浙江地区成年人骨性眶缘测量及其与衰老的关系
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摘要
目的考察颅面部骨性眶缘的参数(眶缘面积、上下眶缘对角线长度、内外眶缘对角线长度)在不同性别中的差异及其在面颅老化中的意义,为临床年轻化治疗提供思路和解剖学依据。方法采集114例不同年龄段的浙江籍成年人(青年男性22例、女性20例,中年男性23例、女性14例,老年男性18例、女性17例)颅面骨薄层CT扫描数据进行三维重建,将三维图像导出,采用Adobe Photoshop(2018版)软件测量上下眶缘对角线(L1)和内外眶缘对角线(L2)长度及骨性眶缘面积(S),对眶缘面积进行分区(S1、S2、S3、S4)测量和分析,对比不同性别和年龄组之间以上参数的差异。结果随年龄增大,男女性上下对角线长度有显著增加(P<0. 05),但不同性别L1长度发生显著增长的时间段不同,在中年组出现显著的性别差异;各个年龄组内男性的内外对角线长度均大于女性(P<0. 05),但L2不随年龄增长而变化(P>0. 05);男性的骨性眶缘总面积随年龄变化不明显,但眶缘平面分区面积S1、S2、S3随年龄增长而增大,S4反而缩小;女性骨性眶缘面积整体上随衰老而增大,增大的主要为眶下半部,即S3和S4区域。在中年期男性的骨性眶缘面积大于女性(P<0. 05)。结论浙江籍成年人的骨性眶缘面积随衰老而发生变化,男性与女性的变化模式具有不同特征。女性的骨性眶缘面积增大更明显,主要表现为眶下半部扩大。男性眶缘总面积虽然随老龄化无明显改变,但其区域面积和形态发生变化。
Objective To study the significance of parameters of bony orbit in different age groups of Chinese population in both genders,providing anatomical evidence and strategy for clinical rejuvenation. Methods The data were obtained from 114 adults from Zhejiang province who underwent computed tomographic examinations followed by 3 D reconstruction with volume rendering. They were divided into 3 groups: young, mid-age and old-age groups. The measurements of orbital aperture area( S) that including four subareas( S1,S2,S3,S4),up-to-bottom diagonal( L1),and medium-to-lateral diagonal( L2) were obtained and calculated by Adobe Photoshop software. The comparison was made among age and gender groups. Results There was significant increasing of up-to-bottom diagonals( L1) with aging in both genders( P<0. 05),and a sexual difference appeared in mid-age group. The medium-to-lateral diagonals( L2) for male subjects were longer than female in all age groups( P<0. 05). But L2 did not change with aging. The total orbital aperture area of male subjects had no obvious change,while the subarea S1,S2,and S3 significantly increased and S4 decreased with aging. The orbital aperture area of female subjects rose from young to old-age group and the most augmented parts were S3 and S4. There was significant difference between male and female subjects in mid-age group. Conclusion The bony orbital aperture area changed with aging,but the changing pattern varied in male and female subjects. The study and analysis of the morphological change of the orbital aperture is significant to our clinical treatment in cosmetic rejuvenation.
Objective To study the significance of parameters of bony orbit in different age groups of Chinese population in both genders,providing anatomical evidence and strategy for clinical rejuvenation. Methods The data were obtained from 114 adults from Zhejiang province who underwent computed tomographic examinations followed by 3 D reconstruction with volume rendering. They were divided into 3 groups: young, mid-age and old-age groups. The measurements of orbital aperture area( S) that including four subareas( S1,S2,S3,S4),up-to-bottom diagonal( L1),and medium-to-lateral diagonal( L2) were obtained and calculated by Adobe Photoshop software. The comparison was made among age and gender groups. Results There was significant increasing of up-to-bottom diagonals( L1) with aging in both genders( P<0. 05),and a sexual difference appeared in mid-age group. The medium-to-lateral diagonals( L2) for male subjects were longer than female in all age groups( P<0. 05). But L2 did not change with aging. The total orbital aperture area of male subjects had no obvious change,while the subarea S1,S2,and S3 significantly increased and S4 decreased with aging. The orbital aperture area of female subjects rose from young to old-age group and the most augmented parts were S3 and S4. There was significant difference between male and female subjects in mid-age group. Conclusion The bony orbital aperture area changed with aging,but the changing pattern varied in male and female subjects. The study and analysis of the morphological change of the orbital aperture is significant to our clinical treatment in cosmetic rejuvenation.
引文
[1]Kahn DM,Shaw RB Jr.Aging of the bony orbit:a threedimensional computed tomographic study[J].Aesth Surg J,2008,28(3):258-264.
[2]Zhao Y,Wu SF.The aging of facial skeleton[J].Chinese Journal of Plastic Surgery,2015,31(6):483-487.(in Chinese)赵烨,吴溯帆.面部骨骼的衰老[J].中华整形外科杂志,2015,31(6):483-487.
[3]Furuta M.Measurement of orbital volume by computed tomography especially on the growth of the orbit[J].Jpn J Ophthalmol,2001,45(6):600-606.
[4]Pessa JE,Desvigne LD,Lambros VS,et al.Changes in ocular globe-to-orbital rim position with age implications for aesthetic blepharoplasty of the lower eyelids[J].Aesth Plast Surg,1999,23(5):337-342.
[5]Zhao Y,Yan Sh,Liang LG,et al.Measurement of the aging changes of facial bone in Chinese[J].Chinese Journal of Aesthetic and Plastic Surgery,2015,26(10):582-585.(in Chinese)赵烨,严晟,梁灵刚,等.中国人面部骨骼老龄化的测量[J].中国美容整形外科杂志,2015,26(10):582-585.
