Upper airway characteristics in unilateral hemifacial microsomia patients: a three-dimensional radiographic retrospective study.

This study investigated upper airway characteristics in hemifacial microsomia (HFM) patients. A total of 68 HFM patients, categorized into four phenotypes (type I, IIa, IIb, and III), and 82 age-, sex-, and body mass index-matched controls were analysed. 3D airway models were reconstructed using Mimics software, and several parameters, including airway volume, mean cross-sectional area (CSA), minimum CSA (min-CSA), and lateral-to-anterior-posterior (LAT/AP) ratio, were measured. Results showed that HFM patients had significantly smaller total airway volume, mean-CSA, surface area, and min-CSA compared to controls (all P < 0.001). The total airway LAT/AP ratio was significantly higher in HFM patients (P = 0.028). Airway dimensions progressively decreased from type I to type III, with type III exhibiting the most severe abnormalities in volume (P = 0.002), mean-CSA (P = 0.004), and min-CSA (P = 0.049). The asymmetry index was significantly higher in HFM patients for nasopharyngeal (P = 0.004), glossopharyngeal (P < 0.001), and hypopharyngeal (P < 0.001) volumes. Type III patients showed the largest asymmetry in the glossopharyngeal (P = 0.002) and hypopharyngeal (P < 0.001) regions. These findings suggest that type III HFM patients have more severe airway abnormalities compared to other phenotypes, which should be considered when planning treatment.