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J C Kolar

Publications and source records attributed to J C Kolar.

14 recordsLinked to original sources
PubMed1997

Preoperative anthropometric dysmorphology in metopic synostosis.

Anthropometric identification of dysmorphology in craniofacial anomalies, including the craniosynostoses, provides invaluable assistance in clinical diagnosis as well as offering a technique for interpreting possible deformities in skeletal remains. Premature closure of the metopic suture is a rare form of craniosynostosis, representing about 4% of clinically diagnosed synostoses. Accompanying this closure are defects of the head and face, particularly the upper face and orbits. To identify quantitatively the craniofacial dysmorphology associated with metopic synostosis, 50 patients with a diagnosis of primary (nonsyndromal) metopic synostosis were examined using a battery of 24 anthropometric measurements from which 11 proportion indices were calculated. The data were compared to sex- and age-matched normal students and converted to standard (Z) scores before being analyzed using Student's t-test. The data indicate a complex pattern of dysmorphology arising from the synostosis which affects the upper face and orbits as well as the cranial vault. The entire fronto-orbito-zygomatic complex is narrowed, and vertex is reduced. There is compensatory sagittal and transverse growth of the posterior neurocranium and compensatory vertical and sagittal growth of the upper face. There are statistically significant differences in the pattern of dysmorphology between patients presenting prior to 6 months of age and those older but not significant differences between sexes.

Age Factors↗
PubMed1996

Trigonocephaly-associated hypotelorism: is treatment necessary?

This study was designed to examine whether hypotelorism associated with trigonocephaly might be self-correcting. Only patients who required surgical treatment and had undergone preoperative and postoperative anthropometric measurements were included. In no case was any attempt made to correct the hypotelorism surgically. The study sample consisted of 16 patients, of whom 10 underwent preoperative and postoperative computed tomography in addition to anthropometric examinations. The results were compared with sex- and age-matched pooled normal standards, converted to standard Z scores, and analyzed by means of Student's t tests. Both intercanthal and interorbital widths increased significantly postoperatively, with improvements in delta Z scores of 0.445 (p < or = 0.01) and 0.638 (p < or = 0.05). These increases exceeded average growth increments by 1.6 mm for intercanthal width and 1.3 mm for interorbital width. Improvement in the intercanthal widths was significantly greater in the more severely affected children than in those whose conditions were less severe. A greater improvement in interorbital width also was noted in children treated at less than 6 months of age compared with those treated later. The younger the patient at surgery, the greater was the improvement, suggesting that early surgery may somehow release a constraint on interorbital growth.

Aging↗
PubMed1988

Patterns of dysmorphology in Crouzon syndrome: an anthropometric study.

Twenty-four craniofacial proportion indices were calculated from 26 surface measurements taken directly from the head and face in 61 patients with Crouzon syndrome, aged 11 days to 32 years. All patients were North American caucasians who had not undergone facial repair. The measurements and proportions were compared with those in healthy controls of the same age and sex. In most patients, the only disproportions present were a wide forehead in relation to the cranial breadth and wide orbital region compared with the face width. The proportions were in the normal range in most cases (71.7%), although many tended toward its extremities. Disproportions were associated most frequently with a combination of abnormal and normal measurements (48.9%); however, a large number (42.4%) involved two normal measurements. Among the normal proportions, most involved two normal measurements, although almost one fourth (22.8%) were associated with one or two abnormal measurements.

Adolescent↗
PubMed1987

Anthropometric evaluation of dysmorphology in craniofacial anomalies: Treacher Collins syndrome.

Advances in surgical techniques for correction of craniofacial anomalies have necessitated the development of objective pre- and postoperative quantitative assessments. Standard anthropometric techniques, supplemented by additional methods oriented to specific clinical problems, have proved useful in defining surface dysmorphology in craniofacial patients. A series of 77 surface measurements of the head and face and 41 proportions were determined in 20 preoperative patients with Treacher Collins syndrome, a rare congenital defect of the first and second branchial arches. To permit comparison with age- and sex-specific data for healthy North American children, the patient data were converted to standard (Z) scores. To test the hypothesis Z = 0, Student's t-test was performed on all variables. The anthropometric findings verified many of the clinical findings in this syndrome. In addition, a number of previously unreported defects were found. The cranium was low and short with a low, narrow forehead and a narrow cranial base. The face was narrow and shallow, the mandible long and narrow, and the lower face receding. The eye fissures were short with an antimongoloid inclination, but the orbits were hyperteloric. The nasal root was high and wide, the nasofrontal angle open, and the bridge inclination low. The labial fissure was narrow, and the ears were microtic. Except in the nasal root the defects were hypoplastic. Most of these defects were either horizontal or anteroposterior. Recognition of the defective areas and their contribution to disproportions of the head and face is important in the development of surgical strategies.

