RUSH: OOOOE a icle o p oo ing <# 3507>
_______________________
Dea Au ho :
The p oo o you a icle o be published by Else ie in OOOE - O al Su ge y, is a ailable as a PDF ile a
he ollowing URL:
h p:// apidp oo .cadmus.com/RapidP oo / e ie al/index.jsp
Login: you e-mail add ess
Passwo d: 77NNksK25GF2
Also a ached a e ins uc ions on he anno a ion o PDF iles, as well as a Que y Fo m i we ha e any
ques ions ega ding you a icle.
P oo co ec ions can now be anno a ed on-sc een, which allows you o indica e you co ec ion di ec ly on
he PDF p oo . Anno a ing and e u ning you PDF p oo as an email a achmen will ensu e quick and
accu a e publica ion o you a icle. To ead hese iles and anno a e he elec onic p oo wi h co ec ions
you will need he la es e sion o Adobe Reade , which is a ailable o ee a :
h p://www.adobe.com/p oduc s/ac oba / eads ep.h ml. Please also see he accompanying ins uc ions o
u he in o ma ion.
I PDF anno a ions a e no easible, please conside one o he ollowing me hods o e u ning p oo
co ec ions:
* Lis he co ec ions (including eplies o any au ho que ies) in an e-mail and e u n o me a
[email p o ec ed] o simply use he Reply bu on. Using his op ion, please e e o he line numbe s on
he p oo .
* Ma k co ec ions and any o he commen s (including eplies o any au ho que ies) on a p in ou o he
PDF ile and ax i o Jill Shephe d ( ax #: 352-483-3417).
* I none o he abo e op ions a e possible, please exp ess mail a ma ked up copy o you a icle o he
add ess below.
A e accessing he PDF p oo , please:
* ca e ully p oo ead he en i e a icle, including ables, equa ions, igu e legends, and e e ences;
* con i m ha all e e ences, ables, and igu es ma ch up co ec ly wi h hei ci a ions in ex ;
* ensu e accu acy and spelling o a ilia ions, add esses, and au ho names;
* check ha any G eek le e s (such as "mu") ha e been ansla ed co ec ly;
* e i y scien i ic no a ions, d ug dosages, and manu ac u e names and loca ions;
* be su e pe mission has been p ocu ed o any ep in ed ma e ials; and
* answe all au ho que ies comple ely ( hese a e lis ed on he las page).
Changes ha signi ican ly al e he con en o he a icle, such as new igu es and ables o ew i en
sec ions, will only be conside ed a his s age wi h he Edi o 's app o al. I is impo an ha all o you
co ec ions a e sen back o us in one communica ion. Please check you p oo ca e ully be o e eplying, as
inclusion o any subsequen co ec ions canno be gua an eed and he e will be no u he oppo uni y o
p oo ead you a icle.
I you submi ed usable colo igu es wi h you a icle hey will appea in colo on he web, a no ex a
OOOE - O al Su ge y
Copy o e-mail No i ica ion z1k5549
cha ge. In he p in ed issue, colo ep oduc ion depends on jou nal policy and whe he you ag ee o bea any
cos s. Any 'supplemen a y' ma e ial o you a icle (i.e., no appea ing in p in ) will be accessible a e you
co ec ed a icle is placed online; such ma e ial is no pa o he p oo ing p ocess and is he e o e no
a ached he e.
PLEASE RESPOND WITHIN 48 HOURS, e en i you ha e no co ec ions, and include he jou nal name
and a icle numbe on any co espondence.
Kind ega ds,
Jill Shephe d
Jou nal Manage
Else ie Inc.
17007 O ange A e.
Uma illa,FL 32784
Phone: 352-483-8113
Fax: 352-483-3417
[email p o ec ed]
P-anno a ePDF- 8.1
INSTRUCTIONS ON THE ANNOTATION OF PDF FILES
To iew, p in and anno a e you a icle you will need Adobe Reade e sion 7 (o highe ). This p og am is eely
a ailable o a whole se ies o pla o ms ha include PC, Mac, and UNIX and can be downloaded om
h p://www.adobe.com/p oduc s/ac oba / eads ep2.h ml. The exac sys em equi emen s a e gi en a he Adobe si e:
h p://www.adobe.com/p oduc s/ac oba /ac sys em eqs.h ml#70win.
