What is a Zygomaticomaxillary complex fracture?

What is a Zygomaticomaxillary complex fracture?

A zygomatic complex fracture is a fracture that involves the zygoma and its surrounding bones. The typical lines of a zygomatic complex fracture are: A fracture emanating from the inferior orbital fissure superiorly along the sphenozygomatic suture to the frontozygomatic suture where it crosses the lateral orbital rim.

How long does it take for a zygomatic fracture to heal?

Even if a fracture is held in place with plates and screws it still takes approximately six weeks for your cheekbone to heal completely. During this recovery period, you will need to be careful to avoid an injury to this area of your face, as it may cause the cheekbone to move out of position.

When should a ZMC fracture be fixed?

Indications for surgical repair of zygomatic complex fractures include displacement or instability of the fracture, mechanical restriction of mandibular movement (chewing), alteration in facial contour, globe dystopia, enophthalmos, diplopia, or sensory nerve deficit.

What happens if the zygomatic bone is damaged?

Fractures of the ZMC or zygomatic arch can often lead to unsightly malar depression, which should be corrected to restore a normal facial contour. ZMC fractures can also cause significant functional issues, including trismus, enophthalmos and/or diplopia, and paresthesias of the infraorbital nerve.

Where is Zygomaticomaxillary located?

Relevant Anatomy The malar eminence is the most prominent portion of the zygomaticomaxillary complex (ZMC) and is located approximately 2 cm inferior to the lateral canthus.

How do you fix a zygomatic fracture?

Most zygomatic complex fractures can be treated solely by an intraoral approach and rigid fixation at the zygomaticomaxillary buttress. Further exposure of the zygomaticofrontal junction or inferior orbital rim is necessary for severely displaced fractures, which require additional fixation.

What is Zygomaticomaxillary complex?

The zygomaticomaxillary complex (ZMC) plays a key role in the structure, function, and aesthetic appearance of the facial skeleton. It provides normal cheek contour and separates the orbital contents from the temporal fossa and the maxillary sinus.

What nerves are frequently involved in ZMC fractures?

Paresthesia of the face is a common sequela of a ZMC fracture given its proximity to sensory nerves such as the infraorbital nerve, the zygomaticofacial nerve, and the zygomaticotemporal nerve (all branches of cranial nerve V2).

Why is Intra Oral Surgical is the preferred choice for surgical correction of ZMC fractures?

The intraoral surgical approach offers several advantages compared to the extraoral approach including no visible skin scar, visualization of the fracture line at the zygomaticomaxillary buttress and the infraorbital nerve, closer and more precise application of force by the operator, placement of fixation plates at …

Does a fractured cheekbone require surgery?

Once it has determined the cheekbone is broken the surgeon will decide if surgery is needed. Sometimes depending on the situation, such as if the cheekbone fracture is stable, no surgery is recommended. But, it will be advised if it affects the daily function of the patient or causes a cosmetic defect.

How is a fractured cheekbone treated?

Cheekbone fractures usually heal without infection but it may be necessary to give you antibiotics, particularly if a “graft” has been used. Initially it may be necessary to give you antibiotics through a vein in your arm whilst you are in hospital.

Can a facial fracture heal on its own?

Often a facial fracture may be left to heal on its own. No treatment may be necessary if the broken bone stays in normal position, but injuries causing severe fractures may need to be surgically repaired.

What are the treatment options for zygomaticomaxillary complex (ZMC) fractures?

Medical management includes a soft diet, analgesia, and close follow-up care. The ultimate goal in treating zygomaticomaxillary complex (ZMC) fractures is to obtain an accurate stable reduction while minimizing external scars and functional deformity. [ 33]

When is a scalp incision indicated in the treatment of zygomatic fracture?

Finally, for severely comminuted ZMC fractures with disruption of the zygomatic arch, a coronal scalp incision is required. Scalp incisions are associated with little morbidity, but often result in apparent scars and scalp anesthesia.

What is the best approach to the frontozygomatic suture line?

The 3 most common approaches to the frontozygomatic buttress are the lateral upper lid blepharoplasty, lateral brow, and hemicoronal incisions. A lateral upper lid blepharoplasty incision provides excellent access to the frontozygomatic suture line with better aesthetic results than the lateral brow incision.

How is the zygomaticomaxillary buttress fractured in a tetrapod injury?

The zygomaticomaxillary buttress is commonly fractured in tetrapod injuries. Use a transverse buccal sulcus incision to expose this area. The incision is well hidden, results in no external scar, and exposes the entire face of the maxilla. Incise the mucosa 1.5-2 cm above the gingiva using guarded electrocautery.

https://www.youtube.com/watch?v=nyrAmRVRHPo