Module 5 - Head and Neck

Craniomaxillofacial Trauma

Zygomatic Fractures


1. Overview

  • Articulates with the frontal bone superiorly, maxilla medially & maxillary alveolus inferiorly, temporal bone laterally, and sphenoid bone in the lateral orbit
  • Fractures occur least frequently at the FZ suture. When minimally displaced at FZ suture, ORIF without fixation is frequently possible
  • Fractures with inward displacement may impede mandibular function by impinging on coronoid process
  • Second most common facial fracture
  • Forms the lateral and inferior orbital rim and malar eminence
  • With the exception of isolated arch fractures, always include orbital floor
  • Displaced fractures are treated surgically

2. Signs & Symptoms of Zygomatic Fractures

  • Periorbital and subconjunctival hemorrhage/ hematoma
  • V2 numbness
  • Ipsilateral epistaxis (due to maxillary sinus mucosa tear)
  • Asymmetry with inferior malar +/- malocclusion
  • Infraorbital rim step deformity with pain & tenderness

3. Emergency Room Treatment

  • Rule out other injuries
  • Assess visual acuity and range of EOM movement
  • Assess occlusal function
  • X-rays

4. Radiographic Examination

  • Plain x-rays (Cadwell, Water's, Submental vertex)
  • CT Scan

 

Author: Dr. R. Bendor-Samuel