PDF ANNOTATIONS ( o his you will need Adobe Reade e sion 7 o 8; o use e sion 9 see below)
To make anno a ions in he PDF ile, go o he main Adobe oolba and change he cu so om a hand symbol o he
no mal cu so by clicking on he ‘Selec ’ bu on in he menu ba a he op. When you open he PDF ile
using Adobe Reade , he Commen ing oolba should be displayed au oma ically; i no , click on ‘Tools’, selec
‘Commen ing’ (o ‘Commen & Ma kup’), hen click on ‘Commen ing oolba ’ (o Show Commen & Ma kup
oolba in Ac oba Reade 8, o Show Commen ing ba on he Mac). I hese op ions a e no a ailable in you Adobe
Reade menus hen i is possible ha you Adobe e sion is lowe han e sion 7 o he PDF has no been p epa ed
p ope ly.
(PC, Adobe e sion 7)
(PC, Adobe e sion 8, igh -click on i le ba (Commen & Ma kup) o show addi ional icons)
(Mac)
PDF ANNOTATIONS (Adobe Reade e sion 9)
The de aul o he Commen ing oolba is se o ‘o ’ in e sion 9. To change his se ing selec ‘Edi | P e e ences’,
hen ‘Documen s’ (a le unde ‘Ca ego ies’), hen selec he op ion ‘Ne e ’ o ‘PDF/A View Mode’ – see nex page
( he Commen ing oolba is he same as in e sion 8).
(Changing he de aul se ing, Adobe e sion 9)
PLEASE DO NOT ATTEMPT TO EDIT THE ARTICLE TEXT ITSELF
TO INDICATE INSERT, REPLACE, OR REMOVE TEXT
xInse ex
Click he ‘Tex Edi s’ bu on on he Commen ing oolba . Click o se he cu so loca ion in he
ex and simply s a yping. The ex will appea in a commen ing box. You may also cu -and-pas e ex om
ano he ile in o he commen ing box. Close he box by clicking on ‘x’ in he op igh -hand co ne . I can be
dele ed by igh clicking ( o he PC, c l-click on he Mac) on i and selec ing ‘Dele e’.
xReplace ex
Click he ‘Tex Edi s’ bu on on he Commen ing oolba . To highligh he ex o be eplaced,
click and d ag he cu so o e he ex . Then simply ype in he eplacemen ex . The eplacemen ex will appea
in a commen ing box. You may also cu -and-pas e ex om ano he ile in o his box. To eplace o ma ed ex
(an equa ion o example) please A ach a ile (see below).
xRemo e ex
Click he ‘Tex Edi s’ bu on on he Commen ing oolba . Click and d ag o e he ex o be
dele ed. Then p ess he dele e bu on on you keyboa d. The ex o be dele ed will hen be s uck h ough.
HIGHLIGHT TEXT / MAKE A COMMENT
Click on he ‘Highligh ’ bu on on he Commen ing oolba . Click and d ag o e he ex . To make a commen ,
double click on he highligh ed ex and simply s a yping.
ATTACH A FILE
Click on he ‘A ach a File’ bu on on he Commen ing oolba . Click on he igu e, able o o ma ed ex o
be eplaced. A window will au oma ically open allowing you o a ach he ile. To make a commen , go o ‘Gene al’
and hen ‘Desc ip ion’ in he ‘P ope ies’ window. A g aphic will appea indica ing he inse ion o a ile.
LEAVE A NOTE / COMMENT
Click on he ‘No e Tool’ bu on on he Commen ing oolba . Click o se he loca ion o he no e on he
documen and simply s a yping. Do no use his ea u e o make ex edi s.
REVIEW
To e iew you changes, click on he ‘Show’ bu on on he Commen ing oolba . Choose ‘Show
Commen s Lis ’. Na iga e by clicking on a co ec ion in he lis . Al e na i ely, double click on any ma k-up o open
he commen ing box.
UNDO / DELETE CHANGE
To undo any changes made, use he igh click bu on on you mouse ( o PCs, C l-Click o he Mac). Al e na i ely
click on ‘Edi ’ in he main Adobe menu and hen ‘Undo’. You can also dele e edi s using he igh click (C l-click on
he Mac) and selec ing ‘Dele e’.
