Original ArticlesImportance of Craniofacial Asymmetry in SurgeryKizilkanat, Emine PhD*; Boyan, Neslihan PhD*; Ozsahin, Esin MD, PhD†; Tekdemir, Ibrahim MD‡; Soames, Roger PhD§; Oguz, Ozkan PhD*Author Information *Department of Anatomy, Faculty of Medicine, Cukurova University †Department of Anatomy, Baskent University, Adana Research and Teaching Hospital, Adana ‡Department of Anatomy, Ankara University, Faculty of Medicine, Ankara, Turkey §Centre for Anatomy and Human Identification College of Life Sciences, University of Dundee, Dundee, UK This manuscript was presented as a poster presentation at the Joint Meeting of Anatomical Societies in Bursa/Turkey, May 19 to 22, 2011. The authors declare no conflict of interest. Reprints: Ozkan Oguz, PhD, Department of Anatomy, Faculty of Medicine, Cukurova University, 01330 Balcali, Adana, Turkey (e-mail: email@example.com). Neurosurgery Quarterly: August 2011 - Volume 21 - Issue 3 - p 147-149 doi: 10.1097/WNQ.0b013e31822c476a Buy Metrics Abstract Asymmetry in human craniofacial bones is a common feature in all individuals. These right-side and left-side differences may give rise to misleading clinical and radiologic evaluation in cases of potential trauma. In addition, a knowledge of asymmetry is important for some surgical procedures and approaches. The purpose of this study was to determine some aspects of craniofacial asymmetry in human skulls. Measurements using a digital calliper were taken between specific bony features from the right and left sides of 45 dry Anatolian skulls of unknown age and sex. From these measurements an asymmetry index was calculated. The right and left mean values and associated standard deviations of the following distances were found: the infraorbital foramen to the anterior nasal spine 34.87±2.65 and 33.96±2.59 mm; the greater palatine foramen to the posterior nasal spine 17.72±1.69 and 17.37±1.75 mm; the foramen spinosum to the basion 36.22±2.80 and 36.29±2.76 mm; and the foramen spinosum to the zygomatic arch at the zygomatic-temporal suture 37.60±3.58 and 37.88±3.12 mm. For each of these linear distances an asymmetry index [(right side−left side)/right side)×100 was calculated. The mean and standard deviation of the asymmetry indices were: infraorbital foramen to the anterior nasal spine 4.69±3.67 mm; greater palatine foramen to the posterior nasal spine 4.51±4.63 mm; foramen spinosum to the basion 3.25±3.34 mm; and foramen spinosum to the zygomatic arch at the zygomatic-temporal suture 3.71±3.49 mm. An awareness of craniofacial asymmetry is important when planning surgical intervention in all patients, in particular in those with recognizable craniofacial asymmetry. © 2011 Lippincott Williams & Wilkins, Inc.