Facial Growth in Children With Thalassaemia and Sickle Cell Anaemia

Objectives: To measure and analyse average facial growth of children with Thalassaemia and Sickle Cell Anaemia (SC) and compare it to an age-matched control at pre-defined time points over a period of eighteen to thirty six months.
Methods: This study consisted of 45 participants and 16 control participants. The participants were divided into 2 study groups, 30 children with Thalassaemia subdivided into Transfusion Dependent Thalassaemia (TDT) and Transfusion Non Dependent Thalassaemia (TNDT) and 15 children with SC. The group of 16 controls consisted of 8 unaffected siblings of children with SC and 8 unaffected siblings of children with Thalassaemia.
3D facial imaging (3dMD) was carried out on a 6-monthly basis over 36 months in the Thalassaemia study group and 18 months in the SC and control group. The consecutive 3-D images were superimposed and the differences between the images at different time points based on six predefined area measurements were analysed with statistical tests.
Results: The reproducibility of the 3dMD system was found to be within 0.1mm. Analysis of facial scans indicated more average facial growth in TDT than NTDT. When children with Thalassaemia (TDT and NTDT) were compared to unaffected sibling controls, it was found that the controls showed more average facial growth than children with TDT and NTDT in all facial areas. Children with SC showed more average facial growth than those with both TDT and NTDT, these changes were more pronounced when compared to the NTDT group. Children with SC showed less average facial growth than unaffected siblings controls in all facial areas.
Conclusions: 3-D facial scans were used as a non-invasive tool to detect facial growth in children for up to 3 years. Results from the study showed altered facial growth in participants compared to controls. The mid-face showed more growth in children with NTDT when compared to both TDT and controls and there was a tendency for more frontal growth in children with SC. In general these children with haemoglobinopathies showed slower facial growth but transfusion treatment improved this to some extent possibly suggesting the role of anaemia in growth retardation. Additional clinical research with increased numbers of participants is required to further assess the clinical validity and applicability of 3dMD in this field.