A simple zygomatic fracture is a hairline break in the zygoma, or cheekbone. Complex fractures may include the cheekbone and part of the orbit of the eye. If the fracture has caused a piece of the cheekbone to move or become displaced, plastic surgery may be needed to restore the pieces of zygoma bone to its original location. Non-displaced fractures are usually treated with ice and pain medications. Receiving prompt medical care may avoid permanent disfigurement, nerve damage, and vision problems.
Most people find that swelling, bruising, and pain are common after a cheekbone fracture. Displaced bone fragments can cause increased pressure on ocular nerves and may cause an intraorbital hemorrhage, resulting in vision problems. Some people may not be able to chew due to restricted masseter muscle movement. Displaced bone fractures may cause the face to look different, and the most common disfigurement is called a dishpan face because of the concave cheekbone.
Complex zygomatic fractures usually require surgery to restore bone stability and a normal appearance. The reconstructive surgery is performed within three weeks of the injury that caused the fracture. In addition to correcting the symmetry of the face, the surgery should restore nerve function and enable the patient to chew comfortably again. It will also relieve pressure on the occipital orbit, correcting the vision problems some people have after the fracture occurs.
The plastic surgeon will likely use a transoral approach during surgery to repair the zygomatic fracture. Transoral means the surgeon will make an incision inside the mouth to access the fractured bone. This technique reduces visible scarring from the operation. A second incision near the eye orbit may be necessary if a piece of the zygoma bone has been displaced into the orbital rim. Stabilization of the fracture may require titanium plates and screws to be implanted.
Immediately after the surgery, the oral wound is packed with gauze and a compression wrap may be put on the face to reduce swelling. Painkillers will be prescribed for up to ten days after the operation. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) will then be recommended to relieve any residual pain and inflammation.
A person with a healing zygomatic fracture should avoid some activities. Until the fracture has completely healed it is very important not engage in nose blowing. It could force air into the eye orbit and cause blindness. Sports and any other vigorous activity should be avoided until the doctor has released the person to normal activities.
