Zygomaticofacial, zygomaticoorbital and zygomaticotemporal foramina: anatomical study.

The zygomatic nerve may be disrupted when elevating periorbita from the lateral wall during orbital surgery, and care should be taken to prevent injury to this nerve during lateral orbitotomy approaches to access intraorbital soft-tissue tumors. Furthermore, the precise introduction of anesthetics to the zygomaticoorbital (ZO), zygomaticofacial (ZF) and zygomaticotemporal (ZT) foramina could be important data for the plastic and reconstructive surgeon operating in the area. The aim of the present study was to investigate the morphologic and topographic anatomy, and variations of the ZO, ZF and ZT. The present study was performed using 200 dry human skulls. The ZF, ZO and ZT foramina varied from being absent to as many as four small openings. We classified each of these foramina as types I-V for single, double, triple, quadruple and absent foramina, respectively. The relative frequency was as follows: type I, ZO 50%, ZF 40%, ZT 30%; type II, ZO 20%, ZF 15%, ZT 15%; type III, ZO 10%, ZF 5%, ZT 5%; type IV, ZO 3%, ZF 1%, ZT-; and type V, ZO 17%, ZF 39%, ZT 50%. A detailed knowledge of the anatomic morphometry of this area is necessary for a surgeon when performing maxillofacial surgery and regional block anesthesia. Anatomic variations in this area may be present and a surgeon must take this into consideration so as to increase surgical success.