How to Repair Old (Overlooked) Zygoma/Maxilla Bone when the Crack / Split Goes Through Infraorbital "Tunnel"?

How to avoid a damage of infraorbital nerve during surgery of that place. Is it possible in that case ?

Doctor Answers 1

Maxillary fracture

As this is an inherently weaker part of the bone it is common for blowout fractures and malar complex fractures to involve the infraorbital tunnel. Fortunately, damage to this nerve leads to sometimes annoying numbness but no physical deformity. Decompression of this nerve is easily performed from the orbital floor or maxillary sinus roof. If there is a depression from trauma I repair this with fillers or implants. On the rare occasion the malar complex ("tripod") is rotated I place my infraorbital rim osteotomy lateral to the infraorbital foramen. If there is no physical deformity or chronic pain from nerve compression I would defer treatment. At this late stage it is very unlikely that intervention would resolve any sensory deficit.

Honolulu Facial Plastic Surgeon
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