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Related Experiment Video

Updated: May 19, 2026

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla

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Published on: October 18, 2021

Anatomic Variations of the Zygomatic Arch: Rethinking the Indications for the Orbitozygomatic Approach.

Daisuke Nakashima¹, Tetsuya Negoto¹, Nobuyuki Takeshige¹

¹Department of Neurosurgery, Kurume University of Medicine.

Neurologia Medico-Chirurgica

|May 17, 2026

Summary

This summary is machine-generated.

Temporary zygomatic arch removal (zygomectomy) can be avoided in certain brain surgeries. A "Low-set Zygoma" anatomical feature, identified via CT scans, indicates when a less invasive surgical approach may suffice, reducing potential complications.

Keywords:

Low-set Zygoma middle cranial fossa orbitozygomatic approach pterional approach zygomatic arch

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Area of Science:

Neurosurgery
Anatomy
Radiology

Background:

The orbitozygomatic approach offers wider surgical exposure but is more invasive than the pterional approach, sometimes necessitating zygomatic arch removal (zygomectomy).
Avoiding zygomectomy can reduce surgical invasiveness and potential complications.
The anatomical feasibility of achieving adequate exposure without zygomectomy depends on the zygomatic arch's position relative to the middle cranial fossa floor.

Purpose of the Study:

To introduce and examine the clinical and anatomical relevance of a
Low-set Zygoma" concept.
To determine if adequate surgical exposure can be achieved without zygomectomy in specific anatomical variations.
To identify predictors for the presence of a Low-set Zygoma.

Main Methods:

Analysis of high-resolution cranial computed tomography (CT) scans from 105 adults to measure the vertical distance between the zygomatic arch and the middle cranial fossa floor.
Definition of "Low-set Zygoma" as a middle cranial fossa height of ≥ -3.0 mm.
Stratification into "Low-set Zygoma" and "non-Low-set Zygoma" groups, with statistical analysis of demographic variables and clinical outcomes from three pterional approaches performed in patients with Low-set Zygoma.

Main Results:

A "Low-set Zygoma" was defined based on CT measurements, with the mean vertical distance being -2.36 mm.
Three pterional approaches were successfully performed in patients with "Low-set Zygoma" without complications, achieving adequate exposure.
Adult body height was the sole independent predictor (p = 0.037); individuals shorter than 162.5 cm were more likely to have a "Low-set Zygoma".

Conclusions:

A "Low-set Zygoma" is a reliable anatomical indicator for potentially avoiding unnecessary zygomectomy during orbitozygomatic approaches.
This finding supports more individualized preoperative planning in neurosurgery.
Identifying patients with "Low-set Zygoma" may lead to less invasive surgical strategies and improved patient outcomes.