Zygomaticofacial foramen and its surgical anatomy in plastic and maxillofacial surgery - a systematic review plus meta-analysis.

[BACKGROUND] A comprehensive understanding of the zygomaticofacial foramen (ZFF) is essential in clinical and surgical settings, particularly in procedures involving facial trauma repair, reconstructive and plastic surgery. The aim of this meta-analysis was to obtain anatomical data on ZFF and its variations, in order to investigate its physiological as well as clinical implications.

[MATERIALS AND METHODS] A large-scale search was conducted in all major databases (PubMed, Embase, Science Direct, Scopus and Web of Science) in order to determine and pool all relevant ZFF data. A total of 22 studies (5,438 skull sides) was included. The analysis revealed that in the majority of skull sides, the number of ZFF was one (45.34%, 95% CI: 41.56-49.12), followed by two (25.83%, 95% CI: 18.27-33.39), and then zero (14.11%, 95% CI: 10.15-18.07). The mean diameter of ZFF was 1.23 mm (95% CI: 0.33-2.13). The mean distance from the ZFF to the zygomatic angle was 12.02 mm (95% CI: 10.06-13.98), to the closest point of the orbital rim - 6.71 mm (95% CI: 5.98-7.43), to the midpoint of frontozygomatic suture - 25.50 mm (95% CI: 24.91-26.10), and to the lowest point of the zygomaticomaxillary suture- 19.00 mm (95% CI: 18.39-19.61).

[CONCLUSIONS] Understanding the precise anatomy and variability of the ZFF's prevalence, number and spatial relationships is critical in surgical and clinical practices involving the midfacial region.