ABSTRACT
OBJECTIVES: To determine the prevalence and characteristics of zygomatic air cell defect (ZACD) among a general dental clinic population. METHODS: The panoramic radiographs of 2734 dental clinic outpatients were examined for the presence of ZACD. ZACD was defined as a nonexpansile, nondestructive cyst-like radiolucency in the zygomatic process of the temporal bone which appears similar to the mastoid air cells and which does not extend further anteriorly than the zygomaticotemporal suture. RESULTS: ZACD was found in 40 patients (1.5%) with a mean age of 49.6 (s.d. 18.0) years. Twenty cases (50%) each occurred in males and females. Meta-analysis of three large case series comprising 4579 patients revealed a total of 76 cases of ZACD (1.7% prevalence) occurring over an age range of 15-83 years. Thirty-four (44.7%) occurred in males while 42 (55.3%) occurred in females. Bilateral ZACD were found in 17 patients (22.4%). CONCLUSIONS: ZACD is not a rare anatomical variant, and clinicians planning eminectomy or other surgical procedures involving the zygomatic arch are advised to obtain appropriate presurgical imaging studies to avoid the need for creative intra-operative reconstruction.