[6]Levine RA,Garza JR,Wang PT,et al.Adult facial growth:applications to aesthetic surgery[J].Aesthetic Plast Surg,2003,27(4):265-268.
[7]Pessa JE.An algorithm of facial aging verification of lambros’s theory by three-dimensional stereolithography,with reference to the pathogenesis of midfacial aging,scleral show,and the lateral suborbital trough deformity[J].Plast Reconstr Surg,2000,106(2):479-488.
[8]Pessa JE,Slice DE,Hanz KR,et al.Aging and the shape of the mandible[J].Plast Reconstr Surg,2008,121(1):196-200.
[9]IlankovanⅤ.Anatomy of ageing face[J].Br J Oral Maxillofac Surg,2014,52(3):195-202.
[10]Pecora NG,Baccetti T,Mc Namara JA Jr.The aging craniofacial complex:a longitudinal cephalometric study from late adolescence to late adulthood[J].Am J Orthod Dentofacial Orthop,2008,134(4):496-505.
[11]FerringⅤ,Pancherz H.Divine proportions in the growing face[J].Am J Orthod Dentofacial Orthop,2008,134(4):472-479.
[12]Fitzgerald R,Graivier MH,Kane M,et al.Update on facial aging[J].Aesth Surg J,2010,30(Suppl 1):11S-24S.
[13]Nanda SK.Differential growth of the female face in the anteroposterior dimension[J].Angle Orthod,1992,62(1):23-34.
[14]Mendelson BC,Wong CH.Changes in the facial skeleton with aging implications and clinical applications in facialrejuvenation[J].Aesth Plast Surg,2012,36(4):753-760.
[15]Wei X,Yang NZ,Wang ZhJ,et al.Morphological basis of aging of the bony orbit[J].Chinese Journal of Aesthetic and Plastic Surgery,2016,27(9):566-571.(in Chinese)韦昕,杨柠泽,王志军,等.骨眶老化的形态学基础研究[J].中国美容整形外科杂志,2016,27(9):566-571.
[16]David M.Kahn,Robert B.Shaw.Aging of the bony orbit:A threedimensional computed tomographic study[J].Aesthet Surg J,2008,28(3):258-264.
[17]Matros E,Garcia JA,Yaremchuk MJ.Changes in eyebrow position and shape with aging[J].Plast Reconstr Surg,2009,124(4):1296-1301.
[2]Zhao Y,Wu SF.The aging of facial skeleton[J].Chinese Journal of Plastic Surgery,2015,31(6):483-487.(in Chinese)赵烨,吴溯帆.面部骨骼的衰老[J].中华整形外科杂志,2015,31(6):483-487.
[3]Furuta M.Measurement of orbital volume by computed tomography especially on the growth of the orbit[J].Jpn J Ophthalmol,2001,45(6):600-606.
[4]Pessa JE,Desvigne LD,Lambros VS,et al.Changes in ocular globe-to-orbital rim position with age implications for aesthetic blepharoplasty of the lower eyelids[J].Aesth Plast Surg,1999,23(5):337-342.
[5]Zhao Y,Yan Sh,Liang LG,et al.Measurement of the aging changes of facial bone in Chinese[J].Chinese Journal of Aesthetic and Plastic Surgery,2015,26(10):582-585.(in Chinese)赵烨,严晟,梁灵刚,等.中国人面部骨骼老龄化的测量[J].中国美容整形外科杂志,2015,26(10):582-585.
[6]Levine RA,Garza JR,Wang PT,et al.Adult facial growth:applications to aesthetic surgery[J].Aesthetic Plast Surg,2003,27(4):265-268.
[7]Pessa JE.An algorithm of facial aging verification of lambros’s theory by three-dimensional stereolithography,with reference to the pathogenesis of midfacial aging,scleral show,and the lateral suborbital trough deformity[J].Plast Reconstr Surg,2000,106(2):479-488.
[8]Pessa JE,Slice DE,Hanz KR,et al.Aging and the shape of the mandible[J].Plast Reconstr Surg,2008,121(1):196-200.
[9]IlankovanⅤ.Anatomy of ageing face[J].Br J Oral Maxillofac Surg,2014,52(3):195-202.
[10]Pecora NG,Baccetti T,Mc Namara JA Jr.The aging craniofacial complex:a longitudinal cephalometric study from late adolescence to late adulthood[J].Am J Orthod Dentofacial Orthop,2008,134(4):496-505.
[11]FerringⅤ,Pancherz H.Divine proportions in the growing face[J].Am J Orthod Dentofacial Orthop,2008,134(4):472-479.
[12]Fitzgerald R,Graivier MH,Kane M,et al.Update on facial aging[J].Aesth Surg J,2010,30(Suppl 1):11S-24S.
[13]Nanda SK.Differential growth of the female face in the anteroposterior dimension[J].Angle Orthod,1992,62(1):23-34.
[14]Mendelson BC,Wong CH.Changes in the facial skeleton with aging implications and clinical applications in facialrejuvenation[J].Aesth Plast Surg,2012,36(4):753-760.
[15]Wei X,Yang NZ,Wang ZhJ,et al.Morphological basis of aging of the bony orbit[J].Chinese Journal of Aesthetic and Plastic Surgery,2016,27(9):566-571.(in Chinese)韦昕,杨柠泽,王志军,等.骨眶老化的形态学基础研究[J].中国美容整形外科杂志,2016,27(9):566-571.
[16]David M.Kahn,Robert B.Shaw.Aging of the bony orbit:A threedimensional computed tomographic study[J].Aesthet Surg J,2008,28(3):258-264.
[17]Matros E,Garcia JA,Yaremchuk MJ.Changes in eyebrow position and shape with aging[J].Plast Reconstr Surg,2009,124(4):1296-1301.