SEND YOUR ANNOTATED PDF FILE BACK TO ELSEVIER
Sa e he anno a ions o you ile and e u n as an e-mail a achmen using he ‘ eply’ bu on o he o iginal mail.
Be o e e u ning, please ensu e you ha e answe ed any ques ions aised on he Que y o m and ha you ha e inse ed
all co ec ions: la e inclusion o any subsequen co ec ions canno be gua an eed.
No e: Comp ehensi e ins uc ions a e p o ided wi hin you PDF ile: o access hese ins uc ions please click on he
Commen s and Ma kup menu in he main ool ba , o click on Help.
FURTHER POINTS
xAny (g ey) hal ones (pho og aphs, mic og aphs, e c.) a e bes iewed on sc een, o which hey a e op imized,
and you local p in e may no be able o ou pu he g eys co ec ly.
xI he PDF iles con ain colou images, and i you do ha e a local colou p in e a ailable, hen i will be likely
ha you will no be able o co ec ly ep oduce he colou s on i , as local a ia ions can occu .
xI you p in he PDF ile a ached, and no ice some ‘non-s anda d’ ou pu , please check i he p oblem is also
p esen on sc een. I he co ec p in e d i e o you p in e is no ins alled on you PC, he p in ed ou pu will
be dis o ed.

JOBNAME: AUTHOR QUERIES PAGE: 1 SESS: 3 OUTPUT: Mon Sep 27 13:58:31 2010
/ ap aid2/z1k⫺moe/z1k⫺moe/z1k99908/z1k5549d08z
AQ1— Please e i y Web add ess; page was no ound.
AQ2— To be mo e concise, conside eplacing wi h ‘ om’, ‘because’ o ‘by’.
AQ3— Please p o ide he ci y and s a e o LEAD Technologies.
AQ4— Please cla i y “ acili ies he s udy.”
AQ5— Please p o ide olume numbe and yea o e . 28.
AQ6— Please con i m email add ess is co ec .
AQ7— Please see Unci ed Re e ences sec ion o missing e e ences.
AQ8— Au ho a ilia ions will appea di e en ly in he p in and online e sions o you pape .
The PDF shows how he a ilia ions will p esen ollowing jou nal s yle, whe eas he
sea chable online e sion will p esen as ollows in o de o p o ide comple e unab idged
a ilia ions. Please check he accu acy o he a ilia ion(s) o each au ho and make changes as
app op ia e.
a
Lec u e , Mas e ’s P og am in O hodon ics and Den o acial O hopedics, School o Den is y,
Uni e si y o Se ille, Se ille, Spain
b
Clinical Assis an in O al Su ge y, Uni e si y o Se ille, Se ille, Spain
c
P o esso o O al Su ge y, Depa men o S oma ology, Uni e si y o Se ille, Se ille, Spain
d
P o esso o Special Ca e Pa ien s, Depa men o S oma ology, Uni e si y o Se ille, Se ille,
Spain
e
P o esso o O hodon ics, Chai man o O hodon ics, Depa men o S oma ology, Uni e si y
o Se ille, Se ille, Spain
P o esso o O al Su ge y, Chai man o O al Su ge y, Depa men o S oma ology, Uni e si y
o Se ille, Se ille, Spain
AUTHOR QUERIES
AUTHOR PLEASE ANSWER ALL QUERIES 1
C anio acial cha ac e is ics in c i-du-cha synd ome
Rosa-Ma ía Yáñez-Vico, BDS, MSc,
a
Ángela Rod íguez-Caballe o, BDS,
b
Alejand o Iglesias-Lina es, DDS, MSc,
a
Noelia Gue a-López, BDS,
b
Daniel To es-Laga es, DDS, MSc,
c
Guille mo Machuca-Po illo, MD,
d
En ique Solano-Reina, MD, MSc,
e
and José-Luis Gu ié ez-Pé ez, MD,
Se ille, Spain
UNIVERSITY OF SEVLLE
Objec i e. The pu pose o his s udy was o analyze c anio acial cha ac e is ics om la e al head p o ile adiog aphs
o pa ien s wi h c i-du-cha (CdC) synd ome.
