Correlation between facial asymmetry, shoulder imbalance, and adolescent idiopathic scoliosis.

We conducted a prospective cross-sectional study to examine the correlation between facial asymmetry, shoulder imbalance, and adolescent idiopathic scoliosis. Sixty-nine adolescent idiopathic scoliosis patients and 29 healthy volunteers were enrolled in this study. All patients underwent whole-spine standing anteroposterior radiographs and frontal cephalograms. Patients were divided into mild, moderate, and severe groups depending on Cobb angle (10°-25°, 25°-40°, and >40°, respectively). Facial measurements included maxilla height difference, ramus length difference, and anterior nasal spine-menton angle. Shoulder measurements included coracoid height difference, clavicular angle, clavicle-rib intersection difference, and radiographic shoulder height.The anterior nasal spine-menton angle in the severe group (>40°) was higher than in the other groups (P<.05), as was the clavicle-rib intersection difference (P<.05). In addition, the magnitude of the curve showed a possible correlation with the anterior nasal spine-menton angle and clavicle-rib intersection difference in scoliosis patients (r=0.433 and r=0.511, respectively). According to different curve patterns, the anterior nasal spine-menton angle and clavicle-rib intersection difference were significantly higher in the double thoracic group than in the other groups (P<.05). In the correlation analysis, the ramus length difference and anterior nasal spine-menton angle had a possible correlation with the coracoid height difference, clavicular angle, radiographic shoulder height, and clavicle-rib intersection difference (P<.05).

[1]  B. Qian,et al.  Discrepancy between radiographic shoulder balance and cosmetic shoulder balance in adolescent idiopathic scoliosis patients with double thoracic curve , 2008, European Spine Journal.

[2]  Mutlu Hayran,et al.  Evaluation of shoulder balance in the normal adolescent population and its correlation with radiological parameters , 2008, European Spine Journal.

[3]  Hoi-Jeong Lim,et al.  Classification of facial asymmetry by cluster analysis. , 2007, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[4]  J. Emans,et al.  Congenital scoliosis: a review and update. , 2007, Journal of pediatric orthopedics.

[5]  S. Lai,et al.  Refinement of the SRS-22 Health-Related Quality of Life Questionnaire Function Domain , 2006, Spine.

[6]  E. Fogarty,et al.  Adolescent idiopathic scoliosis as developmental instability , 2005, Genetica.

[7]  G. Danesh,et al.  Interdisciplinary Study of Orthopedic and Orthodontic Findings in Pre-school Infants , 2003, Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie.

[8]  J. Huggare,et al.  Trunk asymmetry and facial symmetry in young adults , 2003, Acta odontologica Scandinavica.

[9]  D. Burton,et al.  The Reliability and Concurrent Validity of the Scoliosis Research Society-22 Patient Questionnaire for Idiopathic Scoliosis , 2003, Spine.

[10]  L. Lenke,et al.  Correlation of Radiographic, Clinical, and Patient Assessment of Shoulder Balance Following Fusion Versus Nonfusion of the Proximal Thoracic Curve in Adolescent Idiopathic Scoliosis , 2002, Spine.

[11]  R. Betz,et al.  Spontaneous Proximal Thoracic Curve Correction After Isolated Fusion of the Main Thoracic Curve in Adolescent Idiopathic Scoliosis , 2001, Spine.

[12]  N. Kumar,et al.  Patterns of Presentation of Congenital Scoliosis , 2000, Journal of orthopaedic surgery.

[13]  S. Suk,et al.  Indications of Proximal Thoracic Curve Fusion in Thoracic Adolescent Idiopathic Scoliosis: Recognition and Treatment of Double Thoracic Curve Pattern in Adolescent Idiopathic Scoliosis Treated With Segmental Instrumentation , 1999, Spine.

[14]  J. Huggare,et al.  Reference structures for assessment of frontal head posture. , 1998, European journal of orthodontics.

[15]  T. Iwahara,et al.  Quantification of cosmesis for patients affected by adolescent idiopathic scoliosis , 1998, European Spine Journal.

[16]  E. Fogarty,et al.  Scoliosis and Developmental Theory: Adolescent Idiopathic Scoliosis , 1997, Spine.

[17]  J. Bago,et al.  Four Radiological Measures to Estimate Shoulder Balance in Scoliosis , 1996, Journal of pediatric orthopedics. Part B.

[18]  E. Fogarty,et al.  Adolescent Idiopathic Scoliosis and Cerebral Asymmetry: An Examination of a Nonspinal Perceptual System , 1995, Spine.

[19]  R J Jefferson,et al.  Quantifying the cosmetic defect of adolescent idiopathic scoliosis. , 1993, Spine.

[20]  S Peck,et al.  Skeletal asymmetry in esthetically pleasing faces. , 2009, The Angle orthodontist.

[21]  J. Huggare.  Natural head position recording on frontal skull radiographs. , 1989, Acta odontologica Scandinavica.

[22]  M. Mcmaster,et al.  The natural history of congenital scoliosis. A study of two hundred and fifty-one patients. , 1982, The Journal of bone and joint surgery. American volume.