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Abstract
To describe a new method for measuring anomalous head positions by using a cell phone. The photo rotation feature of the iPhone® PHOTOS application was used. With the patient seated on a chair, a horizontal stripe was fixed on the wall in the background and a sagittal stripe was fixed on the seat. Photographs were obtained in the following views: front view (photographs A and B; with the head tilted over one shoulder) and upper axial view (photographs C and D; viewing the forehead and nose) (A and C are without camera rotation, and B and D are with camera rotation). A blank sheet of paper with two straight lines making a 32-degree angle was also photographed. Thirty examiners were instructed to measure the rotation required to align the reference points with the orthogonal axes. In order to set benchmarks to be compared with the measurements obtained by the examiners, blue lines were digitally added to the front and upper view photographs. In the photograph of the sheet of paper (p=0.380 and a=5%), the observed values did not differ statistically from the known value of 32 degrees. Mean measurements were as follows: front view photograph A, 22.8 ± 2.77; front view B, 21.4 ± 1.61; upper view C, 19.6 ± 2.36; and upper view D, 20.1 ± 2.33 degrees. The mean difference in measurements for the front view photograph A was -1.88 (95% CI -2.88 to -0.88), front view B was -0.37 (95% CI -0.97 to 0.17), upper view C was 1.43 (95% CI 0.55 to 2.24), and upper view D was 1.87 (95% CI 1.02 to 2.77). The method used in this study for measuring anomalous head position is reproducible, with maximum variations for AHPs of 2.88 degrees around the X-axis and 2.77 degrees around the Y-axis.
Highlights
The anomalous head position (AHP) is an important sign of various diseases
Photographs were obtained in the following views: front view and upper axial view (A and C are without camera rotation, and B and D are with camera rotation)
Using the iPhone®, the patient was photographed in the following two views: front view, with the head tilted over the right shoulder, and upper axial view, where the forehead could be seen and the nose and head were turned to the left
Summary
The anomalous head position (AHP) is an important sign of various diseases. Some of these diseases are ortho pedic, such as scoliosis and congenital torticollis, while others are ophthalmologic, such as some forms of strabismus, nystagmus, blepharoptosis, visual field defects, and refractive errors[1]. In an attempt to obtain the best visual acuity, patients with alterations in the visual field or those who. In cases of early-onset homonymous hemianopia in children, torticollis, which is ipsilateral to the visual field defect, was observed. Refractive error-related AHP appears because of attempts to obtain the best visual acuity. Khawam et al[3] observed astigmatism of 1-4D in most patients with refractive error-related AHP. High myopic individuals may lower the mentum or tilt the head in an attempt to create a pinhole effect with the nose or forehead
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