Bilateral Absence of the Zygomatic Nerve and Zygomaticofacial Nerve and Foramina

The zygomaticofacial branch (ZFb) of the zygomatic nerve travels along the inferolateral angle of the orbit, traverses the zygomaticofacial foramen (ZFF) in the zygomatic bone, and then perforates the orbicularis oculi muscle to finally reach the skin of the malar area, which it innervates. The bilateral absence of the ZFb and the ZFF was found in an 80-year-old Caucasian cadaver. In addition, both zygomatic nerves were absent. A thin nerve arising from the lacrimal nerve passed below it and gave rise to the lacrimal branch and a communicating branch to the lacrimal nerve. This then entered the small bony canal, which opened at the medial aspect of the lateral wall of the orbit on the right and left sides. The bilateral absence of the ZFb of the zygomatic nerve and its foramen appears to be uncommon but should be realized during surgery or invasive procedures over the cheek or infraorbital region. The additional absence of both zygomatic nerves is exceptional.