Zhang, Kevin R.; Chon, Brian H.; Hwang, Catherine J.; Jellema, Lyman M.; Perry, Julian D.
To compare bony orbital volumes in young skulls with those of older skulls to elucidate aging-associated changes of the orbit.
One hundred Caucasian male skulls from the Hamann-Todd collection of the Cleveland Museum of Natural History were studied. There were 50 young skulls (age range, 19–33 years) and 50 senescent skulls (age range, 79–96 years). Volcanic sand was used to fill each orbit in an identical fashion and weighed as a proxy for volume. Digital calipers were used to perform linear measurements of the orbit. The relationship between orbit measures and skull size was assessed using Pearson’s correlations and 95% CI, and statistical models to compare age groups adjusted for skull size.
The volume of the orbits (P < 0.001), the horizontal diameter of the orbit (P = 0.015), and the orbital depth (P < 0.001) were significantly larger in the senescent group of skulls after adjusting for skull surface area. No significant differences were found in the vertical diameters of the orbit between the 2 groups. Skull size did not statistically differ between the age groups.
Increases in the depth and horizontal dimensions of the orbit lead to increasing bony orbital volume with increasing age. These changes in size and shape of the orbit with age may contribute to phenotypic changes of aging and may affect disease processes and management.
Min Ji Kim, Min Jin Lee, Woo Shik Jeong, Helen Hong, Jong Woo Choi
Although some data for western norms in orbit shape were reported, the standard norms for Asian orbits were not established yet. The data would be very valuable for the various surgical procedures as well as the production of the appropriate instruments and implants. Therefore, we suggest a Korean orbit mean shape model based on the three-dimensional computer modeling, which includes the analysis of the various parameters with the calculated average value, thereby providing a standard mean shape orbital model that could be used for the Asian patients’ orbital surgeries. This paper would be the first literature that provides the standard orbit model for Asians.
We developed orbit-specific computer software (AMC-SWUⓇ) for the production of an orbit mean shape model. The production steps included semi-automatic segmentation, shape reconstruction, statistical shape model generation, and mean shape and variance model production. The study included records of 48 male and 48 female patients who met the inclusion criteria. Three-dimensional facial bone computed tomography (CT) images of 96 patients were obtained, and these images were used to produce a representative mean shape model.
The mean models had vertical dimensions of 36.93 and 35.11 mm, horizontal dimensions of 38.49 and 36.79 mm, and rim dimensions of 45.76 and 42.90 mm for males and females, respectively. We developed a realistic, visualized three-dimensional Korean orbit mean shape model and compared its parameters with calculated values. There is a variance in orbital dimensions between the sexes and the orbital changes with age. We also demonstrated orbital anatomic differences between ethnic groups.
Shoaib Ugradar, Robert Goldberg & Daniel Rootman
Purpose: To characterise variations in the location of the optic canal and its entry into the orbit in relation to the sphenoid sinus.
Methods: In this observational study, patients with high-resolution computed tomography (CT) scans seen by 2 specialists (RG and DR) over a period of 12 years were reviewed for study entry. The primary outcome measure was characterisation of the optic canal route in relation to the sphenoid sinus and the location of its opening within the orbit. Three-dimensional reconstructions of the bony orbits were created using the Mimics imaging software. Optic canals were classified according to the location of their entry into the orbit. Type 1 was defined as a canalicular course along the lateral wall of the sphenoid sinus and entry into the orbit through the medial wall. Type 2 was defined as a canalicular course in the superior wall of the sphenoid sinus with entry into the orbit through the roof. The angle of entry of each nerve into the orbit was calculated.
Results: One-hundred patients (52 females and 48 males) contributed 100 orbits to the study. Type 1 configuration was noted in 90 orbits, whereas Type 2 was noted in 10 orbits. The mean angle (SD) of entry of Type 1 optic nerves into the orbit was 61° (10.7), whereas the angle of entry of Type 2 nerves was 32.35° (6.8). The difference was significant (p < 0.01).
Conclusions: This study demonstrates variability of the path and outlet of the optic canal and presents a relatively common (10%) configuration in which the optic canal travels in the roof of the sphenoid sinus rather than the expected position in the lateral wall.
De Biasio, Fabrizio; Miotti, Giovanni; Zingaretti, Nicola; Castriotta, Luigi; Parodi, Pier Camillo
Purpose: Several anatomical and physio-pathologic studies of eyelid region have allowed the creation of theories on facial tissues aging dynamics, which have not been clarified yet. We assessed the signs of aging in the region over the time by observing the characteristics in the same person at different times of his/her life.
Methods: We compared the position of the main anatomical landmarks of the eyelid region of 80 patients by overlaying their photographs when they were 20, 40, and 60 years old. Then we made comparisons in the group of men (40 people) and in the group of women (40 people) and between men and women.
