Anat Cell Biol.  2024 Jun;57(2):204-212. 10.5115/acb.23.293.

Anatomical study of the zygomaticofacial foramen and zygomatic canals communicating with the zygomaticofacial foramen for zygomatic implant treatment: a cadaver study with micro-computed tomography analysis

• Kawata K
• Ide Y
• Sunohara M

• KMID: 2556564
• DOI: http://doi.org/10.5115/acb.23.293

Abstract

In the present study, anatomical assessment of zygomaticofacial foramina (ZFFs) and zygomatic canals communicating with ZFFs were performed using cadaver micro-computed tomography images. It was suggested that all ZFFs were located above the jugale (Ju)-zygomaxillare (Zm) line, which is the reference line connecting the Ju and Zm, and most were located in the zygomatic body area (ZBA). The anteroposterior position of the ZFF in the ZBA was within a middle to posterior region and was most often located slightly posteriorly in males and closer to the middle of the region in females. The mean distance from the Ju-Zm line to the ZFF in the ZBA was 12.36 mm (standard deviation [SD] 1.52 mm) in males and 11.48 mm (SD 1.61 mm) in females. In zygomatic canals communicating with ZFFs, most zygomatic canals were type I canals, communicating from the zygomaticoorbital foramen and harboring the zygomaticofacial nerve, and the others were type II canals, communicating from the zygomaticotemporal foramen and located near the posterior margin of the frontal process. These results provide useful anatomical information for preventing nerve injury during surgical procedures for zygomatic implant treatment.

Keyword

Zygomatic implants; Zygomaticofacial nerve; Zygomatic canal; Zygomaticofacial foramen; Micro-computed tomography

Figure

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  Fig. 1 Schema of two branches (ZFN and ZTN) of the zygomatic nerve passing through the zygomatic bone. ZFN, zygomaticofacial nerve; ZTN, zygomaticotemporal nerve; ZOF, zygomaticoorbital foramen; ZTF, zygomaticotemporal foramen; ZFF, zygomaticofacial foramen.

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  Fig. 2 Micro-CT images of zygomatic foramina. Slices of images obtained at the ZOF (A), ZTF (B), and ZFF levels (C, D), and a 3D image (E) of the zygomatic bone are shown. The ZOF, ZTF, and ZFF are identified on slice images, and the diameter of the ZFF is measured (D). ZOF, zygomaticoorbital foramen; ZTF, zygomaticotemporal foramen; ZFF, zygomaticofacial foramen; CT, computed tomography; 3D, three-dimensional.

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  Fig. 3 Assessment of the location of the ZFF. The Ju-Zm line, which connects Ju and Zm, is established as a reference for zygomatic implant placement. Division of the lateral surface into three areas (FPA, ZBA, TPA) allows investigation of the location of the ZFF (A). To determine the anteroposterior location of the ZFF in the ZBA, the zygomatic bone is anteroposteriorly divided into five equal parts (A, AM, M, PM, P) based on the Ju-Zm to facilitate anteroposterior location assessment (B). Determining the location of the ZFF in the ZBA facilitates measuring the distance between the Ju-Zm line and ZFF (C). ZFF, zygomaticofacial foramen; Ju, jugale; Zm, zygomaxillare; FPA, frontal process area; ZBA, zygomatic body area; TPA, temporal process area; A, anterior area; AM, anterior middle area; M, middle area; PM, posterior middle area; P, posterior area.

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  Fig. 4 Assessment of zygomatic canals communicating with ZFFs. A 3D representation of zygomatic canals is shown in (A). The zygomatic canal communicating with the ZFF is the focus of the present study (B). The canal is classified as either type I or II, depending on whether its course communicates with the ZOF. *Type I canals are further classified as type Ia (98 canals) or Ib (60 canals), depending on whether they communicate with the ZTF. The courses of type Ia, Ib, and II canals are shown in (C). ZOF, zygomaticoorbital foramen (green arrowheads); ZTF, zygomaticotemporal foramen (blue arrowheads); ZFF, zygomaticofacial foramen (orange arrowheads); 3D, three-dimensional.

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  Fig. 5 Diameter of the ZFF. ZFF, zygomaticofacial foramen. There is no significant difference between males and females (P>0.05, t-test).

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  Fig. 6 Location of the ZFF in three zygomatic bone regions: the ZBA, FPA, and TPA (see Fig. 3A). ZFF, zygomaticofacial foramen; ZBA, zygomatic body area; FPA, frontal process area; TPA, temporal process area. No significant difference between males and females is observed (P>0.05, chi-squared test).

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  Fig. 7 Anteroposterior location of the ZFF in the ZBA in the following five areas: A, AM, M, PM, and P (see Fig. 3B). ZFF, zygomaticofacial foramen; ZBA, zygomatic body area; A, anterior area; AM, anterior middle area; M, middle area; PM, posterior middle area; P, posterior area. A significant difference between males and females is seen (P<0.05, chi-squared test).

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  Fig. 8 Distance between the Ju-Zm line and the ZFF in the ZBA (see Fig. 3C). ZFF, zygomaticofacial foramen; Ju, jugale; Zm, zygomaxillare; ZBA, zygomatic body area. *P<0.05 (t-test).

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  Fig. 9 3D micro-CT images of zygomatic canals communicating with ZFFs in several cases. Zygomaticoorbital foramen (green arrowheads), zygomaticotemporal foramen (blue arrowheads). ZFF, zygomaticofacial foramen (orange arrowheads); 3D, three-dimensional; CT, computed tomography.

Reference

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