Association of Smartphone Addiction with Facial Asymmetry and Craniofacial Morphometry in Young Adults
Yıl 2025,
Cilt: 35 Sayı: 6, 1297 - 1309, 31.12.2025
Rabia Koca
,
Yunus Emre Kundakcı
,
Ümran Arıcan
Öz
Aim: To examine the differences in facial asymmetry and head-neck posture between young adults who are at risk for smartphone addiction and those who are not. The findings seek to raise awareness about postural health and facial aesthetics, and to inform clinical assessments and interventions in this area.
Methods: This study examined facial asymmetry and head-neck posture measurements among young adults at risk for smartphone addiction and those not. The study included 126 healthy university students aged 19–30. Participants were surveyed about their phone usage habits, screen time, and levels of addiction. To assess phone addiction, the Smartphone Addiction Scale-Short Form (SAS-SF) was employed. Furthermore, craniofacial symmetry and posture analyses were conducted using photogrammetric measurements and ImageJ software. The chin-brow vertical angle (CBVA) and craniovertebral angle (CVA) were calculated to evaluate head and neck posture. Additionally, the tragion-acromion distance was measured to assess lateral neck flexion.
Results: In the data analysis, it was found that GM-ex and nas-zg length asymmetry measurements were significantly higher in individuals at risk of addiction (p<0.05). However, no significant differences were observed between the groups in CBVA, CVA, or tragion-acromion distance. Regarding gender, the risk of phone addiction was significantly higher in women, but this difference did not substantially affect facial symmetry or posture.
Conclusions: Smartphone use may partially change the shape of certain facial areas, but it is not the only factor that affects these measurements. However, a larger and long-term study is needed to confirm these effects.
Etik Beyan
This study was approved by the Scientific Research Ethics Committee of Afyonkarahisar Health Sciences University (approval date: 02.05.2025; approval number: 2025/6). Written informed consent was obtained from all participants prior to inclusion in the study.
Destekleyen Kurum
Scientific Research Ethics Committee of Afyonkarahisar Health Sciences University
Teşekkür
The authors would like to thank all the participants.
Kaynakça
-
1. Choi KY. Analysis of facial asymmetry. Arch Craniofac Surg. 2015;16(1):1-10.
-
2. Akhil G, Senthil Kumar KP, Raja S, Janardhanan K. Three-dimensional assessment of facial asymmetry: a systematic review. J Pharm Bioallied Sci. 2015;7(2):433-7.
-
3. David D, Giannini C, Chiarelli F, Mohn A. Text neck syndrome in children and adolescents. Int J Environ Res Public Health. 2021;18(4):1565.
-
4. Akbari MR, Khorrami-Nejad M, Kangari H, Heirani M, Akbarzadeh Baghban A, Raeesdana K, et al. Does head tilt influence facial appearance more than head turn? J Ophthalmic Vis Res. 2023;18(3).
-
5. Brühl M, Hmida J, Tomschi F, Cucchi D, Wirtz DC, Strauss AC, et al. Smartphone use—influence on posture and gait during standing and walking. Healthcare. 2023;11(18):2543.
-
6. Fontenele TMO, Nunes PPB, Silva FVM, et al. Smartphone addiction and postural alterations in the cervical region in adolescents. Rev Paul Pediatr. 2023;42
-
7. Akbari MR, Khorrami-Nejad M, Askarizadeh F, Pour FF, Ranjbar Pazooki M, Moeinitabar MR. Facial asymmetry in ocular torticollis. J Curr Ophthalmol. 2015;27(1–2):4-11.
-
8. Park J, Lim O. Relationship between the craniovertebral angle, cervical lordosis, and cervical muscles. Korean Soc Phys Med. 2022;17(1):40-8.
-
9. Henao Romero S, Sierra Peña JA, Diaz Orduz RC, Berbeo-Calderon ME. Horizontal gaze assessment: an extensive narrative review. World Neurosurg. 2024;187-6.
-
10. George S, Spiegel M, Protopsaltis T, Buckland AJ, Gomez JA, Ramchandran S, et al. Mandibular slope: a reproducible and simple measure of horizontal gaze. Spine Deform. 2020;8(5):893-9.
