• Archives of Plastic Surgery
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• v.38 no.6
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• pp.851-860
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• 2011

Purpose: Reduction by simply assembling bones is recognized as treatment for a zygoma fracture. However, in patients who originally had a protruding zygoma, the fractured parts look like malarplasty after the edema subsides, giving a soft impression which patients notice. Thus, we created symmetry through simultaneous contralateral malar reduction in a unilateral zygoma fracture. Methods: In this study, the patients who had surgery between July, 2008 and December, 2009 with admission were object. In 76 patients with a zygoma fracture, the patients with bilateral zygoma fractures were excluded. Among 48 patients who had a reduction only after a unilateral zygoma fracture, the patients hoping for a reduction of their rough protruding zygoma were analyzed with front cephalometry. The study progressed on 22 patients who had simultaneous contralateral malar reduction in a unilateral zygoma fracture with consent. After fixing the fracture, we did a straight zygoma osteotomy through a 1.5 cm intraoral incision. After that, we created symmetry with a special ruler and fixed the broken zygomatic arch with a screw and plate. We evaluated the facial index and satisfaction with a statistical analysis before and after the surgery. Results: In 22 patients, there was no reoperation except for 1 patient who had a zygoma fracture. None of the patients were treated for infection or hematoma. Two patients complained of paresthesia after the malar reduction operation, but this subsided in 4 months. Most of them were satisfied with the malar reduction, especially the women, and we obtained a better mid facial contour with decreased facial width ($p$ <0.05). Conclusion: Existing zygoma fracture surgery focuses on anatomical reduction. However, we need to have a cosmetic viewpoint in fractures as interests of face contour arise. Thus, contralateral malar reduction got a 4.7 (range 0~5) from patients who had malar reduction surgery in our hospital. Although adjusting to all zygoma fractures has limitations, it can be a new method in zygoma fractures when there are limited indications of protruding zygoma and careful attention is given to patients' high demands.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.366-369
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• 1999

The nasal and zygoma bone are parts of frequently fracturing of facial bones because of anatomically protrusion. Of facial bone fractures, nasal bone is at the high level of incidence rate. But zygoma fracture that anatomical characteristics increase the incidence rate also is occupied considerable part of the facial bone fracture. The outline of face is decided by form of underlying skeletal structure, of that, zygoma plays an important role in. Zygoma is closely attached to surrounding anatomic structure as orbit, maxillary sinus. Aesthetic and functional disturbance are developed by zygoma fracture from trauma, complications, as facial asymmetry, trismus, sensory disturbance, epistaxis, periorbital hemorrhage, diplopia etc, are developed. The patterns of complications following displacement of fractured fragment of zygoma by trauma are slightly different.

• Archives of Craniofacial Surgery
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• v.23 no.6
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• pp.274-277
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• 2022

Fractures of the zygoma are rarely encountered in pediatric patients. This report presents a case of a 3-year-old child who presented with a vertically split fracture of the marginal tubercle of the zygoma. The marginal tubercle, a bony portion present on the posterior border of the frontal process, assists in attaching the temporalis fascia. This patient was treated surgically with bony fixation using tissue glue. To the best of our knowledge, no cases of fracture of the marginal tubercle of the zygoma have been reported in the literature. Fractures of the marginal tubercle of the zygoma in pediatric patients may be overlooked because of their anatomic location and the musculoskeletal characteristics of these patients. Here, we discuss the clinical features of marginal tubercle fractures of the zygoma.

• Archives of Craniofacial Surgery
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• v.10 no.2
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• pp.76-80
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• 2009

Purpose: Zygoma is a major portion of the midfacial skeleton, forms the malar prominence and the three adjacent bony articulations. Zygoma fracture is a very common in facial trauma. Open reduction and rigid fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial asymmetry and depression. However, it is possible to happen the complications related to the plates and screws. So, we planned to treat the 24 patients of Group II, III, IV zygoma fractures with precise reduction and non-fixation method via intraoral approach. Methods: From August, 2006, to August, 2009, we treated 24 cases of zygoma fracture with reduction and non-fixation methods. Before the surgery, we choose the patients who could be treated with this method among the Group II, III, IV patients. Results: No patients in this study had postoperative complications such as displacement of bony fragments, facial depression and asymmetry, malocclusion, hypoesthesia. Satisfactory aesthetic and functional results can be obtained. Conclusion: In the treatment of the zygoma fracture, it is possible to treat with precise reduction and non-fixation method. The greatest advantage is to decrease the operative time, no need to wide dissection, no complications related to the plates and screws. For the using of this method, it is necessary to choose the adequate patients through the preoperative planning.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.783-790
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• 2011

