Photographic Facial Soft Tissue Analysis of Healthy Turkish Young Adults: Anthropometric Measurements

Background  The purpose of this study was to establish facial soft tissue norms for Turkish young adults. Methods  Anthropometric measurements of the facial soft tissue were taken from 281 female and 149 male Turkish adults aged between 18 and 24 years. The soft tissue facial profiles were digitally analyzed using linear (17 vertical and 10 horizontal) measurements made with standardized photographic records, taken in a natural head position, to determine the average soft tissue facial profile for males and females. Results  A statistically significant difference was found between males and females in 20 of 27 measurements taken (p < 0.001). The most prominent differences between the sexes were observed in the measurements taken from the face region. Results were compared with other ethnic groups.     

Comparison of craniofacial measurements of young adult African-American and North American white males and females

Surgical correction of craniofacial disfigurements depends for its success on precise knowledge of the craniofacial norms of the patient's racial/ethnic groups. The norms of North American whites should be restricted to patients of Caucasian origin and not applied to members of other races. This study therefore sought to determine differences in anthropometric measurements of the craniofacial complex between African-American and North American white subjects of both sexes and of similar age (18-25 years old). The study group consisted of healthy young adult African-Americans, 50 males and 50 females. The analysis of craniofacial morphology was based on 51 anthropometric measurements: 9 cranial, 10 facial, 8 orbital, 14 nasal, 4 oral and 6 auricular. The results were compared with 51 norms previously established for North American whites in the same age group, generally based on 109 males and 200 females, fewer in comparisons of some nasal measurements (ac-ac, sbal-sbal, ac-sn, nostril axis). Highly significant differences between groups were found in every craniofacial region, especially in the orbital and nasal areas, and confirmed the need to establish separate norms for African-Americans to guide corrective surgery of the head and face.     

三维摄影测量技术评估青年人群面部不对称性

目的评估中国青年人群的面部不对称性。方法 2017年5至12月在北京地区公开招募青年受试者。使用VECTRA H1三维立体照相机为所有受试者拍摄面部三维照片。将照片导入Geomagic Wrap 2017中,标记软组织标志点并建立坐标系,通过外眦点的水平面和过口角点的水平面将面部分为上、中、下3个部分。冠状面上,通过坐标计算双侧标志点到正中矢状面的距离以及睑裂高;面深度方面,通过坐标计算面深度指标,共13个测量指标。以配对t检验比较双侧测量值是否存在统计学差异,并计算双侧绝对差值和非对称率。最后对男性和女性的测量结果进行比较,P<0.05为差异有统计学意义。结果共招募到122名青年受试者,其中男性60名,年龄(25.1±3.8)岁,女性62名,年龄(27.3±4.3)岁。(1)冠状面上,男性双侧耳屏点和口角点到正中矢状面距离比较,差异有统计学意义(P<0.05);女性双侧外眦点、上睑顶点以及耳屏点到正中矢状面距离比较,差异均有统计学意义(P<0.05)。双侧标志点中(除外睑裂高),双侧外眦点到正中矢状面的距离绝对差值最小,在男性和女性中分别为(1.00±0.88) mm和(1.08±0.79) mm(t=0.541,P=0.589),非对称率仅为2.1%和2.4%;双侧耳屏点到正中矢状面距离的绝对差值最大,在男性和女性中分别达到(3.45±2.54) mm和(2.89±2.86) mm(t=-1.149,P=0.253),非对称率为4.6%和4.1%。(2)面深度方面,所有受试者双侧面深度指标比较,差异均有统计学意义(P<0.05)。双侧耳屏点到颏前点距离绝对差值最大,在男性和女性中分别达到(2.62±1.69) mm和(2.45±1.69) mm(t=-0.491,P=0.625),非对称率均为1.8%;双侧耳屏点到眉间点距离绝对差值最小,在男性和女性中分别为(1.77±1.25) mm和(1.91±1.54) mm(t=0.587,P=0.558),非对称率为1.4%和1.6%。结论中国青年人群中普遍存在一定的面部不对称性,双侧绝对差值一般不超过3.5 mm,上1/3面部的对称性较高,下1/3面部对称性较低。     

