Case Report
Copyright ©The Author(s) 2020 Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2294-2304
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2294
Various diagnostic possibilities for zygomatic arch pain: Seven case reports and review of literature
Seoeun Park, Ji Woon Park
Seoeun Park, Ji Woon Park, Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul 03080, South Korea
Author contributions: Park S reviewed the literature and contributed to drafting of the manuscript; Park JW was responsible for the revision of the manuscript and for contributing important intellectual content; All authors issued final approval for the version to be submitted.
Informed consent statement: This retrospective study was based on laboratory and physical examination results and disease outcomes obtained from medical records and did not involve patients’ personal information. This study was approved by the Institutional Review Board of Seoul National University Dental Hospital (ERI19004). The IRB authorized the exemption of informed consent from the subjects.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ji Woon Park, DDS, PhD, Associate Professor, Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, 101 Yunkeun-Dong, Chongro-Ku, Seoul 03080, South Korea. ankara01@snu.ac.kr
Received: January 4, 2020
Peer-review started: January 4, 2020
First decision: April 8, 2020
Revised: April 24, 2020
Accepted: May 23, 2020
Article in press: May 23, 2020
Published online: June 6, 2020
Processing time: 155 Days and 4.6 Hours
Abstract
BACKGROUND

Pain of the zygomatic arch region is common among patients with orofacial pain, especially in those with temporomandibular disorder-related pain of a myogenic origin. Since zygomatic arch pain may occur due to various causes other than muscle pain, appropriate diagnosis and treatment planning is essential to ensure its successful management. Unfortunately, zygomatic arch pain has not been handled as an independent clinical feature until now, and studies have mainly focused on pain resulting from trauma and surgical procedures.

CASE SUMMARY

We describe 7 independent cases, all of which presented with the identical chief complaint of pain in the zygomatic arch region. However, the underlying causes were different for each, being myofascial pain, myositis, tooth crack, dental caries, sinusitis, neuropathic pain, and salivary gland tumor respectively. In this case report, the clinical features of each case are investigated and diseases to be considered in the diagnostic process are suggested, along with the diagnostic modalities (including computed tomography and magnetic resonance imaging) that can lead to the appropriate final diagnosis.

CONCLUSION

Zygomatic arch pain is a common complaint encountered in the orofacial pain clinic but may lead to misdiagnosis. Clinicians must have in-depth knowledge of the possible differential diagnoses and evaluation tools.

Keywords: Zygomatic arch, Myositis, Odontogenic pain, Sinusitis, Neuropathic pain, Salivary gland tumor, Case report

Core tip: Many patients visiting the orofacial pain clinic have zygomatic arch pain as their chief complaint. However, the pain that the patient describes may not always originate from the masseter muscle, as easily considered. The orofacial region is a common site for referred pain and is frequently the cause of misdiagnosis and confusion for both the clinician and patient. This report examines the various diagnostic results of 7 patients with chief complaint of pain in the zygomatic arch region, including myofascial pain, myositis, odontogenic pain, sinusitis, neuropathy, and salivary gland tumor. Imaging and diagnostic anesthesia should be understood to avoid misdiagnosis.