 percent type IIa, 16 percent type IIb, and 22 percent type III. Type IIb/III compared with type I/IIa were 11,100 and 17,773 mm 3 , respectively (p = 0.0029). Segmental evaluation of type IIb/III versus type I/IIa showed 3590 versus 6510 mm 3 for the proximal segments (p = 0.0022) and 7449 versus 10,829 mm 3 for the dental-bearing segments (p = 0.0221). All Hemifacial Microsomia hemimandibles (types I to III) were significantly less than controls: 14,837 versus 20,418 mm 3 (p = 0.0005). Both dentate and proximal Hemifacial Microsomia segments statistically decreased in volume with increasing Pruzansky score. The dentate segment of the unaffected Hemifacial Microsomia side was statistically less than controls. Conclusions: This study volumetrically characterized the Hemifacial Microsomia mandibular deformity. As expected, with increasing Pruzansky severity, hemimandibular and proximal segment volumes declined. Unexpectedly, the Hemifacial dentate segment also proved significantly diminished, corresponding to the degree of proximal volume loss.

  • Hemifacial Microsomia : Clinical Features and Pictographic Representations of the OMENS Classification System
    Plastic and Reconstructive Surgery, 2007
    Co-Authors: Alexander J. Gougoutas, Davinder J Singh, David W Low, Scott P. Bartlett
    Abstract:

    Learning Objectives:After reviewing this article, the participant should be able to: 1. Describe the fundamental malformations defining Hemifacial Microsomia. 2. Distinguish Hemifacial Microsomia from other congenital craniofacial anomalies sharing similar features. 3. Understand the variety of syst

  • Hemifacial Microsomia: clinical features and pictographic representations of the OMENS classification system.
    Plastic and reconstructive surgery, 2007
    Co-Authors: Alexander J. Gougoutas, Davinder J Singh, David W Low, Scott P. Bartlett
    Abstract:

    After reviewing this article, the participant should be able to: 1. Describe the fundamental malformations defining Hemifacial Microsomia. 2. Distinguish Hemifacial Microsomia from other congenital craniofacial anomalies sharing similar features. 3. Understand the variety of systems developed to clinically classify the features of this disorder. 4. Describe the format of the OMENS clinical classification system and appreciate its possible advantages and limitations. The clinical manifestations of Hemifacial Microsomia comprise a spectrum that is both broad and complex. The fundamental features include unilateral hypoplasia of the craniofacial skeleton and its overlying soft tissue. Numerous schemes have been developed to classify this spectrum. One of the most recent classification systems, the OMENS system, scores five clinical manifestations of Hemifacial Microsomia according to dysmorphic severity on a scale from 0 to 3: orbital asymmetry, mandibular hypoplasia, ear deformity, nerve dysfunction, and soft-tissue deficiency. The authors describe the diverse features of Hemifacial Microsomia and the numerous attempts at its clinical classification, with particular emphasis on the OMENS system. With the possible exception of the OMENS scheme, the various systems developed to classify the clinical features of Hemifacial Microsomia fail to possess the flexibility and versatility needed to categorize all potential phenotypes of this complex disorder. The OMENS system represents the most comprehensive, versatile, objective, and easily adaptable attempt at clinical classification of Hemifacial Microsomia to date. The authors propose a concise clinical evaluation form using a modified version of the system to promote the use of the OMENS system, to aid in the evaluation of Hemifacial Microsomia patients, and to assist in data sharing among academic institutions.

Davinder J Singh - One of the best experts on this subject based on the ideXlab platform.

  • Hemifacial Microsomia : Clinical Features and Pictographic Representations of the OMENS Classification System
    Plastic and Reconstructive Surgery, 2007
    Co-Authors: Alexander J. Gougoutas, Davinder J Singh, David W Low, Scott P. Bartlett
    Abstract:

    Learning Objectives:After reviewing this article, the participant should be able to: 1. Describe the fundamental malformations defining Hemifacial Microsomia. 2. Distinguish Hemifacial Microsomia from other congenital craniofacial anomalies sharing similar features. 3. Understand the variety of syst

  • Hemifacial Microsomia: clinical features and pictographic representations of the OMENS classification system.
    Plastic and reconstructive surgery, 2007
    Co-Authors: Alexander J. Gougoutas, Davinder J Singh, David W Low, Scott P. Bartlett
    Abstract:

    After reviewing this article, the participant should be able to: 1. Describe the fundamental malformations defining Hemifacial Microsomia. 2. Distinguish Hemifacial Microsomia from other congenital craniofacial anomalies sharing similar features. 3. Understand the variety of systems developed to clinically classify the features of this disorder. 4. Describe the format of the OMENS clinical classification system and appreciate its possible advantages and limitations. The clinical manifestations of Hemifacial Microsomia comprise a spectrum that is both broad and complex. The fundamental features include unilateral hypoplasia of the craniofacial skeleton and its overlying soft tissue. Numerous schemes have been developed to classify this spectrum. One of the most recent classification systems, the OMENS system, scores five clinical manifestations of Hemifacial Microsomia according to dysmorphic severity on a scale from 0 to 3: orbital asymmetry, mandibular hypoplasia, ear deformity, nerve dysfunction, and soft-tissue deficiency. The authors describe the diverse features of Hemifacial Microsomia and the numerous attempts at its clinical classification, with particular emphasis on the OMENS system. With the possible exception of the OMENS scheme, the various systems developed to classify the clinical features of Hemifacial Microsomia fail to possess the flexibility and versatility needed to categorize all potential phenotypes of this complex disorder. The OMENS system represents the most comprehensive, versatile, objective, and easily adaptable attempt at clinical classification of Hemifacial Microsomia to date. The authors propose a concise clinical evaluation form using a modified version of the system to promote the use of the OMENS system, to aid in the evaluation of Hemifacial Microsomia patients, and to assist in data sharing among academic institutions.

