Various surgical approaches and treatment strategies have been proposed to obtain successful treatment outcome, including the Gilles temporal approach, coronal, eyebrow, upper eyelid, transconjunctival, infraciliary lower eyelid, and intraoral vestibular approaches. Zygomatic complex fractures with no or minimal displacement are often treated without surgical intervention, whereas fractures with functional or esthetic impairments in the form of diplopia, extraocular muscle entrapment, malocclusion, restricted mouth opening and/or depression of the malar prominence often necessitate surgical intervention. The integrity of the zygomatic complex is fundamental in maintaining normal facial width and prominence of the cheek. Diagnosis of zygomatic complex fractures is usually clinical, with confirmation by computed tomography (CT) scan. The main clinical features of zygomatic complex fractures include diplopia, enophthalmos, subconjunctival ecchymosis, extraocular muscle entrapment, cosmetic deformity with depression of the malar eminence, facial widening, malocclusion and neurosensory disturbances of the infraorbital nerve. However, there is geographic and sociodemographic variation in the epidemiology of maxillofacial fractures due to socioeconomic, cultural and environmental factors. The etiology of zygomatic complex fractures primarily includes road traffic accidents, violent assaults, falls and sports injuries. Fracture of the zygomatic complex is one of the most common facial injuries in maxillofacial trauma and predominately appears in young adult males. The zygomatic complex is responsible for the protection of the orbital contents and the mid-facial contour. The zygomatic bone defines the anterior and lateral projection of the face and articulates with the frontal, sphenoid, temporal, and maxillary bones.
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