Evaluation of the Zygomaticofacial Foramen Through Computed and Cone Beam Computed Tomography Imaging

The zygomaticofacial foramen (ZFF) serves as a critical anatomical landmark in zygomatic implant surgery and facial flap procedures. This study aimed to compare the effectiveness of computed tomography (CT) and cone-beam computed tomography (CBCT) in visualizing the ZFF, and to determine which imaging modality provides greater reliability for clinical and surgical planning.

A total of 100 CT and 100 CBCT scans were retrospectively analyzed, providing radiological data from 400 zygomatic bones. The number and location of ZFFs were assessed by 2 independent observers. The relationship between ZFF number and variables such as side, sex, and age was statistically analyzed.

Computed tomography and CBCT detected a comparable number of foramina (270 and 267, respectively), with no statistically significant difference between the modalities (P > 0.05). A significant correlation between right and left sides was observed (r = 0.672, P < 0.001), indicating a tendency for bilateral symmetry. The most common finding was the presence of a single foramen (48%), followed by 2 foramina (31.2%). Females exhibited a significantly greater number of foramina than males (P = 0.012), whereas age showed no significant correlation.

Both CT and CBCT provide comparable accuracy in detecting the ZFF. This finding is clinically significant as it provides an evidence-based rationale for selecting CBCT, a modality with a lower radiation dose and reduced cost, for preoperative evaluation. These results confirm that clinicians can confidently use CBCT for individualized, imaging-based surgical planning to minimize neurovascular complications without sacrificing diagnostic reliability.