-
11. Suk KS, Kim KT, Lee SH, Kim JM. Significance of chin-brow vertical angle in correction of kyphotic deformity of ankylosing spondylitis patients. Spine (Phila Pa 1976). 2003;28(17):2001-5.
-
12. Khan A, Khan Z, Bhati P, Hussain ME. Influence of forward head posture on cervicocephalic kinesthesia and electromyographic activity of neck musculature in asymptomatic individuals. J Chiropr Med. 2020;19(4):230-40.
-
13. Gürlek Çelik N. Analysis of External Ear Morphometry in University Students. Maltepe Tıp Derg. 2024;16(3):69-73.
-
14. Koca R, Gürlek Çelik N, Akman B. The Effect of Nasal Septum Deviation on Nasopharyngeal Volume. Kocatepe Tıp Dergisi. 2025;26(4):307-16.
-
15. Kamaşak Arpaçay B, Bilir BB, Uğuz E, Gorgulu O, Ulcay T, Aycan K. Genç erişkinlerde kraniyofasiyal ölçümlerin ve fasiyal asimetrinin cinsiyete göre karşılaştırılması. Kocatepe Tıp Dergisi. 2025;26(1):39-46.
-
16. Kwon M, Kim DJ, Cho H, Yang S. The smartphone addiction scale: development and validation of a short version for adolescents. PLoS One. 2013;8(12).
-
17. Noyan CO, Enez Darçın A, Nurmedov S, Yilmaz O, Dilbaz N. Akıllı telefon bağımlılığı ölçeğinin kısa formunun üniversite öğrencilerinde Türkçe geçerlilik ve güvenilirlik çalışması. Anadolu Psikiyatri Derg. 2015;16(Suppl 1):73-81.
-
18. Şata M, Karip F. Akıllı telefon bağımlılığı ölçeği-kısa versiyonu’nun ergenler için Türk kültürüne uyarlanması. Cumhuriyet Int J Educ. 2017;6(4):426-40.
-
19. Habets LLMH, Bezuur JN, Naeiji M, et al. The orthopantomogram, an aid in diagnosis of temporomandibular joint problems. II. The vertical symmetry. J Oral Rehabil. 1988;15(5):465-71.
-
20. Yan YZ, Shao ZX, Pan XX, Chen SQ, Wu AM, Tian NF, et al. Acceptable chin–brow vertical angle for neutral position radiography: preliminary analyses based on parameters of the whole sagittal spine of an asymptomatic Chinese population. World Neurosurg. 2018;120-96.
-
21. Torkamani MH, Mokhtarinia HR, Vahedi M, et al. Relationships between cervical sagittal posture, muscle endurance, joint position sense, range of motion and level of smartphone addiction. BMC Musculoskelet Disord. 2023;24:61.
-
22. Tokgöz G. Study of the relationship between smartphone addiction and head and shoulder posture curvatures in adolescent individuals. Rev Gestao Secretariado. 2023;14(10):18765-77.
-
23. Bomen BB, Kulkarni S. The relationship between addiction to smartphone usage and protracted shoulders, forward head posture and thoracic kyphosis in college students. Int J Health Sci Res. 2022;12(2):220-6.
-
24. Yaşartürk F, Aydın R, Genç A. The relationship between smartphone use and postural disorders: an investigation on university students. Res Sport Educ Sci. 2025;27(2):108-19.
-
25. Andone I, Błaszkiewicz K, Eibes M, Trendafilov B, Montag C, Markowetz A. How age and gender affect smartphone usage. In: Proceedings of the 2016 ACM International Joint Conference on Pervasive and Ubiquitous Computing: Adjunct. New York: Association for Computing Machinery; 2016. p. 9-12.
-
26. Roque-Hernández RV, Salazar-Hernández R, López-Mendoza A. Diferencias de género en el uso de teléfonos inteligentes: un estudio cuantitativo entre universitarios mexicanos. EDUCAR. 2024;60(2):429-45.
-
27. Alhammad A, Almalki H, Suliman I, Alhelali A, Alhjili M, Althomali O. Prevalence and contributing factors of neck pain among Taibah University students: a posture and gender-based analysis. Mol Cell Biomech. 2024;21(2):343.