Adolescent↗
PubMed1987

Anthropometrics and art in the aesthetics of women's faces.

Attractiveness of the face is not an abstract conception but a quantitatively well-defined anatomic quality. Harmony, disharmony, and disproportion of the face depend on the quality of the relationships between individual measurements of the craniofacial complex. The statistical expression of this relationship is the proportion index. A proportionate face, one with its proportion indices located within the normal range (mean +/- 2 SD), is healthy but not necessarily attractive. In an attractive face the proportion indices are in an optimal relationship, statistically in the range of mean +/- 1 SD. The existence of such a range ensures the great variability possible even among attractive faces. Disproportion, or even mild disharmony in a sensitive area of the face (orbits, nose, lips), reduces the aesthetic quality of the face. Restoration of harmony demands correction of the disproportionate relationships, which is achieved by appropriate changes in the measurements. Norms of measurements and proportion indices found in attractive faces serve as guides in calculating changes. Ethnic differences in North American Caucasian women proved not to be of major concern when planning aesthetic correction.

Anthropometry↗
PubMed1987

Anthropometric guidelines in cranio-orbital surgery.

Surface measurements and proportions of the cranio-orbital region provide valuable information to the surgeon both before and after surgery. They supplement the data obtained from x-ray cephalometry. Preoperatively, the proportion indices help to identify the most deformed areas and reveal which measurements contribute to the disproportion. When surgery is being planned, the defective measurements help the surgeon to calculate the changes necessary. After surgery, the quality of proportionality achieved permits assessment of the degree of improvement.

Adolescent↗
PubMed1986

Geography of the nose: a morphometric study.

The noses of 34 attractive young North American Caucasian women were analyzed quantitatively, based on 19 nasal measurements (6 single and 7 paired linear measurements, 3 angles, and 3 inclinations) and 15 craniofacial measurements (10 linear measurements and 5 inclinations) taken directly from the face of the women. The relationship between the nasal measurements was studied in 16 proportion indices and the relationship between the nasal and the other craniofacial measurements in 13 interareal indices. The findings were also compared with those in 21 women with below-average faces. Two types of facial harmony disruption were identified: disharmony, a normal index with a visually apparent failure of proportionality, and disproportion, an index value outside of the normal range. The percentage of disharmonies and disproportions was significantly higher in the group of 21 women with below-average faces. The study revealed a wide variety of "ideal" noses. Only a small portion of the measurements (12%) and proportion indices (7%) were at the mean value. At least two-thirds of the interareal proportion indices were located in the mean +/- 1 standard deviation portion of the normal range. Only about one-fifth of the interareal indices were disharmonious and 2.8% disproportionate. The disproportions were more areal in the attractive faces and more interareal in the below-average faces. The greatest disproportion in the attractive face was the moderately short columella in relation to the tip protrusion and in the below-average face the long nasal bridge related to the upper-lip height. Disproportions were associated with combinations of normal and abnormal measurements, or with two normal measurements of unequal quality, which resulted in a slightly smaller disfigurement. Analysis of ethnic and racial differences showed the soft nose as the main feature of the most characteristic differences. The study revealed that the key to restoration of facial harmony is the renewal of the uniformity of proportion index qualities by elimination disharmonies and/or disproportionate relationships.

Adult↗
PubMed1985

Abnormal measurements and disproportions in the face of Down's syndrome patients: preliminary report of an anthropometric study.

Using 32 measurements taken from the surface of the cranial-orbital-facial-aural area, 9 proportion indices were calculated to detect the most striking locations of disfigurement in 52 Down's syndrome patients (29 males and 23 females), all white North Americans, aged between 3 and 31 years. A shallow upper-third of the face depth (between the nasal root and the ear's tragi) and a short right auricle were the most frequent subnormal findings (each 71.5 percent), with subnormal palpebral fissures in third place (68.8 percent). The most striking supernormality was the inclination of the palpebral fissure, which was greater than the maximum normal in 46.9 percent. The most striking and frequent (46.9 percent) disproportion was caused by the presence of markedly short palpebral fissures in the vicinity of normal-wide spaces between the eyes (enen), followed by hyperteloric orbits (40.4 percent) and disproportionately short noses (28.9 percent). Major (moderate or marked) epicanthi were found in a high percentage (42 percent) of the patients and aggravated the visual impression of the already damaged orbito-nasal area. Preliminary results of the analysis of the proportion indices in various age groups showed that some disproportions in the orbits and face decreased with age.

