The Supraorbital Margin of Japanese Who Have No Visible Superior Palpebral Crease and Persistently Lift the Eyebrow in Primary Gaze Is Higher and More Obtuse Than Those Who Do Not

Yoshito Mishima, MD; Kiyoshi Matsuo, MD, PhD; Shunsuke Yuzuriha, MD, PhD; Ai Kaneko, MD

Disclosures

ePlasty. 2013;13 

In This Article

Subjects and Methods

We enrolled 23 Japanese male subjects (24.5 ± 7.2 years old), who had sustained a fracture of the nose or orbital floor and who had been examined by 3-dimensional computed tomography (3D-CT) imaging of the orbit. The subjects did not have previous neurotoxin injected to their forehead or glabellar complex, previous upper lid blepharoplasty, or any eyelid ptosis or neuromuscular diseases. This cohort consisted of 10 subjects who had no visible SPC and who persistently lifted the eyebrows (Fig 3a) and 13 subjects who did not (Fig 3b). It was confirmed that digital immobilization of the eyebrow movement during eyelid opening restricted eyelid opening and folding in all subjects without visible SPC.

We evaluated whether the subjects without visible SPC persistently lifted their eyelids more than the subjects with visible SPC. Eyebrow height between the uppermost margin of the eyebrow above the center of the pupil and the intercanthal line were measured on the noninjured sides in primary gaze for statistical comparison of both group subjects without and with visible SPC. The measurements were based either on a 10-mm square scale (Casmatch, Dai Nippon Printing Co, Ltd, Tokyo, Japan) attached to the face or the corneal horizontal diameter measured after photographing.

Then, we evaluate whether the presence of persistently lifted eyebrow in primary gaze affected the relative height of the supraorbital margin in coronal view 3D-CT imaging. The vertical distance (VD) between the line of the horizontal distance (HD) and the highest point of the supraorbital margin was divided by the HD between the facial midline and the middle point of the frontozygomatic suture (Figs 3d, 3e). The resultant quotients (VD/HD) were compared between the groups.

Finally, we evaluated whether the shape of the supraorbital margin in the coronal view affected that in the sagittal view. The sagittal angles between a horizontal plane parallel to the Frankfurt plane and a plane tangent to the orbital roof at the highest supraorbital margin were measured in sagittal view 3D-CT images (Figs 4a-4d). A correlational analysis was performed between the above-determined VD/HD quotients in the coronal view and the sagittal view angles.

Figure 4.

Correlation between the relative coronal height (VD/HD) of the supraorbital margin and the obtuseness of the sagittal angle (θ) of the supraorbital margin. The sagittal angles between a horizontal plane parallel to the Frankfurt plane and a plane tangent to the orbital roof were measured at the highest supraorbital margin in the sagittal view in 3D-CT images in a representative subject without visible SPC who persistently lifted the eyebrow in primary gaze (a) and a representative subject with visible SPC who did not (b). (c) The relationship between the relative coronal height (VD/HD) of the supraorbital margin and the obtuseness of the sagittal angle (θ) was significantly correlated (r = 0.925, P < .0001) for 10 subjects without visible SPC (filled circles) and 13 subjects with visible SPC (open circles).

All subjects and patients gave informed consent to participate in the study, which was approved by our institutional review board for human subjects. Statistical analysis was performed using the Student t test and the Pearson correlation coefficient. A P value of less than .05 was used to indicate statistical significance.

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