Midfacial Structural Aging and Its Association With Fracture Distribution: Insights From CT Images

Facial structures and fracture patterns change with aging; however, the relationship between midfacial skeletal aging and fracture distribution remains unclear. We retrospectively analyzed clinical records and computed tomography scans of 186 patients with facial trauma (aged 1-90 years). Among patients with fractures (n = 117), nasal fractures were significantly and independently associated with younger age ( P = 0.023), whereas zygomaticomaxillary complex fractures were significantly and independently associated with older age ( P = 0.039). In patients without facial fractures (n = 69), the volumes of the maxillary sinus and orbit, as well as the sagittal and axial prominences of the midfacial bone, were measured on three-dimensional reconstructed computed tomography images. Bony orbital volume and sagittal prominence showed significantly positive correlations with age ( r = 0.338, P < 0.01; r = 0.566; P < 0.01, respectively). These findings suggest that age-related increases in bony orbital volume and sagittal prominence may contribute to the higher prevalence of zygomaticomaxillary complex fractures in older individuals.