Proportionality in Asian and North American Caucasian Faces Using Neoclassical Facial Canons as Criteria

Nine projective linear measurements were taken to determine morphometric differences of the face among healthy young adult Chinese, Vietnamese, and Thais (60 in each group) and to assess the validity of six neoclassical facial canons in these populations. In addition, the findings in the Asian ethnic groups were compared to the data of 60 North American Caucasians. The canons served as criteria for determining the differences between the Asians and Caucasians. In neither Asian nor Caucasian subjects were the three sections of the facial profile equal. The validity of the five other facial canons was more frequent in Caucasians (range: 16.7–36.7%) than in Asians (range: 1.7–26.7%). Horizontal measurement results were significantly greater in the faces of the Asians (en–en, al–al, zy–zy) than in their white counterparts; as a result, the variation between the classical proportions and the actual measurements was significantly higher among Asians (range: 90–100%) than Caucasians (range: 13.3–48%). The dominant characteristics of the Asian face were a wider intercanthal distance in relation to a shorter palpebral fissure, a much wider soft nose within wide facial contours, a smaller mouth width, and a lower face smaller than the forehead height. In the absence of valid anthropometric norms of craniofacial measurements and proportion indices, our results, based on quantitative analysis of the main vertical and horizontal measurements of the face, offers surgeons guidance in judging the faces of Asian patients in preparation for corrective surgery.     

Anthropometric proportion indices in the craniofacial regions of 73 patients with forms of isolated coronal synostosis

The study group consisted of 73 North American patients (29 males and 44 females), aged between 0-5 months and 20 years, 26 with right, 33 with left, and 14 with bicoronal synostosis. Basic proportion indices were established in 5 craniofacial regions (cranial, facial, orbital, nasal, oral) calculated from 2 projective measurements [cranial: eu-eu, g-op; facial: n-gn, zy-zy; orbital: en-en, ex-ex; nasal: al-al, n-sn; oral: sn-sto, ch-ch (eu, eurion; g, glabella; op, opisthocranion; n, nasion; gn, gnathion; zy, zygion; en, endocanthion; ex, exocanthion; al, alare; sn, subnasale; sto, stomion; ch, chelion)] taken from the patients by the first author before surgery. These data were then compared with the anthropometric norms established for North American whites (Farkas LG. Anthropometry of the Head and Face. 2nd ed. Raven Press; 1994). In males, the total percentage of normal, subnormal, and supernormal proportion indices was smaller than in females in all 3 groups of patients. Generally, the difference in percentage between normal proportions was the smallest (13.1%) and the supernormal one the greatest (68%). In males, the oral measurements showed the highest frequency of normal proportions (100%) in all 3 patient groups, and the cephalic index the lowest (60%-66.7%). Among the abnormal proportions, the supernormal ones were found more often, especially in the cranial region of females with bilateral coronal synostosis (66.7%). Subnormal proportion indices were rare: none were seen in the facial region of males. A subnormal cephalic index (eu-eu/g-op) was not present in either sex in right and bicoronal synostosis and was observed in only 2 males with left coronal synostosis (13.3%). The study showed that the influence of synostosis gradually decreased from the top to the bottom of the face, with the oral region showing no abnormalities.     

面部对称性的量化研究和临床应用

目的探索面部器官的对称性和形态学特征,为面部的修复重建、美容整形手术提供依据。方法随机选择50例正常青年女性,采用计算机辅助的照片测量法,测量面部的对称距离及角度,观察测量数据的差异和变化。然后选出10例,用计算机制作其侧面部合成图,并和原图进行评分比较。两次实验均用SAS软件进行统计分析。结果内外眦连线和水平线的夹角、眉头眉峰连线和水平线的夹角、鼻翼点到口角点间距、口角点到下颌角点间距,以及下颌角点到软组织颏下点间距,在左右两侧面部的测量值有统计学差异。左右两侧面部合成图的评分分值明显小于被测者原先照片的评分值。结论中下面部组织的不对称性较为明显。面部的绝对对称是不存在的。对称性的概念不能独立而单一地应用于人体美学中。面部对称形态特征的标准化研究和范围界定还有待进一步的探索。     

