A marginal process of the zygomatic bone predicts a lateral exit of the zygomaticotemporal nerve: An anatomical study with application to surgery around the midface

Abstract

Previous studies have not verified the contents of accessory foramina of the zygomatic bone on dry skulls and thus could not conclude whether they carried accessory zygomaticofacial nerve branches or branches or the entire trunk of the zygomaticotemporal nerve (ZTN). Therefore, the aim of the current study is to present findings from cadaveric dissections to clarify this relationship. Fifty, fresh frozen, adult cadaveric sides underwent dissection of the ZTN. When identified, these nerves were quantified and their relationship to the zygomatic bone further documented by dissecting through the bone following the course of the nerve from a superficial to deep perspective. Additionally, 100 dry, adult, human skulls were analyzed looking for lateral foramina on the zygomatic bone. On three cadaveric sides (6%), the ZTN was found to pierce the zygomatic bone deeply and exit its superficial lateral surface. For dry skull specimens, a lateral zygomaticotemporal foramen (ZTF) was identified on nine sides (4.5%). For both groups, the presence of a strong marginal process of the zygomatic bone was strongly correlated to a ZTF exiting the lateral surface of the zygomatic bone. Although relatively uncommon, the ZTN can pierce the lateral aspect of the zygomatic bone and thus can be located superficial to the cheek. Such findings should be borne in mind during surgical or other invasive procedures in this area in order to minimize iatrogenic injury to the ZTN.

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

“…The nerves passing within type II canals are unknown, and identifying the nerves running along these courses is of great interest. Siddiqui et al [ 38 ] recently reported that, though relatively uncommon, the ZTN can pierce the marginal process (marginal tubercle) of the zygomatic bone and can thus be located superficially to the cheek region. All ZFFs that were classified as type II in the present study were located near the posterior margin of the FPA; thus, type II canals likely harbor the ZTNs that innervate the cheek.…”