Sphenoid bone fractures associated with the medial transposition of a zygomatic bone fracture are not rare. The force used during open reduction of a zygomatic bone fracture may extend to the orbital apex and site of the sphenoid bone fracture. We report four cases of zygomatic bone fracture associated with a sphenoid bone fracture.
The approaches for Case 1 and Case 2 were different, but good reposition was achieved in both because a wide operative field enabled good reduction with no effects on the sphenoid bone fracture. However, Case 3 had associated sphenoid and frontal bone fractures, and intracranial hematoma. Good reduction was not achieved because of the brain complication. Good results using a general approach were achieved in Case 4, which had associated sphenoid bone and skull base fractures.
We perform simulation surgery to consider the approach and reduction methods prior to actual surgical repair of the zygomatic bone. During the actual surgery, we confirm the bone fracture line of the sphenoid bone directly, and reduction can be performed safely in some cases by adding osteotomy of the lateral orbital wall.
