Three-dimensional comparison of facial changes in patients with thalassemia major and thalassemia intermedia

Objective: Patients with thalassemia develop severe anemia due to ineffective erythropoiesis and extravascular hemolysis, results in craniofacial changes by extramedullary hematopoiesis. There are many studies in the literature showing facial changes in thalassemia, and most of them have been using two-dimensional radiological devices. In this study, showing the three dimensional changes of the facial changes of thalassemia major (TM) and intermedia (TI) patients by using Artec EVA 3D device and the relation of these changes with factors such as blood transfusion, transfusion initiation time, treatment compliance and duration was aimed. Method: Sixty patients (20 TM, 20 TI and 20 controls) were included in this study. Descriptive characteristics and laboratory findings were evaluated. Craniofacial (area, volume, linear and geodesic) measurements were performed. Results: Sixty cases included in the study were equal about gender distribution in all groups and there was no difference between the mean age of the groups. The root mean square (RMS value) less than 18 years was lower in the TI group than in the TM. Mouth area measurement was lower in TM group than TI. The nasal volume measurements of TI group older than 18 years were lower than TM and control. Forehead linear measurements of TI group were lower than TM and control. The nasal root geodesic measurement of the TI group was lower than the control. A positive correlation was found between the number of transfusions and the linear nasal root measurement in the TM group older than 18 years. Conclusion: This is the first study that performed three-dimensional craniofacial measurements in thalassemia patients. It was concluded that early diagnosis and regular transfusion therapy reduced the craniofacial changes seen in thalassemia patients. Three-dimensional measurements can give more detailed results than two-dimensional measurements to show craniofacial changes. Further studies using three-dimensional measurements to demonstrate craniofacial changes in thalassemia patients are needed.