Differences in Horizontal,Neoclassical Facial Canons in Chinese (Han) and North American Caucasian Populations

To better our ability to analyze the facial disproportions of patients of Chinese ancestry, we compared the validity of four neoclassical canons of facial proportion in Chinese and North American Caucasians populations. We tested the frequency of four horizontal facial canons and their eight variations in 206 healthy adults (105 males and 101 females, 18–25 years old) belonging to the predominant ethnic group (Han: 400 million) of the Chinese population, and compared them to those of 103 healthy young North American Caucasian adults. The nose width corresponded to one-quarter of the face width (the nasofacial canon) significantly more frequently in Chinese participants (51.5%) than in Caucasian adults (36.9%). The nose was narrower than one-quarter of the face width in 38.8% of North American Caucasians and in 21.8% of Chinese; this difference was also statistically significant. In defiance of the naso-oral canon, the mouths of Chinese people were significantly more often narrower than 1.5 times the nose width (71.8%), while in North American Caucasian ethnics the mouth was significantly more frequently wider (60.2%).     

西安地区骨性II类面型青年颅面部三维测量值研究

目的:对西安地区汉族骨性II类面型青年进行颅面部软组织的三维测量,将该年龄组的骨性II类面型颅面部各器官之间的三维测量值进行研究,为临床诊断和制定治疗计划提供参考依据。方法:采用Farkas的颅面部软组织表面测量方法,对西安地区面部形态为凸面型的60名汉族青年进行54项测量,将测量结果与司新芹用同法测量的正常面型青年面部软组织三维测量值进行对比。结果:通过抽样调查发现,西安地区西安籍骨性II类面型青年相对正常面型青年在三维方向的特点是:上颌相对下颌前突,颏下点相对后缩(中面1/3弧>t-gn-t下面1/3弧,P<0.01);面下1/3较窄(下颌宽:骨性II类面型<正常面型,P<0.01)。结论:西安地区西安籍骨性II类面型青年相对正常面型青年面部软组织在三维方向上存在较大的差异。     

Effects of the subcranial approach on facial growth and development.

OBJECTIVE: To analyze the long-term effects of subcranial surgery for anterior skull base tumors on facial growth. STUDY DESIGN AND SETTING: Retrospective study (1994 to 2004) in a university-affiliated hospital. Of 108 patients who underwent a subcranial surgical approach for anterior skull base tumors, six adolescents and five young adults fulfilled study entry criteria for age and follow-up data availability (mean, 3.2 +/- 2 years). Cephalometric x-ray films monitored postoperative facial growth. Anteriorly and posteriorly measured horizontal and vertical maxillary growth were compared with normal values. RESULTS: All subjects had superiorly positioned maxillae (shorter in patients with long-standing pathologies). The upper incisor teeth were proclined relative to the cranial base reference planes. All cephalometric changes were within a 10 percent deviation of normal values. CONCLUSIONS: Subcranial surgery for these tumors minimally affects vertical facial skeleton growth. Early surgery is essential for unaffected horizontal growth. SIGNIFICANCE: Guidelines for anterior skull base tumor surgery in adolescents and young adults.     

腭骨外侧缝牵张成骨关闭硬腭裂的长期效果和对颌面发育 …

目的 了解腭骨外侧缝牵张的长期效果和对颌面发育的影响。方法 采用头颅测量方法对经过腭骨外侧缝牵张的６只和正常对照８只Ｂｅａｇｌｅ犬进行观察和分析。结果 所有实验组犬两侧腭骨水平板均在中线形成骨性愈合。两组动物面长度和高度变量无明显差异，实验组面宽度，腭骨水平板宽度和垂反间距均小于对照组，差异具有显著性意义。结论 采用腭骨外侧缝牵张成骨的方法，能够使缺裂的腭骨板形成永久而完善的骨性修复；对在长度和高     

