Fractured Cheekbone (Zygoma)
The zygoma (or cheekbone) is the name given to the bone that forms the prominence of the cheek. It also forms part of the eye socket (lateral and inferior margins) and connects to the frontal bone (forehead) and maxilla (upper jaw).
Zygomatic fractures may involve only a projection on the side of the face (zygomatic arch fracture) or they may involve the complete bone (zygomatic complex fractures).
Isolated zygomatic arch fractures present with a depression (dent) in front of the ear, and may also cause pain and limited opening of the jaw.
Zygomatic complex fractures usually also involve the zygomatic arch but may additionally cause blindness or altered vision if involving the eye socket (orbit), altered sensation over the cheek and maxillary (upper) anterior teeth on the side of the fracture, pain and altered facial symmetry. Bleeding into the maxillary sinus associated with these injuries may also drain through the nose, mimicking a nose bleed (epistaxis).
A CT scan is necessary for thorough assessment of the extent of the injury and may help guide the decsision regarding surgery.
Surgery for an isolated zygomatic arch fracture usually does not involve the use of plates and screws.
Surgery for a zygomatic complex generally involves the use of plates and screws to hold the bone in its correct position and may need to be placed at multiple sites where the zygomatic bone articulates (joins) with other bones. If the orbit is also fractured it may be necessary to reconstruct this area too. The implants used are not generally removed and are quite safe in the longer term.
Following surgery swelling may take several weeks to resolve. Sensation to the cheek and teeth usually improves but will usually take months.
Follow-up is required in the postoperative period and depending upon the injury and progress following surgery may be required for up to 6 months.