Abstract
Facial asymmetry refers to the absence of, or the deviation from the regular mirror image of facial structures, relative to a referenced midline axis. It can be attributed to a wide spectrum of deformities, including congenital, developmental, or acquired conditions, which can originate either prenatally or postnatally. Though highly prevalent, asymmetry commonly goes undiagnosed due to its subtle or relative nature. Among the spectrum of conditions, acquired cases are triggered postnatally, in previously normal individuals, thus subjecting them to sudden, eventful psychological and psychosocial disharmony. When detected early, timely management may help intervene progressive growth of these conditions. This, therefore, emphasizes the need for a thorough diagnostic workup including medical/dental history, clinical examinations, study models, photographic and radiographic records for a case-by-case basis to prevent severe functional and aesthetic complications. Recently, advanced diagnostic procedures, such as stereophotogrammetry, 3D stereolithographic models, skeletal scintigraphy (radionucleotide scans), 3D computed tomographic scans, cone-beam computed tomography, and magnetic resonance imaging, have provided innovative diagnostic instruments for numerous craniofacial defects. This descriptive review aims at focusing on the factors leading to frequently encountered conditions of acquired facial asymmetry and highlights their clinical evaluation, conservative and surgical interventions by a multi-disciplinary team of clinicians.
Highlights
Many multicellular organisms develop bilaterally and exhibit a certain degree of the phenomenon of ‘Symmetry’, described as the presence of equality or lack of clinically significant variation between two halves of the body, demarcated by an imaginary central axis [1,2]
Facial asymmetry (FA) refers to the absence of, or the deviation from the regular mirror image of facial structures, relative to a referenced midline axis, and it is clinically perceived as an imbalance or difference in the proportion of two sides of the face [1,3]
Relative or subclinical asymmetry is often encountered due to the failure in coordinated development and maturation of the craniofacial structures originating from these prominences [3]
Summary
Many multicellular organisms develop bilaterally and exhibit a certain degree of the phenomenon of ‘Symmetry’, described as the presence of equality or lack of clinically significant variation between two halves of the body, demarcated by an imaginary central axis [1,2]. A vital aspect in studying FA is to concurrently evaluate the skeletal, soft tissue, dental, and functional structures causing facial, maxillofacial, and oral asymmetry. FA can be attributed to a wide spectrum of deformities, including congenital, developmental, or acquired conditions, which can originate either prenatally or postnatally, from hard or soft tissue facial, maxillofacial, and oral structures. They may be perceived at rest (a.k.a. Static) or during facial expressions (a.k.a. Dynamic), and may pose as aesthetic, functional, and psychosocial concerns [3,9]. Acquired FAs are predisposed by various external factors; an accurate diagnosis of these cases consists of a thorough medical/dental history check-up, clinical examinations, study models, photographic and radiographic records
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