Quantitative topographical evaluation of the orbitozygomatic complex

Background: The orbitozygomatic complex is a tetrapod-shaped bone of the upper midfacial skeleton of particular clinical significance. By defining the malar prominence, it provides a significant contribution to the overall facial form. Moreover, it is the second most frequently fractured bone on the craniofacial skeleton. A method for quantitative determination of the position of the orbitozygomatic complex has important applications in the fields of reconstructive and aesthetic plastic surgery. Methods: Ten individuals were evaluated using craniofacial anthropometry techniques. The position of the orbitozygomatic complex in three planes, x, y, and z, was determined by measuring linear projective distances between complex landmarks: the maxillozygion (the most prominent landmark on the malar prominence), the orbitale (the lowest point on the inferior orbital rim), the zygion (the most lateral point on the zygomatic arch), and the cranial reference landmarks (the vertex, opisthocranion, and nasion). Results and Conclusions: Low variability between measurements within the same individual (< 1.5 mm) underscores the reliability of the chosen landmarks and techniques in the determination of orbitozygomatic complex position. Second, the complex occupies a consistent position among individuals, as shown by the low intersubject variability. Third, there is no statistically significant difference in the position of the complex, in any plane of space, between the left and right sides of the face. Thus, the authors' method may be used to determine the degree of complex displacement in individuals with unilateral facial trauma or with unilateral residual postsurgical deformity, and to calculate the amount of realignment needed to produce a symmetrical facial appearance.