Adolescent↗
PubMed1985

Vertical and horizontal proportions of the face in young adult North American Caucasians: revision of neoclassical canons.

The validity of nine neoclassical formulas of facial proportions was tested in a group of 153 young adult North American Caucasians. Age-related qualities were investigated in six of the nine canons in 100 six-year-old, 105 twelve-year-old, and 103 eighteen-year-old healthy subjects divided equally between the sexes. The two canons found to be valid most often in young adults were both horizontal proportions (interorbital width equals nose width in 40 percent and nose width equals 1/4 face width in 37 percent). The poorest correspondences are found in the vertical profile proportions, showing equality of no more than two parts of the head and face. Sex does not influence the findings significantly, but age-related differences were observed. Twenty-four variations derived from three vertical profile, four horizontal facial, and two nasoaural neoclassical canons were identified in the group of young adults. For each of the new proportions, the mean absolute and relative differences were calculated. The absolute differences were greater between the facial profile sections (vertical canons) and smaller between the horizontally oriented facial proportions. This study shows a large variability in size of facial features in a normal face. While some of the neoclassical canons may fit a few cases, they do not represent the average facial proportions and their interpretation as a prescription for ideal facial proportions must be tested.

Adolescent↗
PubMed1985

Inclinations of the facial profile: art versus reality.

The average inclinations of five basic facial profile lines and five individual facial profile segments were determined by direct anthropometry in a total group of 232 healthy young adults, all North American Caucasians. Significant sex-related differences were found only in the inclination of the forehead, the lower face, and the lower third of the face, with greater inclinations in males. These results were compared with data obtained from 49 art works produced by ancient, Renaissance, post-Renaissance, and contemporary artists and drawings of the face in scientific papers published by anthropologists, orthodontists, anatomists, and plastic surgeons. In the population study the average inclination of the general and the aesthetic profile lines, the lower face, the forehead, and the lower lip show a receding trend. The upper face is slightly protruded in the males and close to vertical in the females. The chin and the nose are equally prominent in both sexes. The only significant difference is in the greater recession of the lower face in males. The average female population values are reminiscent of those of the Renaissance. The average male inclinations come closest to the findings in the statues of antiquity. The population sample and the contemporary artists showed similar inclinations of the nasal bridge and the lower lip. Generally, the average inclination of the chin in the population is smaller than in any artistic style.

Adult↗
PubMed1985

Craniofacial disproportions in Apert's syndrome: an anthropometric study.

Twenty craniofacial indices composed of 26 surface measurements taken directly from the head and face were determined in 14 Apert's syndrome patients 18 days to 5 years old (younger subgroup) and 14 patients ages 6 years to 15 years old (older subgroup). All of the patients were North American Caucasians who had undergone early suture release but no facial repair. The indices were compared with those in healthy controls of the same age and sex. The wide intercanthal distance in relation to the narrow soft nose was the most frequent (81.5%) and extensive (17.7% above the maximum normal index value) disproportion. Abnormal indices occurred most often with the combination of one abnormal and one normal measurement (61.0%). All seven of the 16 disproportions seen in both age subgroups increased in frequency nonsignificantly with age: the supernormal cephalic, intercanthal, nasal, and vertical mandibulofacial indices and the subnormal nasofacial, upper face, and jaws' arcs indices. Of the six disproportions that decreased in frequency with age, four changed significantly (the supernormal frontoparietal and frontozygomatic indices and the subnormal mandibulofacial and nasozygomatic indices) and two changed nonsignificantly (the supernormal intercanthoalar and subnormal cheilozygomatic indices). With the exception of two nasal proportions, the extent of the disproportionality decreased in all of the indices that increased with age.

Acrocephalosyndactylia↗
PubMed1985

Surface morphology in Treacher Collins syndrome: an anthropometric study.

Between 27 and 65 anthropometric measurements were taken for the head and face of 18 Treacher Collins syndrome patients. The most defective and frequent findings were subnormal facial depth measurements, which increased in disproportionality toward the mandible. Width of the face was more frequently and more severely subnormal than that of the mandible. The orbits were hyperteloric with disproportionately short eye fissures and an antimongoloid inclination. The ears were microtic (more so in width than in length) in 58.8 percent of cases but low-set in only 20 percent. The nose measurements were mostly normal, which explains the "parrot-beak" character of the nose in the presence of a hypoplastic receding chin; the only nose defects were supernormal height and width in the root and subnormal bridge inclination. The most frequently seen striking disproportions were those between the width of the nasal root and the width of the soft nose, followed by the great discrepancy between the markedly narrow face and the usually normal face height.

Adolescent↗