Evaluation of facial asymmetry in patients with unilateral chronic otitis

Facial asymmetry is the discrepancy in size or proportion between the two sides of the face. The causes of facial asymmetry can be categorized as congenital, developmental, or acquired due to illness. Chronic Otitis Media (COM) is the persistent inflammation of the middle ear or mastoid cavity. The relationship between COM and craniofacial development, as well as whether COM is a contributing factor in the development of facial asymmetry, has not been conclusively determined. In this study, we aimed to evaluate facial asymmetry in patients with unilateral COM. This research was designed as a retrospective study. One hundred patients over the age of 18 who underwent surgery due to unilateral (right or left) chronic otitis media comprised the study group, while 100 patients who had not undergone surgery or experienced trauma constituted the control group. The midline of the cranium was identified on temporal CT images. The distances in centimeters (cm) from Porion, the outer edge of the zygomatic arch, and the midpoint of the infraorbital foramen to the midline of the cranium were measured.For each landmark, the asymmetry index (AI) was calculated using the formula AI=│(dR-dL)/(dR+dL)│ (where AI represents the asymmetry index, dR is the measurement on the right side, and dL is the measurement on the left side). In patients with left COM, the measurements of the right and left porion were significantly shorter compared to the control group (p<0.5), while no significant differences were observed in the measurements of the zygomatic arch and infraorbital foramen compared to the control group (p>0.5). In patients with right COM, significant differences were found in the measurements of the right and left porion and zygomatic arch compared to the control group (p<0.5), but no significant difference was observed in the measurements of the infraorbital foramen (p>0.5). In conclusion, our study investigated whether unilateral otitis media has an impact on facial asymmetry using measurements from CT images. The results indicate that otitis media has negative effects on facial development but may not significantly disrupt facial symmetry.