The zygomatic arch, also known as the cheekbone, is a bony protrusion of the skull that connects to the lower eye socket and the maxilla. It is part of the zygomatic maxillary complex and is present in many vertebrates. Zygomatic fractures are common and can cause permanent facial disfigurement if left untreated. Plastic surgery is used to repair the fracture using mini-plates or micro-plates.
In vertebrates, the zygomatic arch is a curved bony protrusion of the skull that extends along the outer edge of the lower eye socket from the temple to the maxilla or maxilla. It is more commonly called the cheekbone, but is also known as the cheekbone or malar bone. The term “zygomatic” derives from the Greek word “zugoma”, which means bar, bolt or yoke, because the shape of the bone structure resembles that of a yoke used to harness oxen.
The zygomatic arch is located just in front of the ear and is one part of a three-part structure that also includes the orbit – the eye socket – and the temporal bone. The zygomatic arch is connected to the mandible – the lower jaw – at the temporomandibular joint and is the origin of the masseter muscle. The entire zygomatic skeletal structure is collectively known as the zygomatic maxillary complex. Besides being part of the human skull, the zygomatic arch is also present in the skeletal facial structures of other vertebrates such as cats, dogs, horses, cows, and more.
Zygomatic arch fractures are among the most common facial injuries, second in frequency only to nasal fractures. The most common causes of zygomatic fractures are high-impact trauma such as automobile accidents, sports injuries, assaults, and falls. The cheekbone connects to the skull at four points, so this type of injury is also called a tetrapod fracture, in which all four connection points are broken; or a tripod fracture, where three of the four connection points are broken. In an isolated zygomatic arch fracture, only one connection point is broken.
The first documented treatment of zygomatic fractures dates back to 3000 BC Guillaume Dupuytren, Howard Lothrop and William Keen, the pioneers of modern zygomatic facial surgery, practiced their techniques in the 18th and 19th centuries. A traction procedure for zygomatic repair was pioneered by Dr. Louis Stroymeyer in 18 and is still in use today. In 19, Dr. Harold Gilles began to conceal the facial incisions required to repair zygomatic hairline fractures, thereby reducing the prominence of facial scars.
Fracture repair of the zygomatic malar complex is usually done by a plastic surgeon. In this procedure, mini-plates or micro-plates are inserted through facial incisions to stabilize the bone or bones for healing. Failure to repair a zygomatic tear can result in permanent facial disfigurement such as lockjaw, which is a flattening of the face; asymmetry of the cheekbones; and a change in the shape and size of the mouth.
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