-
28. Chen YL, Wang TH, Chang WA, Nguyen HT. Gender differences in head and neck posture among smartphone users while walking: insights from field observations in Taipei. J Funct Morphol Kinesiol. 2024;9(4):245.
-
29. Guan X, Fan G, Chen Z, Zeng Y, Zhang H, Hu A, et al. Gender difference in mobile phone use and the impact of digital device exposure on neck posture. Ergonomics. 2016;59(11):1453-61.
-
30. Darby LJ, Millett DT, Kelly N, McIntyre GT, Cronin MS. The effect of smiling on facial asymmetry in adults: a 3D evaluation. Aust Orthod J. 2015;31(2):132-7.
-
31. Kaipainen AE, Sieber KR, Nada RM, Maal TJ, Katsaros C, Fudalej PS. Regional facial asymmetries and attractiveness of the face. Eur J Orthod. 2016;38(6):602-8.
-
32. Hardie S, Hancock P, Rodway P, Penton-Voak I, Carson D, Wright L. The enigma of facial asymmetry: is there a gender-specific pattern of facedness? Laterality. 2005;10(4):295-304.
-
33. Gürlek Çelik N, Akman B, Koca R. Three-dimensional geometric analysis of facial symmetry in skeletal class I individuals. Anatolian Clin. 2024;29(2):100-9.
Genç Yetişkinlerde Akıllı Telefon Bağımlılığının Yüz Asimetrisi ve Kraniyofasiyal Morfometri ile İlişkisi
Yıl 2025,
Cilt: 35 Sayı: 6, 1297 - 1309, 31.12.2025
Rabia Koca
,
Yunus Emre Kundakcı
,
Ümran Arıcan
Öz
Amaç: Akıllı telefon bağımlılığı riski taşıyan ve taşımayan genç yetişkinler arasında yüz asimetrisi ve baş-boyun duruşundaki farklılıkları incelemek. Bulgular, duruş sağlığı ve yüz estetiği konusunda farkındalık yaratmayı ve bu alandaki klinik değerlendirme ve müdahalelere bilgi sağlamayı amaçlamaktadır.
Gereç ve Yöntemler: Bu çalışmada, akıllı telefon bağımlılığı riski taşıyan ve taşımayan genç yetişkinler arasında yüz asimetrisi ve baş-boyun duruşu ölçümleri incelendi. Çalışmaya 19-30 yaşları arasında 126 sağlıklı üniversite öğrencisi katıldı. Katılımcılara telefon kullanım alışkanlıkları, ekran süresi ve bağımlılık düzeyleri hakkında anket uygulandı. Telefon bağımlılığını değerlendirmek için Akıllı Telefon Bağımlılığı Ölçeği-Kısa Formu (AKBÖ) kullanıldı. Ayrıca, fotogrametrik ölçümler ve ImageJ yazılımı kullanılarak kraniyofasiyal simetri ve duruş analizleri yapıldı. Baş ve boyun duruşunu değerlendirmek için çene-kaş dikey açısı (CBVA) ve kraniyovertebral açı (CVA) hesaplandı. Ayrıca, lateral boyun fleksiyonunu değerlendirmek için tragion-acromion mesafesi ölçüldü.
Bulgular: Veri analizinde, GM-ex ve nas-zg uzunluk asimetrisi ölçümlerinin bağımlılık riski taşıyan bireylerde anlamlı derecede daha yüksek olduğu bulundu (p<0,05). Ancak, gruplar arasında CBVA, CVA veya tragion-acromion mesafesinde anlamlı bir fark gözlenmedi. Cinsiyet açısından bakıldığında, telefon bağımlılığı riski kadınlarda anlamlı derecede daha yüksek bulundu, ancak bu fark yüz simetrisini veya duruşu önemli ölçüde etkilemedi.
Sonuçlar: Akıllı telefon kullanımı yüzün belirli bölgelerinin şeklini kısmen değiştirebilir, ancak bu ölçümleri etkileyen tek faktör değildir. Ancak, bu etkileri doğrulamak için daha geniş ve uzun vadeli bir çalışmaya ihtiyaç vardır.