年轻成人安氏I类错牙合亚型的X线头影测量分析

目的:分析年轻成人安氏Ⅰ类错牙合亚型特征.方法:选取101例安氏Ⅰ类错牙合年轻成年患者,拍摄颅颌定位X线片.用头影测量"优选法"的17项测量指标,按水平方向和垂直方向进行聚类分析,并与正常人群进行比较.结果:测量指标按水平方向可聚类为3个亚类,即水平Ⅰ类、Ⅱ类和Ⅲ类,所占比例分别为17.8%、12.9%和65.3%.水平Ⅰ类特征:上颌略偏缩、下颌后缩,Ⅱ类错牙合趋势,上下中切牙唇倾;水平Ⅱ类特征:上颌前凸、下颌后缩,上下中切牙舌倾,上下唇相对于上下切牙突度大;水平Ⅲ类特征:上颌前凸、下颌后缩,上下中切牙唇倾,上下唇相对于上下切牙突度大.按垂直方向聚为Ⅰ类,特征是垂直方向发育不足,尤其是面下1/3为著,下颌呈后旋趋势,上下唇突.结论:年轻成人安氏I类错牙合水平方向分为3个亚类、垂直方向为Ⅰ类.总体趋势是下颌后缩、面下1/3发育不足,但上颌骨、上下前牙和唇位等方面仍有一定的差异,临床应针对性诊治.     

Dental and skeletal changes during pressure garment use in facial burns: a systematic review

OBJECTIVE: Concern exists regarding the combined effect of the burn itself in addition to the continuous use of the pressure garments on craniofacial structures. The purpose of this systematic review was to evaluate the available evidence regarding dental and skeletal changes produced during pressure garment use in facial burns. METHODS: Several electronic databases were screened for relevant articles and reference lists of pertinent articles were also hand-searched. RESULTS: Only a two-part study had the minimal set of criteria sought. They found that children with partial face burns had only a slightly reduced inferior growth of the mandible and an increase protrusion of anterior teeth, which stay unchanged even after discontinuation of the pressure garment. The group of children with total face burns showed changes in the direction of the growth of the mandible, from a normal anterior inferior direction to a more inferior direction, and in the maxillary horizontal growth. A trend of returning toward normality was found thereafter. CONCLUSIONS: There is scarcity of studies reporting dentomaxillofacial effects after pressure garment use in facial burns. The level of evidence presented in these articles does not give support to any strong conclusion regarding the craniofacial effects of facial burn management.     

乳突手术中面神经易损伤区的显微解剖

目的 研究有关乳突手术中的面神经易损伤区的显微解剖,为临床应用提供解剖学资料.方法 通过模拟临床乳突手术方法,解剖20个成人湿头颅标本(40侧颞骨),显露并观测易损伤区内的面神经水平段、垂直段、锥曲段及其毗邻结构.结果 面神经水平段的长度为(8.85±1.01)mm(7.10～11.25mm);直径为(1.88±0.65)mm(1.55～1.90mm);水平段与垂直段的夹角(向前)为(115.50±6.89°)(109.5°～128.6°);匙突到该段的垂直距离为(1.89±0.58)mm(0.90～3.05mm);镫骨足板中点到该段的垂直距离为(1.92±0.52)mm(1.44～2.56mm);镫骨头到该段的垂直距离为(2.30±0.85)mm(1.97～3.11 mm);水平段与鼓室天盖夹角(向后)为(28.5°±3.66°)(25.8°～31.5°);锥曲段的直径为(1.89±0.65)mm(1.56～1.88mm);锥曲段顶点到砧骨短脚尖的距离为(2.55±0.21)mm(2.10～2.90mm);到外半规管隆突的距离为(2.86±0.31)mm(2.23～3.56 mm);面神经垂直段近段的直径为(2.13±0.13)mm(1.90～2.40 mm);鼓索与面神经垂直段的夹角(向上)为(38.60±1.99°)(28.5°～52.5°);锥隆起尖到面神经垂直段的垂直距离为(2.05±0.65)mm(1.85～2.36 mm).结论 面神经易损伤区内的外半规管(水平半规管)隆突、砧骨短脚、匙突、鼓室天盖、镫骨、锥隆起、鼓索是乳突手术中的重要标志,其结构空间位置关系复杂,手术操作必须在熟悉显微解剖学知识的基础上进行.

