The zygomatic nerve is a branch of the maxillary nerve (V2) that enters the orbit through the inferior orbital fissure and divides into the zygomaticotemporal and zygomaticofacial branches. It carries sensory fibres to the skin of the lateral cheek (zygomaticofacial) and anterior temporal region (zygomaticotemporal), and importantly serves as the conduit for postganglionic parasympathetic fibres from the pterygopalatine ganglion to the lacrimal nerve for lacrimal gland secretion.
The zygomatic nerve and its branches are at risk in procedures around the orbit and zygomatic arch, including orbital decompression, zygomatic fracture repair, and temporal fascia harvest. Its role in the secretomotor pathway to the lacrimal gland makes it relevant when assessing dry eye after orbital or midface surgery. The zygomatic nerve is also an important landmark in infraorbital nerve block techniques.
Displaced zygomatic complex fractures may stretch or compress the zygomatic nerve branches, causing lateral cheek and temporal numbness that typically resolves with fracture reduction and fixation, or spontaneously over several months if neuropraxia alone.
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