S udy design. The c anio acial mo phology o 10 CdC pa ien s was e alua ed using s anda d cephalome ic me hods,
measu ing 39 c anio acial a iables on cephalome ic x- ay images.
Resul s. The p incipal cha ac e is ics we e skele al class II malocclusion, caused by mandibula e ogna hism, den al
bip o usion, and a small uppe ai way. Addi ionally, 70% o pa ien s had a s eep pala al plane angle; he c anial base
angle was la ened, also in 70% o pa ien s.
Conclusions. Resul s indica ed ha he dele ion o 5p had an impac on he c anial base, maxilla, mandible, and
uppe ai way, causing dis inc i e ea u es o become appa en h ough i egula g ow h. (O al Su g O al Med O al
Pa hol O al Radiol Endod 2010;xx:xxx)
The c i-du-cha (CdC) synd ome, i s desc ibed by
Lejeune e al.,
1
is cha ac e ized by pa ial dele ion o
he sho a m o ch omosome 5. The size o he dele ion
anges om he en i e sho a m o egion 5p15 and 3
(5 o 40 Mb) only.
2,3
I s equency is es ima ed o be
be ween 1:15,000
4
and 1:50,000
5
o li e-bo n in an s,
bu he p e alence ound by Niebuh
4
in 6000 indi id-
uals wi h men al e a da ion was app oxima ely 1:350.
Fu he mo e, Schinzel’s da a
6
sugges ha i is he mos
common au osomal dele ion synd ome in humans.
The synd ome is cha ac e ized by a high-pi ched mono-
ch oma ic c y like he mewing o a dis essed ki en,
p obably because o anomalies o he la ynx and epiglo is
as well as neu ological, s uc u al, and unc ional al e -
a ions.
4
Addi ional clinical ea u es a e se e e psychomo-
o and men al e a da ion, g ow h delay, and hypo onia.
2,4
Al hough he cha ac e is ic c y is usually conside ed di-
agnos ic o he synd ome,
2
he ca like c y has been ound
wi hou he ypical dysmo phic and se e e de elopmen al
ea u es o he synd ome in indi iduals wi h he limi ed
5p15.3 dele ion.
2,7
C anio acial abno mali ies include mi-
c ocephaly, sligh hype elo ism, epican hal olds, down-
slan ing palpeb al issu es, s abismus, mal o med ea s,
and hypodon ia.
8,9
E en hough he clinical ea u es a e well known as he
esul o desc ip ions by se e al au ho s,
2,7,10
li le is
known abou c anio acial de elopmen . The e a e some
s udies based on an h opome ic da a, such as skull size,
inne can hal dis ance, and e ogna hia.
4,11,12
Mo e e-
cen ly, Kjae and Niebuh
13
in es iga ed he c anial base
o pa ien s wi h CdC synd ome using p o ile adiog aphs
and ound ha he condi ion in ol ed a mal o ma ion o
he c anial base. They poin ed ou ha his pa icula
c anial base egion de elops a ound he no ocho d, a he
loca ion whe e he hombencephalic-de i ed b ains em,
pons, and ce ebellum de elop do sally and whe e he
neu ons mig a e en ally o he la ynx. They sugges ed
ha a c anial de elopmen al ield, o igina ing a he no o-
cho d loca ion, is in ol ed in he mani es a ions o CdC
synd ome.
Cephalome ics in ol es he use o la e al head a-
diog aphs o measu e he skull and acial bones wi h
espec o speci ic e e ence poin s. I is use ul o
e alua ing and quan i ying g ow h and de elopmen
ea u es, such as he ela ionship be ween he jaws, and
be ween he jaws and he c anial bones. The pu pose o
This wo k was suppo ed by a g an o he Depa men o S oma ol-
ogy (CTS-523), awa ded by he Resea ch Ins i u e o he Uni e si y
o Se ille (Spain).
a
Lec u e , Mas e ’s P og am in O hodon ics and Den o acial O ho-
pedics, School o Den is y, Uni e si y o Se ille, Se ille, Spain.
b
Clinical Assis an in O al Su ge y, Uni e si y o Se ille, Se ille,
Spain.
c
P o esso o O al Su ge y, Depa men o S oma ology, Uni e si y
o Se ille, Se ille, Spain.
d
P o esso o Special Ca e Pa ien s, Depa men o S oma ology,
Uni e si y o Se ille, Se ille, Spain.
e
P o esso o O hodon ics, Chai man o O hodon ics, Depa men o
S oma ology, Uni e si y o Se ille, Se ille, Spain.
