Location and incidence of the zygomaticofacial foramen (zff): an anatomic study on dry skulls of the Bosnian and Herzegovinian population

Introduction: Medical interventions involving the zygomatic region, including maxillofacial surgery, implantology, and aesthetic procedures, require a comprehensive understanding of the zygomaticofacial foramen (ZFF) to minimize the risk of injury during surgical manipulation. Materials and Methods: This study examined the location, number and prevalence of zygomaticofacial foramina (ZFF) in fifty-seven dry human skulls of known age and sex. The lateral surface of the zygomatic bone was divided into four regions (A, B, C, and D) to assess the regional distribution of ZFF. Additionally, the distance between each ZFF and the most prominent point of the lateral zygomatic surface (ZP) was measured, using this point as the center of an imaginary clock to precisely determine foramina positioning. Results: Among the 114 sides analyzed, the ZFF was absent in 4.4% of cases. The distribution of foramina per side was as follows: one (40.4%), two (36.8%), three (10.5%), four (5.3%), and five (2.6%). The mean distance between the ZFF and the most prominent point of the zygomatic bone was 8,62 ± 2.54 mm. On the right side, mZFF were most frequently located at 1 o'clock (23.8%), 12 o'clock (25.0%), and 11 o'clock (28.5%), while on the left side, they were most commonly found at 1 o'clock (26.1%), 11 o'clock (28.9%), and 12 o'clock (31.9%). Conclusions: The anatomical variability of the zygomaticofacial foramen (ZFF) in terms of its number and position should be carefully considered when administering regional block anesthesia or performing surgical and aesthetic procedures in the zygomatic region.