autistic facial phenotypes as a possible cause of frontal sinus inflammation

8/18/2019 Autistic facial phenotypes as a possible cause of Frontal Sinus Inflammation

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Autistic facial phenotypes as a possible cause of Frontal Sinus Inflammation

by Yuval Levental

Abstract

It has been shown that certain autistics may have a distinct facial structure which could beindicative of autism. The hypothesis presented is that this structure may possible produce

horizontal inflammation of the frontal sinus. This is based on the idea that for the autistics with

the distinct facial features, the distance between the inner and outer canthi is longer than average,

but the distance between the inner canthi is shorter than average, causing horizontal strain in the

middle. To counteract the excess strain, the nasal bridge possibly pushes perpendicularly

inwards towards the direction of the frontal sinuses. Many autistics experience sensory overload,

and one possible cause could be inflamed frontal sinuses, caused by the tension applied by the

!" facial morphology.

Background

In a #$%% study, &ristina ldridge of the 'niversity of Missouri discovered significant

differences in facial morphology in studied boys with autism spectrum disorder (!") compared

to typically developing (T") boys. The study also found that the facial morphology of boys with

!" could be divided into two uni*ue subgroups

(http+molecularautism.biomedcentral.comarticles%$.%%-#$/$0#12#0#0%3). follow0up #$%/

study found three distinct subgroups of facial morphology among !" boys

(https+www.researchgate.netpublication#44/#$-56acial5!tructure5nalysis5!eparates5ut

ism5!pectrum5"isorders5into5Meaningful57linical5!ubgroups).

The #$%% study used %4 landmar8s on 1dM" images of the faces (6ig. %). There were %1 total

linear distances compared, and 12 were statistically significantly different. Linear distances thatwere significantly reduced in the !" group included those connecting glabella and nasion to

the inner canthi and those connecting nasion with landmar8s located on the nose and philtrum.

Linear distances that were significantly increased in the !" group connected the landmar8s on

the mouth with the inferior nasal region. dditionally, significantly increased linear distances

connected the inner and outer canthi and the lateral upper face with the eyes and contralateral

side of the mouth (http+molecularautism.biomedcentral.comarticles%$.%%-#$/$0#12#0#0%3).

http://molecularautism.biomedcentral.com/articles/10.1186/2040-2392-2-15http://molecularautism.biomedcentral.com/articles/10.1186/2040-2392-2-15


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Figure 1 - Illustration of the anthropometric landmarks collected from the 3dMD images

Most li8ely, the facial features associated with autism cause possible physiological effects which

in turn cause autistic symptomology. This is done through the various forces that are exerted via

the different distances between facial features.

Hypothesis

The distinct facial structure that certain autistics have produces horizontal inflammation of the

frontal sinus, due to the smaller than average nasal bridge area, distance between nasal bridge

forehead, and the opposing surface tensions from the eyes. The distance between the inner and

outer canthi is longer than average, but the distance between the inner canthi is shorter thanaverage, causing horizontal strain in the middle. (6ig. #)

(http+molecularautism.biomedcentral.comarticles%$.%%-#$/$0#12#0#0%3). To counteract the

excess strain, the nasal bridge pushes perpendicularly inwards in the direction of the frontal

sinuses, causing the inflammation. nother reason is that the nasal bridge area is smaller than

average, and that pressure is inversely proportional to area, so the smaller area could cause more

pressure to be directed towards the nasal bridge.

http://molecularautism.biomedcentral.com/articles/10.1186/2040-2392-2-15http://molecularautism.biomedcentral.com/articles/10.1186/2040-2392-2-15


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Figure 2. Results of Euclidean Distance Matrix nal!sis anal!ses of landmark coordinate data

collected from 3dMD images in 2"11 stud!. #hite lines are statisticall! significantl! increased in$o!s %ith autism spectrum disorder &'D() and $lack lines are statisticall! significantl! reduced

in $o!s %ith 'D relati*e to t!picall! de*eloping &+D( $o!s.

Evaluation of hypothesis

There are two frontal sinuses, each one located above each eye (6ig. 1). 9ecause the compressed

nasal bridge is close to them, it will put thermal pressure on them, causing blood vessels to

expand producing sinus inflammation (6ig. /). :ossible evidence against this hypothesis

includes that the nasal bridge will not put enough pressure on the frontal sinuses to cause

significant differences in inflammation.


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Figure. 3 Diagram of ,aranasal 'inuses

Figure Illustrated nose nasal ca*ities

To test this hypothesis, sub;ects with the distinct groupings of facial features seen in the ldridge

et. al studies along with a typically developing group would undergo a sinus M


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(http+lin8.springer.comarticle%$.%$#1+%$#3-3$/1%%4$). treatment plan for temporarily

reducing inflammation could be developed through the usage of nasal sprays.

autistic facial phenotypes as a possible cause of frontal sinus inflammation

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