P o esso o O al Su ge y, Chai man o O al Su ge y, Depa men o
S oma ology, Uni e si y o Se ille, Se ille, Spain.
Recei ed o publica ion May 24, 2010; e u ned o e ision Jul 21,
2010; accep ed o publica ion Aug 20, 2010.
1079-2104/$ - see on ma e
© 2010 Published by Mosby, Inc.
doi:10.1016/j. ipleo.2010.08.021
e1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
his s udy was o analyze c anio acial cha ac e is ics on
la e al head p o ile x- ays in pa ien s wi h CdC syn-
d ome.
MATERIAL AND METHODS
Six een pa ien s om he Spanish C i-du-cha Asso-
cia ion and diagnosed wi h CdC synd ome by hei
espec i e e e ence hospi als belonging o he Public
Heal h Se ice we e selec ed om among pa ien s who
had unde gone some p ocedu e in he Depa men o
O al and Maxillo acial Su ge y a he Facul y o Den-
is y, Uni e si y o Se ille (Spain). Six o hese indi-
iduals we e excluded because he images showed poo
quali y and mo ion a i ac s; excluded subjec s we e
hose wi h se e e men al e a da ion who we e unable
o emain s ill du ing he x- ay exposu e. As a esul , 10
pa ien s—2 males and 8 emales wi h a mean age o
23.9 ⫾6.7 yea s—we e selec ed o he analysis. The
p esen s udy was ca ied ou wi h he ull knowledge
and w i en consen o each subjec and in acco dance
wi h he e hical p inciples go e ning medical esea ch
and human subjec s, as laid down in he Helsinki Dec-
la a ion (2002 e sion, h p://www.wma.ne /e/policy/
b3.h m). The da a ha e been ea ed wi h absolu e con-
iden iali y. Me hods o ga he ing and s o ing da a a e
subjec o he Spanish O ganic Law go e ning pe sonal
da a p o ec ion. The Expe imen al E hics Commi ee a
he Uni e si y o Se ille independen ly app o ed he
p ocedu e.
All subjec s we e pho og aphed and examined in a-
and ex ao ally o gene al medical and den al indings.
The p o ocol included gene a ing la e al cephalome ic
digi al x- ay images, a 70 kV, 12 mA, wi h an expo-
su e ime o 0.80 seconds (Odon o ama PC, T ophy,
Cedex, F ance). Speci ic so wa e (Nemo ec, Mad id,
Spain) was used o he digi al images om which
c anio acial and den al measu emen s we e aken. An-
a omical landma k coo dina es we e de ined and sum-
ma ized as shown in Table I. C anio acial bones and
ela ionships we e measu ed a e being classi ied in o
4 g oups: ai way analysis, skele al p oblems, den al
p oblems, and es he ic p oblems. This classi ica ion
p o ides use ul in o ma ion o de e mining which, i
any, de elopmen al ield is a ec ed in CdC synd ome.
In each g oup, angula and linea measu emen s we e
assessed and quan i ied o his pu pose, as shown in
Table II. Measu emen s ob ained om subjec s wi h he
CdC synd ome we e compa ed wi h s anda d measu e-
men s p o ided by he speci ic so wa e we used, and
s anda d de ia ions calcula ed on he basis o s anda d-
ized age, sex, and ace no ms. Cephalome ic analysis
me hods by S eine ,
14,15
Ricke s,
16
Ja aback and Fiz-
zel,
17
and McNama a
18
we e used o ob ain s anda d
measu emen s. The measu emen s e e ed o p e i-
ously co espond o he mos ep esen a i e and widely
used me hods acco ding o o hodon ic and c anio acial
esea che s. The co espondence be ween cephalome -
ic analyses and measu emen s used a e also shown in
Table II. In aobse e e o was calcula ed o he
sample, which was wice es ed. I was calcula ed in he
ollowing way: SE ⫽公(⌺d2/2n), whe e d is he di -
e ence be ween he double measu emen s and n is he
numbe o pai ed double measu emen s. I was e alu-
a ed using he S uden es o pai ed samples, wi h
absence o signi icance ega ded as indica i e o con-
co dance be ween mean alues. The da a ob ained we e
analyzed using SPSS 17.0 so wa e o Windows
(LEAD Technologies, USA).
