Why Don’T The Bones Looked Healed On CT Scans After Zygomatic Osteotomies?

Q: Dr. Eppley, I had zygomatic bone repositioning. In the CT scan I’m wondering, why I do not see bone union in my maxillary region after zygomatic bone reposition (osteomy, delayed reposition). After surgery there is bone union on zygomatic arch, on the orbital rim, but maxillary region. 

How it’s possible that gap has not reduced even a bit since surgery? Overally the whole bone complex is stabilised but I’m worried about those gaps on maxillary bone 

I attached some pictured from different CTs. CT performed before miniplates removement – 2 years after surgery 

I got tinnitus and ETD and I wonder if such gap can be bad for my health… maybe some bacteria from sinuses may transfer to other skull regions? 

But once again, how it’s possible that gap has not reduced, like there is no bone. I marked (red line) the place where is very small distance between bone ends and still no union there 

Or maybe there is a bone but too thin to be visible on CT? how to check that? 

A: I don’t see any mystery here…. the thin bones of the maxilla and even the zygomatic body often heal by a fibrous union not a bony union. These are thin bones that don’t carry much functional loading forces so they are not going to heal like the thicker skull or mandible. There are no medical issues associated with this type of common midfacial bone healing pattern.

Dr. Barry Eppley

World Renowned Plastic Surgeon