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Akbari MR, Khorrami-Nejad M, Kangari H, Heirani M, Akbarzadeh Baghban A, Raeesdana K, Masoomian B. Does Head Tilt Influence Facial Appearance More Than Head Turn?. JOVR [Internet]. 2023Jul.23 [cited 2024May15];18(3):297–305. Available from: https://knepublishing.com/index.php/JOVR/article/view/13778

https://doi.org/10.18502/jovr.v18i3.13778

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authors

  • Mohamad Reza Akbari

    Mohamad Reza Akbari

    Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Masoud Khorrami-Nejad

    Masoud Khorrami-Nejad

    School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Haleh Kangari

    Haleh Kangari

    School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Mohsen Heirani

    Mohsen Heirani

    Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Alireza Akbarzadeh Baghban

    Alireza Akbarzadeh Baghban

    Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Kiana Raeesdana

    Kiana Raeesdana

    School of Optometry, University of Montreal, Montréal, Canada
  • Babak Masoomian

    Babak Masoomian

    Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

Published Date

  • Jul 23, 2023
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

Does Head Tilt Influence Facial Appearance More Than Head Turn?

Journal of Ophthalmic and Vision Research (JOVR) / July–September 2023, Volume 18, Issue 3 / Pages 297–305

Abstract

Purpose: To evaluate the frequency of facial asymmetry parameters in patients with head tilt versus those with head turn.


Methods: This cross-sectional comparative study was performed on 155 cases, including 58 patients with congenital pure head turn due to Duane retraction syndrome (DRS), 33 patients with congenital pure head tilt due to upshoot in adduction or DRS, and 64 orthotropic subjects as the control group. The facial appearance was evaluated by computerized analysis of digital photographs of patients’ faces. Relative facial size (the ratio of the distance between the external canthus and the corner of the lips of both face sides) and facial angle (the angular difference between a line that connects two external canthi and another line that connects the two corners of the lips) measured as quantitative facial parameters. Qualitative parameters were evaluated by the presence of one-sided face, cheek, and nostril compression; and columella deviation.


Results: The facial asymmetry frequency in patients with head tilt, head turn, and orthotropic subjects was observed in 32 (97%), 50 (86.2%), and 22 (34.3%), respectively (P < 0.001). In patients with head tilt and head turn, the mean facial angle was 1.78º ± 1.01º and 1.19º ± 0.84º, respectively (P = 0.004) and the mean relative facial size was 1.027 ± 0.018 and 1.018 ± 0.014, respectively (P = 0.018). The frequencies of one-sided nostril compression, cheek compression, face compression, and columella deviation in patients with pure head tilt were found in 19 (58%), 21 (64%), 19 (58%), and 19 (58%) patients, respectively, and in patients with pure head turn the frequencies were observed in 42 (72%), 37 (63%), 27 (47%), and 43 (74%), respectively. All quantitative and qualitative facial asymmetry parameters and facial asymmetry frequencies were significantly higher in head tilt and head turn patients as compared to the control group (P < 0.001).


Conclusion: All facial asymmetry parameters in patients with head tilt and head turn were significantly higher than orthotropic subjects. The quantitative parameters such as relative facial size and facial angle were significantly higher in patients with pure head tilt than pure head turn. The results revealed that pure head tilt was associated with a higher prevalence of facial asymmetry than pure head turn.

Keywords:

Duane Retraction Syndrome; Facial Asymmetry; Head Tilt; Head Turn; Upshoot In Adduction

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