Abstract：

Objective To study the microanatomy of the area in which the facial nerve being easy to damage in mastoid surgery, in order to provide microanatomical datas for the clinical works. Methods In 20 adult wet skull specimens (40 temporal bones), the segments of facial nerve and their adjacent structures in the area in which the facial nerve being easy to damage were observed according to operation of mastoid surgery. Results The length of the horizontal segment was (8.85 ± 1.01) mm (7.10-11.25 nun), the diameter was (1.88 ± 0.65) mm (1.55-1.90 mm); The angle opening towards anterior direction between horizontal segment and vertical segment was (115.50 ± 6.89°) (109.5°-128.6°); The vertical distance from the cochlearform process to this segment was (1.89 ± 0.58) mm (0.90-3.05 mm); The vertical distance from the midpoint of the base of stapes to this segment was (1.92 ± 0.52) mm (1.44-2.56 mm); The vertical distance from the head of the stapes to this segment was (2.30 ± 0.85) mm (1.97-3.11 mm); The angle towards posterior direction between horizontal segment of facial nerve and tympanic tegmen was (28.5°± 3.66°) (25.8°-31.5°); The diameter of the pyramidal segment of facial nerve was (1.89 ± 0.65) mm (1.56-1.88 mm); The distance between the su mmit of pyramidal segment of facial nerve and the apex of shor limb of incus was (2.55 ± 0.21) mm (2.10-2.90 mm); The distance from the su mmit to the eminence of the lateral semicircular canal was (2.86 ± 0.31) mm (2.23-3.56 mm); The diameter of the proximal part of vertical segment of facial nerve was (2.13 ± 0.13) mm (1.90-2.40 mm); The angle towards superior direction between verical segment of facial nerve and chorda tympani nerve was (38.60 ± 1.99°) (28.5°-52.5°); The vertical distance from the top of the pyramidal eminence to the vertical segment of the facial nerve was (2.05 ± 0.65) mm (1.85-2.36 mm). Conclusions The eminence of the lateral semicircular canal, short limb of incus, cochlearform process, tympanic tegmen, stapes, pyramidal eminence, chorda tympani nerve in the area are important landmarks to be located in mastoid surgery. The anatomic relations in this area are complicated and compact. Anatomical knowledge is very important to the surgery of this area.     

面动脉的解剖学研究及其临床意义

目的 对面动脉进行解剖学研究以指导临床实践.方法 选用保存一年的10具成人尸体(男6,女4)的20侧面部为解剖标本,从颈总动脉远心端注入红色乳胶溶液,有两具尸体在面前静脉内注入蓝色乳胶.将颜面皮肤锐性剥去,除去皮下脂肪,显露浅组面部表情肌,从颌下缘开始显露面动脉到内眦的全过程,展示它的走行、分支和终末部分以及面横动脉、眶下动脉和眼动脉的吻合支及其与面静脉的相互关系.用同样的方法解剖对侧的血管,以研究两侧的对称性.用游标卡尺测量.小的分支在手术放大镜下进行解剖.结果 在10具尸体的20侧面部标本中,两侧面动脉对称的有4例.终止于内眦动脉的占8/20侧(40%,左2侧,右6侧),终止于鼻外侧动脉的占3/20侧(15%,左2侧,右1侧),终止于上唇动脉的占3/20侧(15%,均为左侧),终止于下唇动脉的占1/20侧(5%,为左侧),终止于下颌下缘的占1/20侧(5%,为左侧),终止于下颌下缘的占1/20侧(5%,为左侧),全面型占2/20侧(10%,左右各一侧).右面动脉主干均可终止于鼻外侧动脉或内眦动脉,而左侧面动脉仅5/10侧(50%)可终止于鼻外侧动脉或内眦动脉.面动脉与面静脉的间距:面动脉与面静脉之间的距离在下颌下缘和内眦处很近,在口角和鼻翼基底处相距较远.结论 面血管存在着大的解剖上的变异,面动脉分支不固定,两侧不总是对称分布,甚至面动脉主干发育不全或缺如.面动静脉间的位置关系存在着广泛的变异,我们认为这些解剖知识对于面部皮瓣的设计是必不可少的.     