Results: The medial portion of the eyebrow was higher in the photograph taken at 60 years of age than in the one taken at 20 years old in 56.2% of cases; it was higher in 47.5% of cases when comparing the images at 20 and 40. The lateral portion of the eyebrow was seen higher in women in the 20 to 40 group, and it was seen lower in men at 60 years in statistical significance. In more than half of the patients observed, there was not a real descent of the eyebrow and the presence of a more or less accentuated form of upper eyelid’s ptosis in the photograph at 60 (globally 47.5%, 55.0% of women and 40.0% of men). This condition was observed in 27.5% of the photographs at 40. There were changes in the horizontal dimension of the palpebral fissure (shortening in 53.7%, preserved in 33.7%, and increased in 12.5% of cases at 60 years old). The position of lateral canthus appeared lower in 40.0% of patients photographed at 60, but it was stable in those photographed at 40. The herniation of the upper eyelid bags was observed in 31.2% of the patients photographed at 60 years old but only in 13.7% at 40. Dermatochalasis of the upper eyelid was present in 67.5% of the people at 60 years old and in 55.0% of those seen when they were 40. Comparing men and women groups 20 to 40, dermatochalasis is more present in men than women at 40 years old with statistical significance. The eyelid-cheek junction was seen to be lower in 75.0% of cases at 60 and in 48.7% of cases at 40, and it is more represented in men than in women.
Conclusion: We have highlighted some interesting elements, partly agreeing with the data already recorded by other authors’, and our data suggest an important role of the eyelid structures senescence and its impact on the surrounding structures.
Cai, Xianxian; Chen, Ying; Li, Qian; Ma, Huan; Tang, Zhixin; Nie, Cong; Lu, Rong Less
Purpose: The periocular features vary in different age groups and ethnic populations. In this study, the authors sought to determine whether age-related differences exist for certain periocular parameters between children and young adults of Chinese Han population.
Methods: OU of 310 children (aged 7–10 years) and 301 young adults (aged 20–30 years) were evaluated by 2-dimensional photogrammetry. All the subjects were of Chinese Han population. The eyelid crease profiles were classified according to their morphology. Periocular measurements, including 11 linear and 3 angular parameters were acquired from standardized photographs, 3 indices were further derived. The presence of epicanthal fold was also recorded. Each of the parameters was compared between the age groups.
Results: A statistical difference was found between the 2 age groups for the distribution of eyelid crease types. Statistical significances existed between the age groups for various parameters, these include palpebral fissure height and width, margin reflex distance, intercanthal and outercanthal width, distance from the medial end of the eyebrow to the medial canthus, distance from the lateral end of the brow to the lateral canthus, crease height and eyebrow height, angle of endocanthion and exocanthion, palpebral fissure inclination, palpebrae fissure index, canthal index, and angular index (p < 0.05). The incidence of epicanthal fold tended to decrease with increase of age.
Conclusions: Age differences exist in periocular features between children and young adults of Chinese Han population. Standards of periocular measurements based on age and race could provide reliable guidelines for clinical examination and planning periocular surgery.
Zhao, Yue; Chundury, Rao V.; Blandford, Alexander D.; Perry, Julian D.
The zygomaticofacial/temporal/orbital nerve is a terminal branch of the zygomatic nerve and exits the orbit through zygomatic foramina. The nomenclature in the literature varies with some studies identifying all 3 foramina on the malar surface of the zygoma, while others describe each along different aspects of the zygoma. In this study, foramen on the malar surface of the zygoma is termed zygomatic foramen, and the authors describe anatomical variations in the position and number of these foramina in an African American population.
Sixty-two African American skulls from the Hamann-Todd collection of the Cleveland Museum of Natural History were studied. The primary outcome was the number of zygomatic foramina on the malar surface of the zygomatic bone. Secondary outcomes included the location of foramina relative to the orbital rim and the frontozygomatic suture. Mean and standard deviation were used to describe measurements. Chi-squared and Wilcoxon signed rank tests were used to analyze measurements between left and right hemicrania.
The average number of foramina was 1.98 ± 0.93. More foramina were found on the right (2.13 ± 0.98) when compared with the left (1.68 ± 0.79; p = 0.001). The average distance between the lateral-most and medial-most foramina was 9.7 ± 5.0 mm. The distance from the orbital rim to the lateral foramen was 8.4 ± 4.2 mm, and distance from the orbital rim to the medial foramen was 7.7 ± 2.1 mm. The frontozygomatic suture was 22.9 ± 3.9 mm from the lateral foramen and 27.9 ± 3.6 mm from the medial foramen.
The locations of the foramina in relation to the frontozygomatic suture and orbital rim were consistent with other populations. However, in this African American population, more zygomatic foramina were noted compared with previously published results in Korean, Indian, Brazilian, and West Anatolian populations. Surgeons should be cognizant of zygomatic foramina in this population to reduce potential neurovascular complications.
Marì Regoli & Eugenio Bertelli
Orbits are connected with the middle cranial fossa via the optic canal, the superior orbital fissure, the M-type orbitomeningeal foramen, the metoptic canal, an accessory anterior opening of the foramen rotundum, and Warwick’s canal. They are also in communication with the anterior cranial fossa via the ethmoidal canals and the A-type orbitomeningeal foramen. The anatomy of these conduits has been recently enriched with several details that are summarized and reviewed in this article.