Assessment of the Orbital and Auricular Asymmetry in Italian and Sudanese Children: A Three-Dimensional Study

Abstract

The evaluation of the symmetry of orbital and ear soft tissues is important for aesthetic and reconstructive surgery. However, little information is available for these facial regions, especially in children. We analyzed the orbital and auricular symmetry in 418 Italian and 206 Sudanese subadult males divided into three age groups (8–11, 12–15, and 16–19 years old). Orbital and auricular height and width were measured for calculating fluctuating and directional asymmetry indices. Differences in asymmetry indices according to ethnicity and age group were assessed through the two-way ANOVA test (p < 0.01), while differences in the prevalence of right or left asymmetry according to ethnicity were assessed through the chi-square test. On average, directional asymmetry indices ranged from −2.1% to 1.1%, while fluctuating asymmetry indices ranged between 2.9% and 5.4%, corresponding to a small effect size and to 1.06–2.34 mm actual dimensions. Sudanese subjects showed a greater asymmetry for all the indices except for the fluctuating asymmetry of orbital height (p < 0.01). The directional asymmetry of auricular width increased with age. A prevalent right-side asymmetry was found for all the orbital indices (p < 0.001) in both populations, although significantly more prevalent in Sudanese individuals (over 83% for both measures), while auricular measures showed a prevalent left asymmetry exclusively in the Sudanese but with lower percentages. Aside from the limited effect size, the results proved the ethnic variability of asymmetry of orbital and auricle regions in children and suggest the need to collect more population data.