Orbital bone. The temporal process of the zygomatic bone

One of the paired elements of the facial part of the skull is the orbital bone. It forms the zygomatic arch, which is the border of the fossa temple.

Structure

Zygomatic bone is a rectangular flat element. It holds the facial (visceral) part of the skull with its brain Department. In addition, it connects the maxillary bone with the sphenoid, temporal and frontal. All this creates for her steady support.

There are three surfaces that comprise the zygomatic bone. Anatomy secretes the buccal (lateral), temporal and orbital parts.

The First of these convex. She with the help of three processes connected with the maxillary bones, the frontal and temporal lobes. The orbital portion is involved in the formation of the lateral wall of the orbit and part of her bottom. Temporal lobe is involved in the formation of the wall of the infratemporal fossa, and its plane turned back.

Surface of the zygomatic bone

Orbital part smooth, it participates in the formation of the anterior orbit, namely part of its outer wall and the lower portion. Outside this surface moves in labeoninae process, and in front it is bounded by the infraorbital region. It also placed special zygoma-orbital hole. Orbital surface of the frontal bone contains well-marked elevation.

Temporal surface facing the inside and back. It participates in the formation of the anterior wall of the fossa temple. Is zygoma-temporal hole. The temporal process of the zygomatic bone, extending from the rear of its corner, is connected with the zygomatic process of the temporal bone. Together they form the zygomatic arch. Between them is the so-called temporo-zygomatic suture.

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Another separate surface of the bone is the zygomatic. It is smooth, convex shape with a special hill and zygoma-facial hole. The upper semicircular edge of the boundary of the entrance to the socket side and bottom. Labeoninae process (considered to be a part of it) is verkhnesolenyy the area of the specified surface. In the front part it is extended more than the rear. Zygomatic process of the frontal bone is connected with it. Between them is colourplates seam. It is located on the rear edge of the upper third of the bone, called the skull.

Also zygomatic bone bonded with a large wing bone called the sphenoid. Their connection forms a wedge-zygomatic suture.

Features

Due to the size of this element of the facial skull, its shape and corners, which are formed with front surfaces that define the body type, sex, race, and age.

Experts note the 2 stages of development of the zygomatic bone: connective tissue and bone. It is noteworthy that the 2-3 area of ossification appear in the first trimester of pregnancy. They are already on the 3rd month of fetal development.

It is Also noteworthy that through the orbital part of the bone using a thin probe is accessed via a perforating channel in the bone in the zygoma-the temporal and zygoma-facial orifice.

Injury

When you face injuries and you can't exclude a fracture of the zygomatic bone. It is characterized by the deformation and retraction of the respective area. In ninegates part and in the area of the zygomatic arch can be seen the so-called step. At the same problems appear when trying to open your mouth or make lateral movement of the lower jaw. Also, fractures are accompanied by hemorrhages in the retina and loss of sensation, numbness in the infraorbital nerve area.

If the zygomatic bone was displaced greatly, it may nosebleeds from the part on the same side and visual impairment that patients describe as double vision. But accurate diagnosis is possible only after x-ray examination.

Treatment Methods

If the fact of the zygomatic bone fracture was confirmed in the picture, it means that it is necessary to restore its anatomical integrity. This is done with repositioning of the fragments in the correct position. After that, they should still fix. If there was no offsets, the treatment is limited to pharmacological therapy and physiotherapy.

Surgical recovery

Surgery is required only in exceptional cases. These include a situation where the zygomatic bone of the skull was fractured, and the processes of the offset.

All surgical interventions can be divided into intraoral and extraoral. Quite well known are the methods of Limberg, Gillies, Dingman. They belong to Waretown methods.

In some cases, to restore its integrity through an incision in the mouth. If the zygomatic bone is fixed with titanium mini-plates, it gives the most stable results.

After conducting any of the types of interventions it is important to avoid possible displacement of fragments of bone. For this it is necessary to limit the movement of the mouth, to eat liquid and soft foods, do not sleep on the affected side of the face.

Description vertovec methods

The Method of Limberg is that through a special puncture (sometimes, however, make a small cross incision) in the lower edge of the zygomatic arch in the cavity of the injected single-toothed hook. The integrity of the bone is reconstructed the movement that is done in the opposite direction of displacement. When it is matching and installed in the correct position you hear a click. It restores symmetry to the face. Also disappearing stair, which was located at the lower edge of the orbit.

In order to restore the integrity of the surface and to put in place the temporal process of the zygomatic bone, the method can be used Gillies. The surgeon makes an incision in the scalp. However, he cuts through the skin, subcutaneous tissue and the temporal fascia. Through the incision, a Elevator under the zygomatic arc or bone, it is introduced under gauze. Then a special tool used as a lever, Outlook is installed in the correct position.

By the method of Dingman in the infratemporal fossa is made through an incision of 1.5 cm is injected retractor. Dissection is done in the area of the lateral portion of the eyebrow. In this case, after restoring the integrity of the surface of the bone at the author recommended to apply wire suture at the lower edge of the orbit, where the frontal process of the zygomatic bone.

Intraoral methods

If you need to remove some svobodnaia bone fragments, blood clots, parts of the mucous membrane, that developed other means of surgical procedures. This is only possible when conducting intraoral operations, which is a revision of the maxillary sinus.

To restore the integrity of the bone incision in the area of the transition folds of the alveolar process. While peeled periosteal-a mucous flap. This is done using a retractor or blade buialskyi, who performed under the temporal process of the zygomatic bone.

When performing the indicated operation, it is also possible to reposition of fragments of the bottom of the sockets. To do this in the appropriate place iodoformi sinus swab. It needs to fill tight in order to hold bone elements for 10-14 days in the right position. The end of this swab is displayed in the lower nasal passage. For this we first impose anastomosis.

To Lock the plane of bone into the correct position using titanium mini-plates or wire seam, the blend in the center of the frontal bone, the lower edge of the supraorbital ridge, called the zygoma-alveolar. But the first method is considered more reliable.

Special cases

In some situations it is necessary to use implants. They are placed in the bone tissue defects. Often doctors recommend in special cases, the use of ceramic implants based on hydroxyapatite combined with titanium plates.

When indicated can be performed decompression of the infraorbital nerve. This is done using the release channel and move it into orbit. To correct bone defects of the alveolar crest can be used implants made of titanium nickelide. This requires the restoration of the epithelial lining of the sinuses by using flaps from the cheek or transplant from the sky. This tactic allows to reduce the risk of maxillary sinusitis, which can develop after injury.

Using exposed seams, can be fixed to the zygomatic arch. For this sew it to the plate, made of fast-hardening plastic. Under it necessarily pave iodoform gauze. It helps to avoid bedsores.