Etik Beyan
Bu çalışma Afyonkarahisar Sağlık Bilimleri Üniversitesi Bilimsel Araştırmalar Etik Kurulu tarafından onaylanmıştır (onay tarihi: 02.05.2025; onay numarası: 2025/6). Çalışmaya katılan tüm bireylerden yazılı bilgilendirilmiş onam alınmıştır
Destekleyen Kurum
Afyonkarahisar Sağlık Bilimleri Üniversitesi Bilimsel Araştırmalar Etik Kurulu
Teşekkür
Yazarlar tüm katılımcılara teşekkürlerini sunarlar.
Kaynakça
-
1. Choi KY. Analysis of facial asymmetry. Arch Craniofac Surg. 2015;16(1):1-10.
-
2. Akhil G, Senthil Kumar KP, Raja S, Janardhanan K. Three-dimensional assessment of facial asymmetry: a systematic review. J Pharm Bioallied Sci. 2015;7(2):433-7.
-
3. David D, Giannini C, Chiarelli F, Mohn A. Text neck syndrome in children and adolescents. Int J Environ Res Public Health. 2021;18(4):1565.
-
4. Akbari MR, Khorrami-Nejad M, Kangari H, Heirani M, Akbarzadeh Baghban A, Raeesdana K, et al. Does head tilt influence facial appearance more than head turn? J Ophthalmic Vis Res. 2023;18(3).
-
5. Brühl M, Hmida J, Tomschi F, Cucchi D, Wirtz DC, Strauss AC, et al. Smartphone use—influence on posture and gait during standing and walking. Healthcare. 2023;11(18):2543.
-
6. Fontenele TMO, Nunes PPB, Silva FVM, et al. Smartphone addiction and postural alterations in the cervical region in adolescents. Rev Paul Pediatr. 2023;42
-
7. Akbari MR, Khorrami-Nejad M, Askarizadeh F, Pour FF, Ranjbar Pazooki M, Moeinitabar MR. Facial asymmetry in ocular torticollis. J Curr Ophthalmol. 2015;27(1–2):4-11.
-
8. Park J, Lim O. Relationship between the craniovertebral angle, cervical lordosis, and cervical muscles. Korean Soc Phys Med. 2022;17(1):40-8.
-
9. Henao Romero S, Sierra Peña JA, Diaz Orduz RC, Berbeo-Calderon ME. Horizontal gaze assessment: an extensive narrative review. World Neurosurg. 2024;187-6.
-
10. George S, Spiegel M, Protopsaltis T, Buckland AJ, Gomez JA, Ramchandran S, et al. Mandibular slope: a reproducible and simple measure of horizontal gaze. Spine Deform. 2020;8(5):893-9.
-
11. Suk KS, Kim KT, Lee SH, Kim JM. Significance of chin-brow vertical angle in correction of kyphotic deformity of ankylosing spondylitis patients. Spine (Phila Pa 1976). 2003;28(17):2001-5.
-
12. Khan A, Khan Z, Bhati P, Hussain ME. Influence of forward head posture on cervicocephalic kinesthesia and electromyographic activity of neck musculature in asymptomatic individuals. J Chiropr Med. 2020;19(4):230-40.
-
13. Gürlek Çelik N. Analysis of External Ear Morphometry in University Students. Maltepe Tıp Derg. 2024;16(3):69-73.
-
14. Koca R, Gürlek Çelik N, Akman B. The Effect of Nasal Septum Deviation on Nasopharyngeal Volume. Kocatepe Tıp Dergisi. 2025;26(4):307-16.
-
15. Kamaşak Arpaçay B, Bilir BB, Uğuz E, Gorgulu O, Ulcay T, Aycan K. Genç erişkinlerde kraniyofasiyal ölçümlerin ve fasiyal asimetrinin cinsiyete göre karşılaştırılması. Kocatepe Tıp Dergisi. 2025;26(1):39-46.
-
16. Kwon M, Kim DJ, Cho H, Yang S. The smartphone addiction scale: development and validation of a short version for adolescents. PLoS One. 2013;8(12).