David W Low - One of the best experts on this subject based on the ideXlab platform.

  • Hemifacial Microsomia : Clinical Features and Pictographic Representations of the OMENS Classification System
    Plastic and Reconstructive Surgery, 2007
    Co-Authors: Alexander J. Gougoutas, Davinder J Singh, David W Low, Scott P. Bartlett
    Abstract:

    Learning Objectives:After reviewing this article, the participant should be able to: 1. Describe the fundamental malformations defining Hemifacial Microsomia. 2. Distinguish Hemifacial Microsomia from other congenital craniofacial anomalies sharing similar features. 3. Understand the variety of syst

  • Hemifacial Microsomia: clinical features and pictographic representations of the OMENS classification system.
    Plastic and reconstructive surgery, 2007
    Co-Authors: Alexander J. Gougoutas, Davinder J Singh, David W Low, Scott P. Bartlett
    Abstract:

    After reviewing this article, the participant should be able to: 1. Describe the fundamental malformations defining Hemifacial Microsomia. 2. Distinguish Hemifacial Microsomia from other congenital craniofacial anomalies sharing similar features. 3. Understand the variety of systems developed to clinically classify the features of this disorder. 4. Describe the format of the OMENS clinical classification system and appreciate its possible advantages and limitations. The clinical manifestations of Hemifacial Microsomia comprise a spectrum that is both broad and complex. The fundamental features include unilateral hypoplasia of the craniofacial skeleton and its overlying soft tissue. Numerous schemes have been developed to classify this spectrum. One of the most recent classification systems, the OMENS system, scores five clinical manifestations of Hemifacial Microsomia according to dysmorphic severity on a scale from 0 to 3: orbital asymmetry, mandibular hypoplasia, ear deformity, nerve dysfunction, and soft-tissue deficiency. The authors describe the diverse features of Hemifacial Microsomia and the numerous attempts at its clinical classification, with particular emphasis on the OMENS system. With the possible exception of the OMENS scheme, the various systems developed to classify the clinical features of Hemifacial Microsomia fail to possess the flexibility and versatility needed to categorize all potential phenotypes of this complex disorder. The OMENS system represents the most comprehensive, versatile, objective, and easily adaptable attempt at clinical classification of Hemifacial Microsomia to date. The authors propose a concise clinical evaluation form using a modified version of the system to promote the use of the OMENS system, to aid in the evaluation of Hemifacial Microsomia patients, and to assist in data sharing among academic institutions.

Leonard B. Kaban - One of the best experts on this subject based on the ideXlab platform.

  • progression of facial asymmetry in Hemifacial Microsomia
    Plastic and Reconstructive Surgery, 2000
    Co-Authors: Gerard Kearns, John B. Mulliken, Bonnie L. Padwa, Leonard B. Kaban
    Abstract:

    Hemifacial Microsomia is a common craniofacial anomaly, variably affecting structures derived from the first and second pharyngeal arches. Correction of the skeletal deformity in children has been advocated to improve growth potential and reduce secondary deformity. However, contrary reports have suggested that facial asymmetry in Hemifacial Microsomia does not increase with growth; therefore, skeletal correction can be postponed, even until adolescence. The purpose of this study was to test the hypothesis that facial asymmetry in Hemifacial Microsomia is progressive. This is a retrospective evaluation of 67 patients with untreated Hemifacial Microsomia. The patients were categorized as: group I (mandible type I, IIa), n = 38, and group II (mandible type IIb, III), n = 29. Pretreatment posterior-anterior cephalometric radiographs were used to analyze asymmetry by measuring the angle between the true horizontal and the following planes: piriform rim, maxillary occlusal plane, and intergonial angle. Angular measurements were averaged for patients in the deciduous ( or =6 or =13 years). In group I, angle piriform rim, maxillary occlusal plane, and intergonial angle increased from 7.0, 4.3, and 4.4 to 8.4, 6.6, and 6.1 degrees, respectively [mean age, 4.1 (deciduous) to 8.6 (mixed) to 21.0 (permanent) years]. In group II, angle piriform rim, maxillary occlusal plane, and intergonial angle increased from 9.5, 6.2, and 5.3 to 11.7, 7.6, and 8.0 degrees, respectively [mean age, 3.4 (deciduous) to 8.0 (mixed) years]. These data demonstrate that Hemifacial Microsomia is progressive and underscores the importance of early surgical correction of mandibular asymmetry in this disorder.

  • Progression of facial asymmetry in Hemifacial Microsomia.
    Plastic and reconstructive surgery, 2000
    Co-Authors: Gerard Kearns, John B. Mulliken, Bonnie L. Padwa, Leonard B. Kaban
    Abstract:

    Hemifacial Microsomia is a common craniofacial anomaly, variably affecting structures derived from the first and second pharyngeal arches. Correction of the skeletal deformity in children has been advocated to improve growth potential and reduce secondary deformity. However, contrary reports have suggested that facial asymmetry in Hemifacial Microsomia does not increase with growth; therefore, skeletal correction can be postponed, even until adolescence. The purpose of this study was to test the hypothesis that facial asymmetry in Hemifacial Microsomia is progressive. This is a retrospective evaluation of 67 patients with untreated Hemifacial Microsomia. The patients were categorized as: group I (mandible type I, IIa), n = 38, and group II (mandible type IIb, III), n = 29. Pretreatment posterior-anterior cephalometric radiographs were used to analyze asymmetry by measuring the angle between the true horizontal and the following planes: piriform rim, maxillary occlusal plane, and intergonial angle. Angular measurements were averaged for patients in the deciduous (