RESULTS
The accu acy o in aobse a ional e o was 0.41
mm o linea measu emen s and 0.63° o angle mea-
su emen s. The e we e no s a is ically signi ican di -
e ences be ween o iginal and epea measu emen s
(P⬎.05).
Ai way analysis emphasized he educed olume in
he uppe espi a o y ac (Table III). The g ea majo -
i y o he acial pa e n measu emen s included sha ed
meso acial cha ac e is ics. Howe e , he e a e pa ame-
e s ha demons a e an ob ious e ical componen in
he g ow h o s udy subjec s, such as a dec eased uppe
gonial angle and an inc eased lowe gonial angle. By
con as , we also ound an inc eased an e io acial
heigh ( he dis ance be ween he nasion and men on
landma ks). In con as , s anda d measu emen s we e
ound o lowe acial heigh (ans-xi-pm) and an e o-
in e io acial heigh (Na-me) (Table III).
An inclined pala al plane was ound o be a s anda d
ea u e o he analyzed subjec s. S a is ical equencies
o his a iable show ha only 30% o subjec s had
s anda d measu emen s and 70% had a ma ked slope.
These da a ep esen one o he mos cha ac e is ic
ea u es o CdC synd ome (Table IV).
Measu emen s o he an e io and pos e io c anial
base showed ha bo h we e educed compa ed wi h
es ablished age, sex, and acial no ms. Howe e , in
70% o cases, he c anial base angle (s-na-ba) was la ge
(Table V) when compa ed wi h age- ela ed s anda ds
o no mal indi iduals.
19-21
Sagi al skele al ea u es
a e all consis en wi h skele al class II malocclusion
caused by mandibula e ogna hism (Table III).
Wi h ega d o den al cephalome ic da a, we ound
den al bip o usion, p o uding lowe inciso s, and ou -
wa d-p o uding uppe inciso s (Table III).
The main es he ic p oblem obse able om he ceph-
alome ic acing was he p esence o a sho uppe lip
wi h a igh nasolabial angle. The lowe lip no mally
p o uded (Table III).
OOOOE
e2 Yáñez-Vico e al. Mon h 2010
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
AQ: 1
T1
T2
AQ: 2
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
AQ: 3
T3
T4
T5
DISCUSSION
C i-du-cha synd ome was i s desc ibed in 1963 by
Lejeune e al.,
1
who comp ehensi ely explained he
common clinical mani es a ions. Since hen, he li e a-
u e has e e ed o pa ien s wi h CdC as exp essing
c anio acial ea u es ha include hype elo ism, an i-
mongoloid obliqui y o he palpeb al issu es, and a
moon ace. Radiological ea u es, such as mic oenceph-
aly and aul y long bone de elopmen ha e also been
desc ibed. Many au ho s ha e epo ed on he clinical
and adiological indings associa ed wi h his syn-
d ome
8,10,13,22-25
; none, howe e ha e measu ed
c anio acial ea u es in ol ing he maxilla y and man-
dibula bones.
In CdC synd ome, he mono onous, high-pi ched c y
like a ca is p obably he mos cha ac e is ic and s ik-
ing clinical ea u e.
26
This has also been ound in
ce ain kinds o diso de s o neu ological diseases.
4
Mo phologic la yngeal al e a ions, such as a small
loppy, cu ed epiglo is,
27
la yngeal hypoplasia, a na -
ow, diamond-shaped o quad angula la ynx, o an
abno mal ai space in he pos e io a ea du ing phona-
ion,
28
ha e all been said o esul in his cha ac e is ic
c y. Ai way analysis ound a na ow uppe ai way
olume, con i med by compu ed omog aphy s udies.
