The zygomatic arch or cheek bone is formed by the zygomatic process of temporal bone and the temporal process of the zygomatic bone (the side of the cheekbone), the two being united by an oblique suture (zygomaticotemporal suture); the tendon of the Temporalis passes medial to the arch to gain insertion into the coronoid process of the mandible. The jugal point is the point at the anterior end of the upper border of the zygomatic arch where the masseteric and maxillary edges meet at an angle. The jugal point is the anterior end of upper border of the zygomatic arch where it meets the process of the zygomatic bone.
The orbitozygomatic approach (OZA) needs additional removal of the orbital rim and zygomatic arch, in addition to standard pterional craniotomy, which increases invasiveness, the risk of facial nerve palsy, temporal muscle atrophy, and deformity after surgery, and results in an extended operative time. Appropriate selection of the OZA requires indications that have yet to be established. The trajectory to basilar apex aneurysm BX aneurysms in the interpeduncular or prepontine cisterns has been suggested to be related to not only the height of the apex of the basilar artery (BA), but also the height and lateral breadth of the bifurcation of the internal carotid artery (ICA).
Simulation using 3DCTA appears to be important for planning the surgical approach for the treatment of BX aneurysms 1).