The zygomatic bone, commonly known as the cheekbone, is a paired, irregular bone that forms the prominence of the cheeks and contributes to the structure of the eye socket. It plays an important role in facial contour and protects the contents of the orbit. Given its exposed position, the cheekbone can indeed be broken.
Understanding Cheekbone Fractures
The zygomatic bone is quite sturdy, acting as a buttress between the skull and the upper jaw. However, its prominent location makes it vulnerable to injury from various forces. Fractures often occur due to direct impact from incidents like physical assaults, motor vehicle accidents, falls, or sports injuries.
Cheekbone fractures can range in complexity. Some fractures are non-displaced, meaning the bone has a crack but its alignment remains undisturbed. Other fractures can be displaced, where the bone fragments are moved from their normal position. More severe impacts, such as from car accidents, may lead to comminuted fractures, where the bone shatters into multiple pieces. Fractures can involve the zygomatic arch or other parts of the bone where it connects to the frontal, temporal, and maxillary bones, and even the sphenoid bone.
Signs You Might Have a Broken Cheekbone
Symptoms of a broken cheekbone include pain, tenderness, and swelling around the cheek. The affected cheek might appear flattened or sunken due to the bone’s displacement, though swelling can sometimes mask this. Bruising around the eye (periorbital ecchymosis) and blood in the white part of the eye (subconjunctival hemorrhage) are often observed.
Numbness or a tingling sensation can occur in the cheek, upper lip, nose, or upper teeth if the infraorbital nerve, which runs through the cheekbone area, is bruised or stretched. Vision changes, such as double vision (diplopia) or blurred vision, may indicate involvement of the eye socket. Difficulty opening the mouth or pain when chewing can also be a symptom, as a displaced cheekbone might interfere with jaw movement. If any of these symptoms appear after facial trauma, seeking medical attention is important to prevent potential long-term complications.
Medical Care for a Broken Cheekbone
Diagnosing a cheekbone fracture involves a physical examination to assess facial asymmetry, tenderness, and any step-off deformities along the bone. Imaging tests, such as X-rays or, more commonly, a CT scan, are used to confirm the fracture, determine its extent, and visualize any associated injuries to the orbit or sinuses. A CT scan provides detailed images, including 3D reconstructions, the standard for assessment.
Treatment approaches vary based on the fracture’s severity and displacement. For stable, non-displaced fractures, conservative management may involve rest, ice application, and pain medication. Patients are often advised to eat a soft diet. However, if the bone is significantly displaced, affects surrounding structures like the eye socket, or causes functional or aesthetic issues, surgical intervention is recommended. Surgical procedures reposition the fractured bone fragments (reduction) and, stabilize them with small plates and screws (internal fixation). These procedures may involve small incisions, sometimes placed discreetly inside the mouth or along natural skin creases to minimize visible scarring.
Healing and Recovery
Healing time for a broken cheekbone varies with fracture severity and whether surgery was performed. Non-displaced fractures may heal within 4 to 6 weeks, with swelling often subsiding in about two weeks. Even after surgical repair, it generally takes six weeks for the cheekbone to fully heal. Pain and discomfort are common initially, managed with prescribed pain medications. Antibiotics may be given, especially if there’s an infection risk or a graft was used.
During recovery, avoid activities that could re-injure the face, such as contact sports, for several weeks. Avoid blowing the nose for at least 10 days to prevent air from entering facial tissues. Follow-up appointments are scheduled to monitor healing and ensure proper alignment. While most cheekbone fractures heal well, some individuals may experience persistent numbness, especially if a nerve was significantly affected, or minor facial asymmetry. These long-term considerations are discussed with the medical team.