22
Ne e heless, subsequen s udies es ablished ha such
ana omical al e a ions we e no necessa ily p esen in
e e y pa ien and he exis ence o some o he o ganic o
unc ional ac o was no being conside ed.
4
Thus, he
s a is ical equency o a ma kedly inclined pala al
plane, ound in 70% o he subjec s, sugges s ha i is
a cha ac e is ic ea u e and p obably in ol ed in he
Table I. Ana omical landma ks used
Poin De ini ion
Sella (S) Poin ep esen ing he cen e o he pi ui a y ossa
Nasion (Na) Mos an e io poin o he on onasal su u e on he midplane
Basion (Ba) Mos pos e o-in e io poin o he cli us
A icula e (A ) The in e sec ion be ween he ex e nal con ou o he c anial base and he do sal con ou o he condyla head
o neck.
Tangen -gonion ( go) The poin o in e sec ion be ween he base and he amus angen s h ough gna ion and a icula e
Men on (Me) The lowes poin o he jaw a he le el o he midsagi al plane o he symphysis
Condylion (Co) The uppe mos poin o he mandibula condyle
A poin (A) The mos pos e io poin on he an e io con ou o he uppe al eola p ocess
Gna ion (Gn) The mos in e io poin on he mandibula symphysis
Pogonion (Pg) The mos an e io poin on he mandibula symphisis
Apex supe ius (As) The apex o he oo o he mos p ominen maxilla y cen al inciso
Inciso su pe ius (Is) The midpoin o he incisal edge o he mos p ominen maxilla y cen al inciso
Inciso in e ius (Ii) The midpoin o he incisal edge o he mos p ominen mandibula cen al inciso
Apex in e ius (Ai) The apex o he oo o he mos p ominen mandibula cen al inciso
Psps poin (psp) The mos pos e io poin on he so pala e
Ppws poin (ppws) Closes poin on he pos e io o pha yngeal wall o psp poin
Pb poin (pb ) In e sec ion o he pos e io bo de o he ongue and he in e io bo de o he mandible
Ppwi poin (ppwi) Closes poin on he pos e io o pha yngeal wall o pb poin
Pm poin (pm) The poin whe e he cu a u e o he an e io bo de o he symphysis changes om conca e o con ex
Xi poin (Xi) A poin loca ed a he cen e o he amus
P e igomaxilla e (P ) The in e sec ion poin o he in e io bo de o he o amen o undum and he pos e io wall o he
p e igomaxilla y issu e
Gonion (Go) The lowes , mos pos e io poin on he gonial angle o he mandible
Po ion (Po) The mos supe io poin on he adiolucency o he ex e nal and in e nal audigo y mea i. I is loca ed
pos e io o he mandibula condyle and pos e io cli us.
O bi ale (O ) The mos in e io poin on he lowe bo de o he bony o bi
CF poin (CF) The in e sec ion poin o he FH plane (F ank o ho izon al plane: a line connec ing he Po and O poin s)
and he PTV plane (P e ygoid e ical plane: a line pe pendicula o he FH plane ho ugh he PT poin ).
An e io nasal spine (ANS) The apex o he an e io nasal spine
Pos e io nasal spine (PNS) The mos pos e io poin on he bonu ha d pala e in he midsagi al plane
S omion supe ius (S s) The lowes midline poin o he uppe lip
B poin (B) The deepes poin on he con ou o he mandible
So isue pogonion (Pg´) The mos p ominen poin on he so issue con ou o he chin in he midsagi al plane
Lab ale supe ius (Ls) The poin deno ing he e million bo de o he uppe lip in he midsagi al plane
Lab ale in e ius (Li) The poin deno ing he e million bo de o he lowe lip in he midsagi al plane
Subnasale (Sn) The poin in he midsagi al plane whe e he base o he columella o he nose mee s he uppe lip
Columela nasal medium (Nm) Geome ic cen e on columela o de subnasal poin o he ip o he nose
Cen e o c anium (Ce) The in e sec ion poin o he Ba-Na plane and he acial axis plane
Condyle (Dc) The poin in he cen e o he condyle neck along Ba-N plane
OOOOE
Volume xx, Numbe x Yáñez-Vico e al. e3
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163