Evaluation of facial asymmetry and cervical spine deviation: A retrospective study

Abstract

Objective

Facial asymmetry may be associated with cervical spine deviation; however, a relationship has not yet been established. This study aimed to clarify an association between facial asymmetry and cervical spine deviation.

Methods

We evaluated facial asymmetry and measured cervical spine angles to determine their effects on cervical deviation in 92 female patients with jaw deformities that were assessed using computed tomography (CT). Frontal, lateral, and axial radiographs were analyzed using cephalometry. We measured distances and angles from the external occipital protuberance to reference points on an atlas and up to the fifth cervical spine. Maxillofacial morphology was constructed in three dimensions from CT images. The primary outcome measure was the cervical spine angle in association with the maxillomandibular (Mx-Md) midline angle.

Results

The cervical spine angle significantly and positively correlated with the Mx-Md midline angle (p < 0.001). Patients with Mx-Md midline angles > 2.5° or ≤ 2.5° were respectively classified as asymmetric (n = 43) and symmetric (n = 49). The average cervical spine angles were 11.21° ± 7.23° in the asymmetric group and 7.53° ± 6.05° in the symmetric group. The cervical spine angle significantly differed between the symmetric and asymmetric groups, with larger cervical spine angles corresponding to increased facial asymmetry (p < 0.001).

Conclusions

This study identified an association between cervical spine deviation and facial symmetry, which may play a role in postural distortion.