Craniofacial Anthropometry

• en-en (interocular distance), measured by sliding caliper: covering tips of caliper with index fingers, place fixed tip above subject's right endocanthion. Use 3rd and 5th fingers to steady Instrument above subject's face as you slide left tip to the left endocanthion.

eu (eurion): the most lateral point on the head (identified in opposition, see below)

• eu-eu (maximum cranial breadth), measured by spreading calipers: slide both tips of caliper down lateral sides of parietal bones, then move caliper tips forward and back until maximum width (eurions) is reached.
• fz r-eu I & fz I-eu r (cranial vault asymmetry), measured across the midline using spreading calipers: fz r-eu I; hold the tip of the caliper on the left eurion [eu-l], slide the other tip of the caliper to the anterior prominence of the right frontozygomaticus [fz-r]. Repeat on opposite side for fz I- eu r.

ex (exocanthion): the outer corner of the eye fissure where the eyelids meet.

• ex-ex (biocular width), measured by sliding caliper: covering tips of caliper as in en-en, place fixed tip of caliper above subject's right exocanthion, slide movable tip to position above subject's left exocanthion; use fingers to steady the instrument above the subject's face.
• ex-t (orbito-tragial distance, also referred to as upper cheek depth), measured on the left and right sides of the face using spreading calipers: hold the anterior tip of caliper to exocanthion, touch posterior tip lightly to tragus. Reverse for other side of face.

ft (frontotemporale): the most medial point on the temporal crest, identified by palpation.

• ft-ft (minimum frontal breadth), measured by spreading calipers: by palpation with index fingers, identify temporal crests of frontal bone. Continue along crests to the deepest (most medial) points of curves superior to the superior orbital rims; make sure caliper tips do not slip into temporal fossae.

fz (frontozygomaticus): the most lateral point on the frontozygomatic suture. 

• fz-fz (supraorbital breadth-bony), measured by spreading caliper:  place tips of caliper at the right and left frontozygomaticus.
• fz-g (supraorbital half-breadth), measured on the right and left sides of the head by sliding caliper: place the tip of the fixed arm at the frontozygomatic suture [fz] and slide the arm medially until it touches glabella.
• fz-g-fz (frontozygomaticus-glabella-frontozygomaticus), measured on the surface above the orbits using a measuring tape: place the tape at the origin of the right frontozygomaticus, guiding the tape over glabella to the left frontozygomaticus.
• fz r-eu I & fz I-eu r (cranial vault asymmetry), measured across the midline using spreading calipers: fz r-eu I; hold the tip of the caliper on the left eurion [eu-l], slide the other tip of the caliper to the anterior prominence of the right frontozygomaticus [fz-r]. Repeat on opposite side for fz I- eu r.
• fz r-t I & fz I- t r (frontal-orbital asymmetry), measure across the midline using spreading calipers: fz r-t l: hold the tip of the caliper on the left tragus [t-l], slide the other tip of the caliper to the right frontozygomaticus [fz-r]. Reverse for opposite side for fzl-tr.

g (glabella): the most prominent point in the median sagittal plane between the supraorbital ridges.

• Head circumference, measured by tape: encircle the tape around the head covering glabella [g] and opisthocranion [op], do not stretch tape too tightly.
• g-op (maximum cranial length), measured by spreading caliper: with anterior caliper tip resting on glabella, slide posterior tip inferiorly along medial line of occipital until maximum width is reached (opisthocranion). Conventional technique keeps calipers along a sagittal midline; however, in patients with plagiocephaly, the posterior point of the skull may not be in the midline of the cranium. For clinical purposes take this measurement at the most posterior location.
• fz-g (supraorbital half-breadth), measured on the right and left sides of the head by sliding caliper: place the tip of the fixed arm at the frontozygomatic suture [fz] and slide the arm medially until it touches glabella.
• fz-g-fz (frontozygomaticus-glabella-frontozygomaticus), measured on the surface above the orbits using a measuring tape: place the tape at the origin of the right frontozygomaticus, guiding the tape over glabella to the left frontozygomaticus.

gn (gnathion): in the midline, the lowest point on the lower border of the chin.