-
17. Noyan CO, Enez Darçın A, Nurmedov S, Yilmaz O, Dilbaz N. Akıllı telefon bağımlılığı ölçeğinin kısa formunun üniversite öğrencilerinde Türkçe geçerlilik ve güvenilirlik çalışması. Anadolu Psikiyatri Derg. 2015;16(Suppl 1):73-81.
-
18. Şata M, Karip F. Akıllı telefon bağımlılığı ölçeği-kısa versiyonu’nun ergenler için Türk kültürüne uyarlanması. Cumhuriyet Int J Educ. 2017;6(4):426-40.
-
19. Habets LLMH, Bezuur JN, Naeiji M, et al. The orthopantomogram, an aid in diagnosis of temporomandibular joint problems. II. The vertical symmetry. J Oral Rehabil. 1988;15(5):465-71.
-
20. Yan YZ, Shao ZX, Pan XX, Chen SQ, Wu AM, Tian NF, et al. Acceptable chin–brow vertical angle for neutral position radiography: preliminary analyses based on parameters of the whole sagittal spine of an asymptomatic Chinese population. World Neurosurg. 2018;120-96.
-
21. Torkamani MH, Mokhtarinia HR, Vahedi M, et al. Relationships between cervical sagittal posture, muscle endurance, joint position sense, range of motion and level of smartphone addiction. BMC Musculoskelet Disord. 2023;24:61.
-
22. Tokgöz G. Study of the relationship between smartphone addiction and head and shoulder posture curvatures in adolescent individuals. Rev Gestao Secretariado. 2023;14(10):18765-77.
-
23. Bomen BB, Kulkarni S. The relationship between addiction to smartphone usage and protracted shoulders, forward head posture and thoracic kyphosis in college students. Int J Health Sci Res. 2022;12(2):220-6.
-
24. Yaşartürk F, Aydın R, Genç A. The relationship between smartphone use and postural disorders: an investigation on university students. Res Sport Educ Sci. 2025;27(2):108-19.
-
25. Andone I, Błaszkiewicz K, Eibes M, Trendafilov B, Montag C, Markowetz A. How age and gender affect smartphone usage. In: Proceedings of the 2016 ACM International Joint Conference on Pervasive and Ubiquitous Computing: Adjunct. New York: Association for Computing Machinery; 2016. p. 9-12.
-
26. Roque-Hernández RV, Salazar-Hernández R, López-Mendoza A. Diferencias de género en el uso de teléfonos inteligentes: un estudio cuantitativo entre universitarios mexicanos. EDUCAR. 2024;60(2):429-45.
-
27. Alhammad A, Almalki H, Suliman I, Alhelali A, Alhjili M, Althomali O. Prevalence and contributing factors of neck pain among Taibah University students: a posture and gender-based analysis. Mol Cell Biomech. 2024;21(2):343.
-
28. Chen YL, Wang TH, Chang WA, Nguyen HT. Gender differences in head and neck posture among smartphone users while walking: insights from field observations in Taipei. J Funct Morphol Kinesiol. 2024;9(4):245.
-
29. Guan X, Fan G, Chen Z, Zeng Y, Zhang H, Hu A, et al. Gender difference in mobile phone use and the impact of digital device exposure on neck posture. Ergonomics. 2016;59(11):1453-61.
-
30. Darby LJ, Millett DT, Kelly N, McIntyre GT, Cronin MS. The effect of smiling on facial asymmetry in adults: a 3D evaluation. Aust Orthod J. 2015;31(2):132-7.
-
31. Kaipainen AE, Sieber KR, Nada RM, Maal TJ, Katsaros C, Fudalej PS. Regional facial asymmetries and attractiveness of the face. Eur J Orthod. 2016;38(6):602-8.
-
32. Hardie S, Hancock P, Rodway P, Penton-Voak I, Carson D, Wright L. The enigma of facial asymmetry: is there a gender-specific pattern of facedness? Laterality. 2005;10(4):295-304.
-
33. Gürlek Çelik N, Akman B, Koca R. Three-dimensional geometric analysis of facial symmetry in skeletal class I individuals. Anatolian Clin. 2024;29(2):100-9.