OBJECTIVES: This study investigates facial directional asymmetry (DA) in early childhood. Using 3D imaging, it aims to assess the DA progression in healthy controls and children with unilateral cleft lip (CL) and unilateral cleft lip and palate (UCLP) following early neonatal cheiloplasty and palatoplasty. MATERIALS & METHODS: The sample consisted of 105 children (groups: cleft 42, control 63) aged 0.2-2 years. DA was analysed using geometric morphometrics, including 3D landmark-based and polygonal mesh analyses. Multivariate statistics were used for assessing DA significance and age group differences. RESULTS: Controls showed no DA in landmarks and only mild protrusion of the right hemiface, increasing with age. In groups with cleft, DA was more pronounced in UCLP and especially in the middle of the face. While older UCLP children showed more asymmetrical faces, DA in children with CL became more comparable to that in controls with increasing age. Older children showed no statistical difference between control and CL in the landmark and polygonal maps parts. CONCLUSIONS: After surgical treatment, a DA pattern was identified, and it was specific for both cleft types and age categories. For both diagnoses, the most notable feature is the protrusion at the cleft site, likely related to post-surgical scarring, but in the UCLP group, it is also the hypoplastic nasal wing and a growth insufficiency of the cheek on the cleft side. CLINICAL RELEVANCE: 3D methodologies provide insight into asymmetry progression and surgical outcomes, supporting improved cleft management for enhanced aesthetic and functional results.

• Keywords
• 3D landmarks-based methods, Directional asymmetry, Facial development with cleft, Geometric morphometrics, Infancy & toddlerhood, Polygonal mesh analyses,
• MeSH
• Facial Asymmetry * diagnostic imaging   MeSH
• Infant MeSH
• Humans MeSH
• Child, Preschool MeSH
• Cleft Palate * surgery   diagnostic imaging   MeSH
• Cleft Lip * surgery   diagnostic imaging   MeSH
• Case-Control Studies MeSH
• Imaging, Three-Dimensional * MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

OBJECTIVES: Facial directional asymmetry research, including age-related changes, is crucial for the evaluation of treatment of craniofacial malformations/trauma in orthodontics, facial surgery and forensic sciences. The aim was to describe facial directional asymmetry (DA) in different age categories of adults using 3D methods. According to our hypothesis, facial shape DA (1) depends on sex; (2) differs among age groups; and (3) has wider variability in older age. MATERIAL AND METHODS: A cross-sectional sample of healthy Czech adults without craniofacial trauma or anomalies consisted of 300 3D facial models (151 females). The age-range in the study was between 20-80 years. The shape asymmetry of 28 3D landmarks was evaluated using geometric morphometrics and multivariate statistics. RESULTS: The manifestation of DA was similar in both sexes and in each age category; however, there were some statistical differences. In contrast to the ideal symmetrical face, the mean asymmetrical faces tended to create a slightly bent "C" shape of the midline. Therefore, the upper face was rotated slightly clockwise and the lower face counter-clockwise. The right eye was located slightly higher, with the nasal tip and mandibular region tilting to the left. Sex differences in facial DA were significant before the age of 40. DA was more significant in the youngest males than in the oldest, while the women's DA did not change. CONCLUSIONS: The DA patterns were similar in both sexes and in all age categories (a slightly bent C shape of the midline); however, some significant local differences between male age groups were found. A significantly more pronounced asymmetry compared to other age groups was found only in the youngest males from 20 to 40 years. Moreover, significant sexual dimorphism of DA rapidly decreased after middle age, likely caused by the same age-related changes of the face during aging.

• MeSH
• Facial Asymmetry * etiology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Nose MeSH
• Sex Characteristics MeSH
• Cross-Sectional Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Imaging, Three-Dimensional * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH