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OP18.03: The X face appraisal, a template for the fetal profile

2010; Wiley; Volume: 36; Issue: S1 Linguagem: Inglês

10.1002/uog.8091

1469-0705

E. de Jong‐Pleij, L. S. M. Ribbert, Ellen Tromp, L. R. Pistorius, C. M. Bilardo,

Prenatal Screening and Diagnostics

An objective evaluation method applicable in various fetal profile anomalies is still missing. Extension in cranial direction of the two lines defining the MNM angle forms a ‘X’. This X face appraisal was studied as a possible template to differentiate between retrognathia and maxillary protrusion in case of an increased MNM angle and also as a possible marker for forehead anomalies. Median profile images, corrected by multiplanar mode, were analysed in 12 fetuses with retrognathia, 22 fetuses with a facial cleft, 3 cases with bossing forehead and 128 normal fetuses (15 + 4–36 + 4 weeks). The ‘X’ arises automatically when the MNM angle is measured with the 'two lines' option. The relationship with the frontal bone of the arm of the ‘X’ placed along the anterior border of the mandible (Fman) was defined as negative, zero or positive according to if the line passed anterior of, tangentially-across or posterior of the frontal bone. When Fman passed posteriorly of the frontal bone the distance between Fman and the most protruding part of the frontal bone was measured. In normal fetuses the mean MNM angle was 13.6° (SD: 1.97°, P5–P95: 10.4°–16.9°). Before 28 weeks (n = 78) Fman always hits tangential the frontal bone. After 28 weeks Fman hits tangential the frontal bone in the majority of cases (43), whereas in 7 cases it passed posteriorly of the frontal bone with at a maximum distance of 5 mm. In all 12 retrognathia cases the MNM angle was increased and the Fman was negative. In 22 fetuses with a facial cleft, the MNM angle was increased in 14 and normal in 8 cases whereas Fman was normal in all cases. In all 3 cases with frontal bossing the distance between Fman and the frontal bone was increased (7.8, 7.4, 3.7 mm at 20 + 6, 32 + 1, 19 + 5 weeks respectively). In case of an increased MNM angle the X face can serves as a template to differentiate between retrognathia and maxillary protrusion. X face can also be used to identify a bossing forehead.