• n-gn (morphological height of face), meausured by sliding caliper: place the fixed tip of caliper at the subject's gnathion, slide the moveable end superiorly until it contacts nasion.
• gn-t (lower face depth), measured on the left and right sides of the face using spreading calipers: similar to mid face depth, place the anterior tip of the caliper to the anterior point of gnathion and touch posterior tip lightly to tragus. Reverse for other side of face.
• v-gn (total craniofacial head height), measured in the midline using a double sliding caliper and a level.

obi (otobasion inferius): the lowest point of attachment of the exteral ear to the head.

obs (otobasion superius): the highest point of attachment of the exteral ear to the head.

op (opisthocranion): the most prominent posterior point on the occiput.

• Head circumference, measured by tape: encircle the tape around the head covering glabella [g] and opisthocranion [op], do not stretch tape too tightly.
• g-op (maximum cranial length), measured by spreading caliper: with anterior caliper tip resting on glabella, slide posterior tip inferiorly along medial line of occipital until maximum width is reached (opisthocranion). Conventional technique keeps calipers along a sagittal midline; however, in patients with plagiocephaly, the posterior point of the skull may not be in the midline of the cranium. For clinical purposes take this measurement at the most posterior location.

po (porion): the most superior point on the upper margin of the external auditory meatus with the head in the Frankfort horizontal plane.

• v-po (auricular head height) measured on the right and left sides of the head using a double sliding caliper and a level.

n (nasion): the midpoint of the nasofrontal suture.

• n-gn (morphological height of face), meausured by sliding caliper: place the fixed tip of caliper at the subject's gnathion, slide the moveable end superiorly until it contacts nasion.
• n-t (upper face depth), measured on the right and life sides of the face using spreading calipers: place the anterior tip of the caliper at nasion [n] and touch the posterior tip lightly to tragus [t]. Reverse for other side of face.
• v-n (anterior head height), measured in the midline using a double sliding caliper and a level.

sn (subnasale): in the midline, the junction between the lower border of the nasal septum and the cutaneous portion of the upper lip.

• sn-t, (mid face depth), measured on the right and left sides of the face using spreading calipers: place the anterior tip of the caliper at subnasale [sn] and touch the posterior tip to tragus [t]. Reverse for other side of face.

t (tragion): at the notch above the tragus of the ear where the upper edge of the cartilage disappears into the skin of the face.

• t-t (cranial base width), measured by sliding caliper: the tragi are soft tissue landmarks; tips of caliper should gently touch the superior margins of tragi.
• ex-t (orbito-tragial distance, also referred to as upper cheek depth), measured on the left and right sides of the face using spreading calipers: hold the anterior tip of caliper to exocanthion, touch posterior tip lightly to tragus. Reverse for other side of face.
• fz r-t I & fz I- t r (frontal-orbital asymmetry), measure across the midline using spreading calipers: fz r-t l: hold the tip of the caliper on the left tragus [t-l], slide the other tip of the caliper to the right frontozygomaticus [fz-r]. Reverse for opposite side for fzl-tr.
• gn-t (lower face depth), measured on the left and right sides of the face using spreading calipers: similar to mid face depth, place the anterior tip of the caliper to the anterior point of gnathion and touch posterior tip lightly to tragus. Reverse for other side of face.
• n-t (upper face depth), measured on the right and life sides of the face using spreading calipers: place the anterior tip of the caliper at nasion [n] and touch the posterior tip lightly to tragus [t]. Reverse for other side of face.
• sn-t, (mid face depth), measured on the right and left sides of the face using spreading calipers: place the anterior tip of the caliper at subnasale [sn] and touch the posterior tip to tragus [t]. Reverse for other side of face.

tr (trichion): the midpoint of the hairline.

v (vertex): the highest point on the head with the head in the Frankfort horizontal plane.

• v-gn (total craniofacial head height), measured in the midline using a double sliding caliper and a level.
• v-po (auricular head height) measured on the right and left sides of the head using a double sliding caliper and a level.
• v-n (anterior head height), measured in the midline using a double sliding caliper and a level.

zy (zygion): the most lateral point on the zygomatic arch.

• zy-zy (maximum facial breadth), measured by spreading caliper: by palpation locate the most lateral point of the zygomatic arch with the tips of index fingers and place the caliper tips on the arches with enough pressure to feel the bone. Move the caliper back and forth, up and down until scale shows maximum reading.

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