The orbital region of subjects with Down syndrome (DS) has been scanty described so far. We wanted to detail the morphologic characteristics of the soft tissue orbital region in Italian and North Sudanese subjects with DS.The three-dimensional coordinates of 10 landmarks on the orbital soft tissues were obtained using computerized anthropometry in 53 Italian and 64 North Sudanese subjects with DS aged 4 to 52 years, and in 461 (Italian) and 682 (North Sudanese) sex-and age-matched controls. From the landmarks, linear distances, ratios, areas, and angles were calculated, z scores computed, and compared by t-tests and analyses of covariance.In North Sudanese DS subjects, intercanthal width and height-tolength ratio were increased; biorbital width, eye height, length, and area were reduced. Eye fissure and orbital inclinations relative to Frankfort plane were reduced, whereas orbital inclinations versus the true horizontal were increased. In Italian DS men, orbital height and height-to-length ratio were increased, eye length was decreased; orbital inclination versus the true horizontal was increased. For almost all measurements, a significant effect of age was found. No effects of sex were found. Ethnic group influenced orbital height, area, and orbital inclination versus Frankfort plane. All paired measurements had similar discrepancies on both sides.The orbital soft tissues of North Sudanese DS subjects differed from those of their reference subjects, but this was only partially true for Italian subjects. The 2 ethnic groups had different alterations in their soft tissue orbital regions that were influenced by age, but not by sex.Key Words: Face, three-dimensional, soft tissues, anthropometry, Down syndrome (J Craniofac Surg 2012;23: 198Y202) T he soft tissues of the orbital region play a major role in the evaluation and recognition of the craniofacial complex, and relevant anthropometric data are often used for multiple diagnostic and forensic procedures. Among others, there are evaluations of traumas, chromosomal and single gene alterations, teratogenic-induced conditions such as the fetal alcohol syndrome, and facial reconstruction.1Y3 Sex, age, and ethnicity are factors that influence the soft tissue characteristics of the orbital region significantly, both in healthy subjects and in patients.
2Y7Down syndrome (DS) (Mendelian Inheritance in Man no. 1906858) is the most frequent autosomal aneuploidy in live-born humans. Down syndrome is produced by the complete or partial trisomy of chromosome 21, and it is characterized by several morphologic and functional alterations of body structures, from cellular organelles to multiorgan systems, which are present in varying degrees in the affected individuals.8 A distinctive craniofacial appearance is present in almost all persons with DS. 8 Subjects with DS have a reduced head size with a modified head shape; a decrease in the interorbital distance, a small palpebral fissure, and a prominent forehead; a hypoplastic facial middle third (maxilla) with a les...
