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The significance of excess soft tissue nasal asymmetry in at\u2010risk relatives is unclear and was examined in the present study. Our sample included 164 unaffected parents from families with a history of orofacial clefting and 243 adult controls. Geometric morphometric methods were used to analyze the coordinates of 15 nasal landmarks collected from three\u2010dimensional facial surface images. Following generalized Procrustes analysis, Procrustes ANOVA and MANOVA tests were applied to determine the type and magnitude of nasal asymmetry present in each group. Group differences in mean nasal asymmetry were also assessed via permutation testing. We found that nasal asymmetry in both parents and controls was directional in nature, although the magnitude of the asymmetry was greater in parents. This was confirmed with permutation testing, where the mean nasal asymmetry was significantly different (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) between parents and controls. The asymmetry was greatest for midline structures and the nostrils. When subsets of parents were subsequently analyzed and compared (parents with bilateral vs. unilateral offspring; parents with left vs. right unilateral offspring), each group showed a similar pattern of asymmetry and could not be distinguished statistically. Thus, the side of the unilateral cleft (right vs. left) in offspring was not associated with the direction of the nasal asymmetry in parents.<\/jats:p>","DOI":"10.1002\/ajmg.a.38688","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T01:11:36Z","timestamp":1523927496000},"page":"1296-1303","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Soft tissue nasal asymmetry as an indicator of orofacial cleft predisposition"],"prefix":"10.1002","volume":"176","author":[{"given":"Charles","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Anthropology University of Pittsburgh Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven F.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Anatomy Midwestern University Downers Grove Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmien","family":"Roosenboom","sequence":"additional","affiliation":[{"name":"Center for Craniofacial and Dental Genetics, Department of Oral Biology University of Pittsburgh Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George L.","family":"Wehby","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy University of Iowa Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina M.","family":"Moreno Uribe","sequence":"additional","affiliation":[{"name":"Department of Orthodontics University of Iowa Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline T.","family":"Hecht","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Texas McGovern Medical Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic W. 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