Division of Oculoplastic and Reconstructive Surgery, Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Ophthalmic Plast Reconstr Surg. 2009 Sep-Oct;25(5):382-6. doi: 10.1097/IOP.0b013e3181b2f766.
The bony skeleton serves as the scaffolding for the soft tissues of the face; however, age-related changes of bony morphology are not well defined. This study sought to compare the anatomic relationships of the facial skeleton and soft tissue structures between young and old men and women.
A retrospective review of CT scans of 100 consecutive patients imaged at Duke University Medical Center between 2004 and 2007 was performed using the Vitrea software package. The study population included 25 younger women (aged 18-30 years), 25 younger men, 25 older women (aged 55-65 years), and 25 older men. Using a standardized reference line, the distances from the anterior corneal plane to the superior orbital rim, lateral orbital rim, lower eyelid fat pad, inferior orbital rim, anterior cheek mass, and pyriform aperture were measured. Three-dimensional bony reconstructions were used to record the angular measurements of 4 bony regions: glabellar, orbital, maxillary, and pyriform aperture.
The glabellar (p = 0.02), orbital (p = 0.0007), maxillary (p = 0.0001), and pyriform (p = 0.008) angles all decreased with age. The maxillary pyriform (p = 0.003) and infraorbital rim (p = 0.02) regressed with age. Anterior cheek mass became less prominent with age (p = 0.001), but the lower eyelid fat pad migrated anteriorly over time (p = 0.007).
The facial skeleton appears to remodel throughout adulthood. Relative to the globe, the facial skeleton appears to rotate such that the frontal bone moves anteriorly and inferiorly while the maxilla moves posteriorly and superiorly. This rotation causes bony angles to become more acute and likely has an effect on the position of overlying soft tissues. These changes appear to be more dramatic in women.
骨性骨架为面部软组织提供支撑；然而，与年龄相关的骨形态变化尚不清楚。本研究旨在比较年轻和老年男女的面部骨骼和软组织结构的解剖关系。
对 2004 年至 2007 年期间在杜克大学医学中心接受 CT 扫描的 100 例连续患者的 CT 扫描进行回顾性分析，使用 Vitrea 软件包进行分析。研究人群包括 25 名年轻女性（年龄 18-30 岁）、25 名年轻男性、25 名老年女性（年龄 55-65 岁）和 25 名老年男性。使用标准化参考线测量前角膜平面到眶上缘、眶外侧缘、下眼睑脂肪垫、眶下缘、前颊部和梨状孔的距离。使用三维骨重建记录额骨、眶骨、上颌骨和梨状孔 4 个骨区的角度测量值。
额骨（p=0.02）、眶骨（p=0.0007）、上颌骨（p=0.0001）和梨状孔（p=0.008）的角度均随年龄增长而减小。上颌骨梨状孔（p=0.003）和眶下嵴（p=0.02）随年龄增长而退缩。随着年龄的增长，前颊部变得不那么突出（p=0.001），但下眼睑脂肪垫向前迁移（p=0.007）。
面部骨骼在整个成年期似乎都在重塑。与眼球相比，面部骨骼似乎会旋转，使额骨向前和向下移动，而上颌骨向后和向上移动。这种旋转导致骨角度变得更加锐利，可能对面部软组织的位置产生影响。这些变化在女性中更为明显。
