Research Article

Zygomaticofacial and zygomaticoorbital foramen - Morphological study of dry of South Indian population Ritya Mary Jibu, M. S. Thenmozhi, Ganesh Lakshmanan*

ABSTRACT

Introduction: The zygomaticofacial foramen is a small opening and it pierces the malar surface of the convex zygomatic near its center. The zygomaticoorbital foramen is two channels in the that let nerves pass through. Materials and Methods: A total of 50 dry human skulls were used and they were probed. Results and Discussion: After probing the zygomaticofacial foramen, it is found that the probe exits from two other foramens – the zygomaticoorbital foramen and the zygomaticotemporal foramen. Conclusion: Majority of the South Indian population have the zygomaticoorbital foramen as the exit of the zygomaticofacial foramen while only a minority had the zygomaticotemporal foramen as the exit.

KEY WORDS: Foramen, Probe, Zygomaticofacial, Zygomaticoorbital, Zygomaticotemporal

INTRODUCTION MATERIALS AND METHODS The zygomaticofacial foramen is a small opening and A total of 50 dry adult human skulls from the it pierces the malar surface of the convex zygomatic Department of Anatomy, Saveetha Dental College, were bone near it’s center.[1] The zygomaticoorbital used for the study. The number of zygomaticofacial foramen is two channels in the skull that let nerves and zygomaticoorbital foramen will be noted and their pass through.[2] Zygomatic nerves and vessels pass incidence on the right and left side will be calculated. through this foramen. The additional knowledge of Their bifurcations and patencies will be probed and this foramen might lead to reduction in the patient’s studied. Those which led only to zygomaticotemporal morbidity during invasive procedure.[3] To avoid will not be studied. The distribution and incidence will injuries to the nerves and vessels, this foramen acts as be further evaluated for any significance. an important landmark for clinical diagnosis.[4] Appropriate probes which are thin but strong and Zygomaticoorbital foramen is present on the inferolateral also flexible were chosen specially for probing to go wall of the . It is an important anatomical structure, through the above-mentioned foramens. especially during retrobulbar anesthesia[5] and also ophthalmologists. The zygomaticoorbital foramen is a potential source of hemorrhage[6], especially during deep lateral incisions near the orbit.[7]

The detailed knowledge of these foramens will help the surgeons in better performance of maxillofacial surgery. It might also lead to very minimal surgical risk. It also helps in identifying the extent of operative field.

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Department of Anatomy, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India

*Corresponding author: Dr. Ganesh Lakshmanan, Department of Anatomy, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai - 600 077, Tamil Nadu, India. Mobile: +91-9894999243. E-mail: [email protected]

Received on: 05-11-2018; Revised on: 09-12-2018; Accepted on: 14-01-2019

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Figure 1: Skulls showing their respective exits (50 skulls)

RESULTS in place or area of occurrence.[12] However, from the population considered here (South Indian population), After probing the zygomaticofacial foramen, the main foramen of exit is the zygomaticoorbital it is found that the probe exits from two other foramen. There could also be a Vice versa of numbers foramens – the zygomaticoorbital foramen and with an other set of people. the zygomaticotemporal foramen. Of 50 observed skulls, 31 skulls showed exit of the probe through the CONCLUSION zygomaticoorbital and 11 skulls showed the exit of the probe through the zygomaticotemporal foramen. From the results, we can find out that a majority of the However, eight skulls did not have a prominent exit South Indian population have the zygomaticoorbital for the probe. foramen as the exit of the zygomaticofacial foramen while only a minority had the zygomaticotemporal DISCUSSION foramen as the exit. This shows that there are interconnected structures passing through these A majority of the probes came out of foramens. There are chances that with the change in zygomaticoorbital foramen when probed through population, there can be a change in the exit of the zygomaticofacial foramen. A few skulls did not foramens when probed. seem to have an appreciable exit due to ossification overtime. The structures passing through the REFERENCES zygomaticofacial foramen are the and vessels, whereas the structures passing 1. Mangal A, Choudhry R, Tuli A, Choudhry S, Choudhry R, Khera through the zygomaticotemporal foramen are the V, et al. Incidence and morphological study of zygomaticofacial and zygomatico-orbital foramina in dry adult human skulls: The [8,9] zygomaticotemporal nerve. The exits can show non-metrical variants. Surg Radiol Anat 2004;26:96-9. that in the South Indian population, majority of the 2. Loukas M, Owens DG, Tubbs RS, Spentzouris G, Elochukwu skulls have the zygomaticoorbital foramen as their A, Jordan R, et al. Zygomaticofacial, zygomaticoorbital and exits when probed through the zygomaticofacial zygomaticotemporal foramina: Anatomical study. Anat Sci Int 2008;83:77-82. foramen while only a minority or a less amount of the 3. Pinho C, Choupina M, Silva P, Ferreira P. A new retroauricular population have the zygomaticotemporal foramen as Flap for Facial Reconstruction. Br J Plast Surg 2003;56:599- the exit. Figure 1 shows the numbers which show the 602. result. Of 50 skulls, 16% (i.e., 8 skulls) do not have a 4. Aksu F, Ceri NG, Arman C, Zeybek FG, Tetik S. Location and incidence of the zygomaticofacial foramen: An anatomic study. proper exit; 22% (i.e., 11 skulls) show exit from the Clin Anat 2009;22:559-62. zygomaticotemporal foramen and 62% (i.e., 31 skulls) 5. Martins C, Li X, Rhoton AL Jr. Role of the zygomaticofacial have the zygomaticoorbital foramen as their exit. foramen in the orbitozygomatic craniotomy: Anatomic report. Neurosurgery 2003;53:168-72. This can mean that there are structures passing through 6. Ellis E 3 rd, el-Attar A, Moos KF. An analysis of 2,067 cases of zygomatico-orbital fracture. J Oral Maxillofac Surg 1985; these foramens which could be interconnected or it 43:417-28. could also mean that these foramens are interconnected 7. McCann PJ, Brocklebank LM, Ayoub AF. Assessment of among themselves.[10] A few of the skulls used had no zygomatico-orbital complex fractures using ultrasonography. exits as the exits had ossified with time.[11] However, Br J Oral Maxillofac Surg 2000;38:525-9. there are chances that with change in population, there 8. Gomes PP, Passeri LA, Barbosa JR. A 5-year retrospective study of zygomatico-orbital complex and zygomatic arch could be a change in the result numbers too as the skulls fractures in Sao Paulo state, Brazil. J Oral Maxillofac Surg and their morphology can slightly differ with change 2006;64:63-7.

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