Craniofacial Asymmetry in Northern Pakistan

INTRODUCTION: Right and left side differences in facial symmetry may give rise to misleading clinical and radiological evaluation in cases of potential trauma. OBJECTIVE: To assess morphometric analysis of local populations is important to facilitate safe surgical approaches in the craniofacial region. To assess common aspects of craniofacial asymmetry in human skulls from Pakistan were investigated. METHODOLOGY: Human skulls (n=126) from medical schools (n=10) of Khyber Pakhtunkhwa Pakistan were examined. The distances measured, using a digital vernier caliper, were: infraorbital foramen to anterior nasal spine (IOF-ANS); greater palatine foramen to posterior nasal spine (GPF-PNS); zygomatic arch at the zygomatic-temporal suture to foramen spinosum (ZTS-FS); foramen spinosum to basion (FS-B). An asymmetry index was calculated using the formula [(right side - left side)/right side) x 100].9 RESULTS: Means and standard deviations for each distance for the left and right sides were: IOF-ANS, 35.4 ± 2.8 mm and 35.7 ± 2.8 mm; GPF-PNS, 16.9 ± 2.0 mm and 17.1 ± 1.9 mm; ZTS-FS; 40.2 ± 2.8 mm and 40.1 ± 2.9 mm, and FS-B, 35.0 ± 2.4 mm and 35.1 ± 2.4 mm. No difference was found between the sides except for IOF-ANS (p = 0.060, paired sample t-test). [If the level of significance has been set at 0.05, then a value of 0.06 is not significant]. Asymmetry indices were: IOF-ANS, 3.9 ± 3.6; GPF-PNS, 4.6 ± 5.3; ZTS-FS, 3.1 ± 2.7; and FS-B, 3.7 ± 3.0. CONCLUSION: There is no difference in the distances between the anatomical landmarks studied on the skull base in a Pakistani population. However, larger population based studies are suggested to examine the difference in left and right side IOF-ANS distance. KEY WORDS: Skull, Craniofacial asymmetry, Asymmetry index, Anatomical landmarks