Classification and Treatment of Facial Tissue Atrophy in Parry–Romberg Disease

BACKGROUND: This report aims to show procedures that the senior author has used for the rehabilitation of facial deformities in Parry-Romberg disease since 1983. The authors also report the classification they use to plan the most appropriate surgical procedure for these patients. METHODS: For this study, 95 patients (67 females and 28 males) with different types of facial tissue depression were classified according to the depth of the defect so adequate treatment could be planned. The cases were classified into four types. For types 1 and 2, only fat grafts were used, whereas for types 3 and 4, a combined procedure was used according to the case using cartilage and bone grafts, free dermis-fat grafts, and galeal flaps. RESULTS: The results were successful, with few or no complications. Objective examinations showed excellent aesthetic improvement, with obvious deformity alleviated and the emotional status of the patients improved. CONCLUSIONS: The authors' practice frequently sees cases of Parry-Romberg disease, which has allowed them to gain significant experience in this field. For depression types 1 and 2, they recommend only fat infiltration, and for types 3 and 4, they favor combined treatment with lipoinjection, galeal flaps, free dermis-fat grafts, and bone and cartilage grafts. Occasionally, in areas of soft tissue with fibrosis, the authors infiltrated around 4 ml of fragmented fascia grafts instead of fat grafts.     

Sliding Osteotomy Genioplasty for Facial Aesthetic Balance: 10 Years of Experience

The chin, one of the most obvious facial structures, plays an important role in the perception of the face as an instrument of communication. To alter the chin contour in a reliable manner, horizontal sliding osteotomy of the mandibular symphysis with advancement of the mobilized segment is the technique of choice for correction of the anterior posterior deficiency. This study describes surgical techniques used in aesthetic and functional surgery of the chin as well as the outcomes. Over a 10-year period, 474 patients underwent orthognathic surgery for correction of their malocclusion. Of these 474 patients, 155 were treated in combination with a sliding genioplasty (SGP) and 37 (29 women and 8 men; average age, 32 years; range, 18–47 years) had an isolated SGP. Of these patients, 33 had chin advancement and 4 had chin reduction. The mean chin advancement was a modest 4.5 mm (range, 2–7 mm), and the mean chin vertical displacement was 3.9 mm (range, 2.5–4.1 mm). All the patients in the mandibular deficiency group had a residual sagittal disproportion of the progonion relative to the subnasale (mean, –7.6 mm) and a newly created vertical disproportion, with mean lower face heights of 67.8 mm compared with mean midface heights of 65.3 mm. The surgical outcome was evaluated by analysis of pre- and postoperative photographs, analysis of pre- and postoperative measurements, and patients’ self judgment. All the patients healed uneventfully without any major postoperative problems. Paraesthesia of the mental nerves occurs to some degree in almost all patients measured by the Simmon Weinstein diagnostic device. In the single sliding chin osteotomy group, no major branches of the mental nerves were transacted. Paraesthesia was only transient, usually lasting for only a few weeks. At least 1 year after the operation, normal sensitivity of the lower lip and both sides of the chin was reported by almost all of the patients (93.1%). All who had only a single genioplasty recovered totally from a neurosensory deficit. The level of satisfaction was significantly high for all the patients. The results were judged to be excellent in 73.2% and good in 23.6% of the cases. Only in 3.2% of the cases was it considered to be poor (bimaxillary surgery combined with SGP). The current findings strongly suggest that SGP is a reliable procedure for achieving harmony of the lower face. In addition, it permits a simplification of facial reconstruction and rejuvenation. The combination of chin advancement and submental recontouring can have a positive effect on facial appearance, provided the increased chin projection is appropriate.     

Anthropometry of the normal and defective ear

Surface measurements of the ear are needed to assess damage in patients with disfigurement or defects of the ears and face. Population norms are useful in calculating the amount of tissue needed to rebuild the ear to adequate size and natural position. Anthropometry proved useful in defining grades of severe, moderate, and mild microtia in 73 patients with various facial syndromes. The division into grades was based on the amount of tissue lost and the degree of asymmetry in the position of the ears. Within each grade the size and position of the ears varied greatly. In almost one-third, the nonoperated microtic ears were symmetrically located, promising the best aesthetic results with the least demanding surgical procedures. In slightly over one-third, the microtic ears were associated with marked horizontal and vertical asymmetries. In cases of horizontal and vertical dislocation exceeding 20 mm, surgical correction of the defective facial framework should precede the building up of a new ear. Data on growth and age of maturation of the ears in the normal population can be useful in choosing the optimal time for ear reconstruction.     