Purpose: The zygoma (Zygomaticomaxillary) complexes make up a large portion of the orbital floor and lateral orbital walls. Zygoma fracture frequently causes the posteromedial displacement of bone fragments, and the collapse or overlapping of internal orbital walls. This process consequently can lead to the orbital volume change. The reduction of zygoma in an anterolateral direction may influence on the potential bone defect area of the internal orbital walls. Thus we performed the quantitative analysis of orbital volume change in zygoma fracture before and after operation. Methods: We conducted a retrospective study of preoperative and postoperative three-dimensional computed tomography scans in 39 patients with zygoma fractures who had not carried out orbital wall reconstruction. Orbital volume measurement was obtained through Aquarius Ver. 4.3.6 program and we compared the orbital volume change of injured orbit with that of the normal contralateral orbit. Results: The average orbital volume of normal orbit was 19.68 $cm^3$. Before the operation, the average orbital volume of injured orbit was 18.42 $cm^3$. The difference of the orbital volume between the injured orbit and the normal orbit was 1.18 $cm^3$ (6.01%) on average. After operation, the average orbital volume of injured orbit was 20.81 $cm^3$. The difference of the orbital volume between the injured orbit and the normal orbit was 1.17 $cm^3$ (5.92%) on average. Conclusion: There are considerable volume changes in zygoma fracture which did not accompany internal orbital wall fracture before and after operation. Our study reflects the change of bony frame, also that of all parts of the orbital wall, in addition to the bony defect area of orbital floor, in an isolated zygoma fracture so that it evaluates orbital volume change more accurately. Thus, the measurement of orbital volume in isolated zygoma fractures helps predict the degree of enophthalmos and decide a surgical plan.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.1-11
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• 1989

This is a retrospective study on maxillofacial fractures. This study was based on a series of 442 patients with maxillofacial fractures treated at Dept, of oral and Maxillofacial Surgery, College of Dentistry, Chon Buk National University from Jan, 1984 to Sep. 1988. The results obtained were as follows: 1. The ratio of Male/Female was 4.8 : 1, and 3rd decade (43.9%) was the highest age group in incidence. 2. Monthly incidence was the highest in Oct,(10.6%). 3. The most frequent maxillofacial fracture site was mandible (70.0%), and zygoma & zygomatic arch (13.6%), maxilla(11.7%) and nasal bone (4.7%) were next in order of frequency. 4. Traffic accidents (47.5%), fight(24.8%) were the most common causes of maxillofacial fractures. 5. The most frequent chief complaint was painful swelling(40.7%). 6. In mandibular fractures, the most frequent fracture site was symphyseal area(28.9%) and simple fracture was the most frequent in type of fracture (71.2%). 7. In maxillary fractures, fracture with other facial bones (64.5%) was more frequent than fracture of maxilla only. The most common type of fracture was unilateral fractures(37.1%). 8. In fracture of zygoma complex, zygoma fracture was the most frequent fracture type(40.3%), zygoma and zygomatic arch fx, (30.6%), zygomatic arch fx, (29.1%) were next in order 9. Open reduction was major method of treatment in maxillofacial fractures : Mandible (77.5%), Maxilla (61.3%), Zygoma complex(43.1%). 10. Maxillofacial fractures were most frequently combined with head injury(39.3%), and lower extremities(17.0%), upper extremities(13.6%) were next in order.

• Journal of Yeungnam Medical Science
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• v.13 no.1
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• pp.22-31
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• 1996

It is difficult to get a satisfactory result for the correction of malunited fracture of zygoma. Triple osteotomy and reposition of malunited zygoma is accepted as the better surgical method than camouflage surgery by means of onlays, if the orbital floor is to be reconstructed. The surgical approach can be divided into bicoronal, periorbital, intraoral and old scar. In 7 patients with malunited fracture of zygoma, the authors used a limited approach through extension of periorbital incision and intraoral incision instead of wide exposure including bicoronal incision. And we performed triple osteotomy and advancement of zygoma complex. The patients were followed for 4.5 months with acceptable result, and this approach was an effective method for the relatively simple tripod type-malunited fracture of zygoma. The authors obtained following conclusions: 1. Preoperative evaluation through thorough measurement of X-rays, investigation of photographs and detail communication with the patients was an important process. 2. Through lateral extension of subciliary incision, lateral eyebrow and intraoral incision, we could obtain adequate exposure for triple osteotomy and advancement of zygoma. 3. The zygoma should be reduced and fixed in an overcorrected superior and medial direction. 4. Return of zygoma to its anatomical position was possible only when it is completely freed from the surrounding soft tissue including masseter. 5. We could not find any different results between autogenous calvareal bone graft and $Medpor^{(R)}$ insertion on the floor of orbit.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.103-113
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• 1990

