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.