The Incidence of the Zygomatico-orbital Foramen and the Importance of Its Location in Surgical Approaches

Yıl 2022, Cilt: 4 Sayı: 1, 49 - 54, 01.01.2022

Gkionoul Ntelı Chatzıoglou , Osman Coşkun , Adnan Öztürk , Ayşin Kale , Özcan Gayretli

https://doi.org/10.37990/medr.983113

Öz

Aim: The present study aimed to reveal the frequency of the zygomatico-orbital foramen (ZOF) in the zygomatic bone, its location, and its connection with the zygomatico-orbital foramen (ZFF) and zygomaticotemporal foramen (ZTF).
Material and Method: Ethics committe eapproval of our study was received by the Istanbul Medical Faculty Clinical Research Ethics Committee. Fifty (27 right; 23 left) hemicraniums of Istanbul University, Department of Anatomy of unknown gender were included in the study. Connections with ZOF were determined by passing fine wire through ZTF and ZFF. The closest point of the ZOF to the orbital rim was measured. The distance from the area used for retrobulbar injections (defined as the point where the 1/3 inferolateral edge and 2/3 inferomedial edge of the aditus orbitalis intersect.) to the ZOF was measured. All measurements were measured with a digital caliper and the data were evaluated with SPPS v.21.
Results: The number of ZOF was found 46 (51.68%) on the right and 43 (48.32%) on the left side. ZOF, was found to be single in 18 (36%) orbits, double in 16 (32%) orbits, 3 (18%) in 9 orbits, and 4 (6%) in 3 orbits. ZOF was absent in 4 (8%) orbits. Of 89 ZOFs, 37 (20 right; 17 left) were found to be associated with (via a channel) ZFF and 16 (8 right; 8 left) with ZTF. It was noted that 36 (18 right; 18 left) ZOF had no connection with any foramina. The closest distance of ZOF to the orbital rim was 4.54±2.33 mm and the distance to the retrorobulbar injection area was 7.89±2.98 mm.
Conclusion: The location and variations of FZO may be helpful in preventing complications during retrobulbar injection, lateral orbitotomy approach for intraorbital tumors, and during surgical interventions such as repair of zygomatic fractures.

Anahtar Kelimeler

Zygomatico-orbital foramen, zygomaticofacial foramen, zygomaticotemporal foramen, zygomatic bone, retrobulbar injection

Kaynakça

• Standring, Susan, ed. Gray's anatomy e-book: the anatomical basis of clinical practice. Elsevier Health Sciences 2020;483-502.
• Aziz KM, Froelich SC, Cohen PL, et al. The one-piece orbitozygomatic approach: The Mac-Carty burr hole and the inferior orbital fissure as keys to techniqueand application. Acta Neurochir 2002;144:15–24.
• Gonzalez LF, Crawford NR, Horgan M, et al. Working area and angle of attack in three cranial base approaches: Pterional, orbitozygomatic and maxillary extension of the orbitozygomatic approach. Neurosurg 2002;96:144–9.
• Martins C, Li X, Rhoton AL Jr. Role of the zygomaticofacial foramen in the orbitozygomatic craniotomy: Anatomic report. Neurosurg 2003;53:168–172.
• Arıncı K, Elhan A. Anatomi. 5th edition. Baskı Güneş Tıp Kitapevleri Ankara. 2014;139
• Loukas M, Owens DG, Tubbs RS, et al. Zygomaticofacial, zygomaticoorbital and zygomaticotemporal foramina: anatomical study. Anat Sci Int 2008;83:77-82.
• Mangal A, Choudhry R, Tuli A, et al. Incidence and morphological study of zygomaticofacial and zygomatico-orbital foramina in dry adult human skulls: the non-metrical variants. Surg Radiol Anat 2004;26:96-9.
• Aksu F, Ceri NG, Arman C, et al. Location and incidence of the zygomaticofacial foramen: an anatomic study. Clin Anat 2009;22:559-62.
• Zhao Y, Chundury VH, Blandford AD, et el. Anatomical Description of Zygomatic Foramina in African American Skulls. Ophthal Plast Reconstr Surg 2017;20:1-4.
• Wartman CT, Loukas M, Tubbs RS. Zygomaticofacial, Zygomaticoorbital, and Zygomaticotemporal Foramina. Clin Anat 2009;22:637–8.
• Ferro A, Basyuni S, Brassett C et al. Study of anatomical variations of the zygomaticofacial foramen and calculation of reliable reference points for operation. Br J Oral Maxillofac Surg 2017;55:1035-45.
• Kim HS, Oh JH, Choi Dh et al. Three-dimensional Courses of Zygomaticofacial and Zygomaticotemporal Canals Using Microcomputed Tomography in Korean. J Craniofac Surg 2013;24:1565-8.
• Dwivedi D, Saxena A, Anurag, Yadav S. Zygomatıco-facial And Zygomatico –orbital Foramina: Morphological Study In Dry Adult Human Skulls. GJRA 2018;7:67-9.
• Celik S, Kazak Z, Ozer MA, et al. Navigational area of the cranio orbital foramen and its significance in orbital surgery. Surg Radiol Anat 2014;36:981–8.
• Patel P, Belinsky I, Howard D, et al. Location of the Zygomaticoorbital Foramen on the Inferolateral Orbital Wall: Clinical Implications. Orbit 2013;32:275-7.
• Babacan S, Güner N, Çini NT, et al. Foramen zygomaticoorbitale, Foramen zygomaticotemporale, Foramen zygomaticofaciale İnsidansı ve Foramen zygomaticofaciale için Güvenli Bölge Tayini. Harran Üniversitesi Tıp Fakültesi Dergisi 2018;15:111-5.
• Jibu RM, Thenmozhi MS, Lakshmanan G. Zygomaticofacial and zygomaticoorbital foramen-Morphological study of dry skulls of South Indian population. Drug Invent Today 2019;11.
• Trivellato PF, Arnez MF, Sverzut CE, et al. A retrospective study of zygomatico-orbital complex and/ or zygomatic arch fractures over a 71-month period. Dent Traumatol 2011;27:135-42.
• Vadim PN, Astakhov YS, Soloviev MM, et al. Zygomaticoorbital Fractures. Orbital Fractures. New York: Springer-Verlag Berlin Heidelberg 2015.
• Ch RR, Farzaliev IM, Akhundov AA, et al. Primitive neuroectodermal tumor of the zygomaticoorbital complex: A rare location and ways of surgical repair of the Area. Head Neck Tumors 2015;5:50-4.
• Coutinho DCO, Martins-Júnior PA, Campos I, et al. Zygomaticofacial, Zygomaticoorbital, and Zygomaticotemporal Foramina. J Craniofac Surg 2018; 29:1583-7.
• Mootha VV, Cowden TP, Sires BS, et al. Subperiosteal orbital hemorrhage from retrobulbar injection resulting in blindness. Arch Ophthalmol 1997;115:123–4.