The study was based on a series of 252 patient with facial bone fractures who visited to Chun Cheon Sacred Heart Hospital, College of Medicine, Hallym University during the period of Dec., 1984 trough Nov., 1989. The results obtained are as follows; 1. The most frequent etiologic factor was traffic accident(45.2%). 2. The ratio of male to female was 5.5 : 1 and 2nd decade(44%) was the highest age group in incidence. 3. Monthly incidence was the highest in Aug(14.3%). 4. The most common site of fracture was mandible(55.3%) and zygoma complex(24.2%), nasal bone(11.6%), maxilla(8.9%) were next in order of frequeny. 5. In mandible fractures, the most frequent site was symphyseal area(36.9%) and 142 cases(85%) had fractures only in mandible. 6. In maxillary fractures, fracture with other facial bones(85.2%) was more frequent than fracture on maxilla only. The major fracture type on maxilla was Le Fort II type. 7. In fracture of zygoma complex, zygoma & zygomatic arch was the most frequent site(52.0%) and zygomatic arch(24.7%), zygoma(23.3%) were next in order. 8. Open reduction was major method of treatment in facial bone fractures except nasal bone ; mandible(62.9%), maxilla(77.8%), zygoma complex(65.8%). 9. Maxillofacial fractures were most frequently combined with head & neck injury(43.1%), and upp. & low. extremities(29.4%), chest and abdomen(11.9%) were in order of frequency.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.43-47
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• 2011

Purpose: Sensory impairment in infraorbital nerve is common symptom following mid-facial fractures. The purpose of this study is to document the incidence of sensory impairment in infraorbital nerve following midfacial fractures and its recovery. Methods: Three hundreds fourteen patients with midfacial fracture were included involving emergence areas of infraorbital nerve. Fractures were classified into zygoma fracture, maxilla fracture, complex comminuted fracture and pure blow out fracture. Neurosensory function was assessed with clinical symptoms and light touch test in infraorbital nerve regions. Patients were followed and sensory function was evaluated immediately, 1, 3 and 6 months after trauma. Results: The total series consisted of 198 zygoma fractures, 19 maxilla fractures, 30 complex comminuted fractures and 67 pure blow out fractures. The incidence of sensory impairment was 60% (63% in zygoma fractures, 84% in maxilla fractures, 93% in complex comminuted fractures, 31% in pure blow out fractures). Persistent sensory impairments were remained in 32% (33% in zygoma fractures, 47% in maxilla fractures, 73% in complex comminuted fractures, 6% in pure blow out fractures) 6 months after trauma. Younger patients had better prognosis than older patients in recovery of infraorbital nerve function ($p$ <0.05, $x^2$-test). Mean recovery time was 11 weeks. Conclusion: The incidence of post-traumatic sensory impairment was different according to fracture types. Age of patients and fracture type were important factors that influence to recovery of sensory impairment. Complex comminuted fracture had poor prognosis, and pure blow out fractures had better prognosis than other fractures.

• Archives of Craniofacial Surgery
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• v.17 no.4
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• pp.206-210
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• 2016

Background: Zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. Zygoma fractures are classified according to Knight and North based on the direction of anatomic displacement and the pattern created by the fracture. In zygomaticomaxillary complex (ZMC) fracture many incisions (lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary, subtarsal, intraoral, direct percutaneous approach) are useful. We reviewed various approaches for the treatment of ZMC fractures and discussed about incisions and fixation methods. Methods: A retrospective review was conducted of patients with ZMC fracture at a single institution from January 2005 to December 2014. Patients with single zygomatic arch fracture were excluded. Results: The identified 694 patients who were admitted for zygomatic fractures from which 192 patients with simple arch fractures were excluded. The remaining 502 patients consisted of 439 males and 63 females, and total 532 zygomatic bone was operated. Orbital fracture was the most common associated fracture. According to the Knight and North classification the most frequent fracture was Group IV. Most fractures were fixated at two points (73%). Conclusion: We reviewed our cases over 10 years according to fracture type and fixation methods. In conclusion, minimal incision, familiar approach and fixation methods of the surgeon are recommended.