Neurosensory changes in the infraorbital nerve following zygomatic fractures

To document the neurosensory changes in the infraorbital nerve following zygomatic fractures managed in various ways. Twenty-five patients were included in the study. Neurosensory function was assessed with calibrated nylon monofilaments, electrical stimulation, heat detection thresholds and respons...

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Published in:Oral surgery, oral medicine, oral pathology, oral radiology and endodontics oral medicine, oral pathology, oral radiology and endodontics, 2005-06, Vol.99 (6), p.657-665
Main Authors: Benoliel, Rafael, Birenboim, Ravit, Regev, Eran, Eliav, Eli
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Analysis of Variance
Biological and medical sciences
Bone Plates
Child
Cranial Nerve Injuries - etiology
Cranial Nerve Injuries - prevention & control
Dentistry
Electric Stimulation
Female
Fracture Fixation, Internal - instrumentation
Fractures, Open - surgery
Hot Temperature
Humans
Male
Medical sciences
Middle Aged
Orbit - innervation
Otorhinolaryngology. Stomatology
Physical Stimulation
Sensory Thresholds
Somatosensory Disorders - etiology
Somatosensory Disorders - prevention & control
Statistics, Nonparametric
Zygomatic Fractures - complications
Zygomatic Fractures - diagnosis
Zygomatic Fractures - pathology
Zygomatic Fractures - surgery
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Summary:To document the neurosensory changes in the infraorbital nerve following zygomatic fractures managed in various ways. Twenty-five patients were included in the study. Neurosensory function was assessed with calibrated nylon monofilaments, electrical stimulation, heat detection thresholds and response to pin prick in the infraorbital, supraorbital, and mental nerve regions. Patients were seen immediately post-trauma, then 1 and 6 months following surgery. Nine fractures were caused by traffic accidents (TAs), 8 by falls, and 8 by a local blow in a physical dispute. The fractures consisted of 15 displaced and 10 minimally or nondisplaced zygomatic complex fractures, and were left surgically untreated in 7 cases (None group), reduced but not fixed in 8 cases (Reduction group), and fixed with plates in 10 cases (Plates group). Plates were employed significantly more often in displaced fractures (chi-squared P = .0006). At 6 months significantly improved infraorbital nerve function was found in the Plate and None groups relative to the Reduction group (ANOVA P = .006). Only 1 case of chronic neuropathic pain was found. This study concurs with previous studies in finding that plate fixation allows for significantly better restoration of infraorbital nerve function. Chronic neuropathic pain following zygomatic fractures is rare.
ISSN:1079-2104
1528-395X
DOI:10.1016/j.tripleo.2004.10.014