{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:26:57Z","timestamp":1777523217661,"version":"3.51.4"},"reference-count":52,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T00:00:00Z","timestamp":1591142400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction and Objectives:<\/jats:title>\n                    <jats:p>Surgical treatment for trigonocephaly aims to eliminate a stigmatizing deformity, yet the severity that captures unwanted attention is unknown. Surgeons intervene at different points of severity, eliciting controversy. This study used eye tracking to investigate when deformity is perceived.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>Three-dimensional photogrammetric images of a normal child and a child with trigonocephaly were mathematically deformed, in 10% increments, to create a spectrum of 11 images. These images were shown to participants using an eye tracker. Participants\u2019 gaze patterns were analyzed, and participants were asked if each image looked \u201cnormal\u201d or \u201cabnormal.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Sixty-six graduate students were recruited. Average dwell time toward pathologic areas of interest (AOIs) increased proportionally, from 0.77 \u00b1 0.33 seconds at 0% deformity to 1.08 \u00b1 0.75 seconds at 100% deformity ( P &lt; .0001). A majority of participants did not agree an image looked \u201cabnormal\u201d until 90% deformity from any angle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Eye tracking can be used as a proxy for attention threshold toward orbitofrontal deformity. The amount of attention toward orbitofrontal AOIs increased proportionally with severity. Participants did not generally agree there was \u201cabnormality\u201d until deformity was severe. This study supports the assertion that surgical intervention may be best reserved for more severe deformity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665620926014","type":"journal-article","created":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T05:38:06Z","timestamp":1591162686000},"page":"1392-1401","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["The Use of Eye Tracking to Discern the Threshold at Which Metopic Orbitofrontal Deformity Attracts Attention"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0124-3592","authenticated-orcid":false,"given":"Mark P.","family":"Pressler","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, UT Southwestern, Dallas, TX, USA"},{"name":"Analytical Imaging and Modeling Center, Children\u2019s Medical Center, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6359-397X","authenticated-orcid":false,"given":"Emily L.","family":"Geisler","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, UT Southwestern, Dallas, TX, USA"},{"name":"Analytical Imaging and Modeling Center, Children\u2019s Medical Center, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9025-399X","authenticated-orcid":false,"given":"Rami R.","family":"Hallac","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, UT Southwestern, Dallas, TX, USA"},{"name":"Analytical Imaging and Modeling Center, Children\u2019s Medical Center, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"Seaward","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, UT Southwestern, Dallas, TX, USA"},{"name":"Analytical Imaging and Modeling Center, Children\u2019s Medical Center, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex A.","family":"Kane","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, UT Southwestern, Dallas, TX, USA"},{"name":"Analytical Imaging and Modeling Center, Children\u2019s Medical Center, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,6,3]]},"reference":[{"key":"bibr2-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e318272dacb"},{"key":"bibr3-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.4863-09.2010"},{"key":"bibr4-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002052"},{"key":"bibr5-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004065"},{"key":"bibr6-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31825dc244"},{"key":"bibr7-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-04747-4_23"},{"key":"bibr8-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000001940"},{"key":"bibr9-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31826683d1"},{"key":"bibr10-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2018.12.024"},{"key":"bibr11-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-24756-7"},{"key":"bibr12-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2016.06.019"},{"key":"bibr13-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1111\/ocr.12140"},{"issue":"3","key":"bibr14-1055665620926014","doi-asserted-by":"crossref","first-page":"e0134339","DOI":"10.1371\/journal.pone.0134339","volume":"107","author":"Dominguez-Martinez E","year":"2015","journal-title":"PLoS One"},{"key":"bibr15-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1068\/p080431"},{"key":"bibr16-1055665620926014","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181f6c5a7"},{"key":"bibr17-1055665620926014","unstructured":"Gerety PA, Taylor JA, Bartlett SP. 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