The Effect of Esotropic Duane Retraction Syndrome on Facial Appearance

To evaluate the facial characteristics in patients with unilateral esotropic Duane retraction syndrome (DRS) with head turn and compare with orthotropic participants.

This cross-sectional descriptive-analytical study was performed on 42 esotropic DRS patients with head turn and 42 orthotropic participants. Four photos of each patient were taken from 40 cm and the pictures were analyzed with Corel Draw X7 software. "Facial angle" (the angle between the line connecting the two outer canthi with the line connecting the corners of lips) and "relative face size" (the ratio of the distance between the outer canthus and lip corner of both face sides) were measured. Qualitative variables of facial asymmetry (columella deviation, one-side compression of the face, nostrils, and cheek) were also recorded.

The mean age of patients and controls was 15 ± 9 and 17 ± 10 years, respectively (P = 0.268). In the DRS group, 35 patients (83.3%) had facial asymmetry, and only 7 patients (16.7%) had symmetrical faces (P <0.001), while in the control group, facial asymmetry was found in 21 participants (50%). The mean relative face size in the DRS group (1.018 ± 0.013) was significantly higher than orthotropic participants (1.010 ± 0.008) (P= .0030). Although the mean facial angle in the DRS group (1.06 ° ± 0.96 °) was higher than orthotropic participants (0.80 ° ± 0.64 °), no significant relationship was observed between them (P = 0.119). The frequency of presence of facial asymmetry, columella deviation, one-side compression of the face, nostrils, and cheek in DRS patients was significantly higher than orthotropic participants (all, P<0.001).

Facial asymmetry in esotropic DRS patients with head turn is significantly higher than in orthotropic participants.