Cephalometrics of Libyan adults

BackgroundCephalometric radiography enables a physician to identify specific areas of craniofacial disproportionality and decide on a treatment plan. Cephalometric analysis is a method for localizeing malocclusion with the facial skeleton and soft tissue structures. This study reports the results from the cephalometric analysis of Libyan adults, as a surrogate for the population of North Africa.MethodsLateral cephalometric radiographs were taken of 100 non-growing Libyan adults: 74 males and 26 females, aged 17–45 years. All subjects had no previous orthodontic treatment. The mean values and standard deviations of 92 parameters were determined.ResultsThe hard tissue cephalometric analysis revealed lower variability in the length of vertical distances compared to those extending more horizontally. In adult Libyans, linear and angular midface measurements (hard tissue and soft tissue) exhibit less variability compared to other measurements taken. Libyans exhibit some of the structural deviations from Bolton's means that were previously found in Americans of African descent. Namely, they are characterized by the greater development of the maxillomandibular complex and by the presence of dentoalveolar protrusion, which must be taken into account when treating patients of this ethnic group.ConclusionThe current study once again confirmed the need to develop cephalometric norms for different ethnic groups, the Arab population in North Africa in particular.     

自体脂肪移植在面部轮廓改善与年轻化中的临床应用

目的 探讨应用自体脂肪颗粒移植改善面部轮廓与面部老龄化的有效性。方法 2013年1月至2014年12月,共140例年龄19~65岁面部轮廓欠佳或面部老化的患者,采用肿胀吸脂术于大腿或下腹部进行脂肪抽吸,获取的脂肪进行过滤、纯化、漂洗等处理,用16~22 G钝头注射针将经处理的颗粒脂肪注射到额颞部、泪沟、颊区、鼻梁、鼻唇沟、颏部、唇部、耳垂及面部其他部位。结果 随访3~18个月,130例一次手术即取得满意效果,10例行2次手术后达到满意效果。所有患者术后均无明显并发症,总体满意率为93.5%,1例出现术后面部局部硬结,5例术后泪沟处肿胀时间超过2个月,半年后基本恢复。所有患者术后均无蜂窝织炎或脂肪坏死发生。结论 面部自体脂肪移植是一项简单、安全、有效的手术,能够自然地重塑面部轮廓、恢复面部容积和改善面部老龄化,绝大多数患者对术后的外观改善感到满意。     

Doppler Ultrasound Evaluation of Facial Transverse and Infraorbital Arteries: Influence of Smoking and Aging Process

Background Plastic surgeons are always concerned about integrity of facial vascularization in smokers and elderly candidates for face-lifting. Using Doppler ultrasound, this study aimed to evaluate influence of chronic smoking and aging on facial transverse and infraorbital artery blood flow. Methods For this study, 40 healthy volunteer women were submitted to bilateral Doppler ultrasound of facial transverse and infraorbital arteries. Volunteers were divided into three groups: group 1 (13 nonsmoking women ages 18–33 years), group 2 (13 nonsmoking women ages 55–70 years), and group 3 (14 smoking women ages 55–70 years). Blood flow parameters measured were peak systolic velocity, end-diastolic velocity, resistivity index, and pulsatility index. Results Chronic smoking did not cause statistically significant alterations in peak systolic velocity in any of the arteries. However, there was a significant augmentation of end-diastolic velocity and a reduction in resistivity and pulsatility index in both arteries. Aging process did not significantly alter any of the parameters evaluated. Findings in both sides of the face were similar for both arteries. Conclusions Chronic smoking significantly altered end-diastolic velocity, resistivity, and pulsatility index in regional arterial circulation of the face. Aging process, however, did not significantly influence any of blood flow parameters studied.