Rafael Benoliel1, Ravit Birenboim, Eran Regev, Eli Eliav. 1. Department of Oral Medicine, Hadassah Faculty of Dental Medicine, The Hebrew University, P.O.B. 12272, Jerusalem 91120, Israel. benoliel@cc.huji.ac.il
Abstract
OBJECTIVE: To document the neurosensory changes in the infraorbital nerve following zygomatic fractures managed in various ways. STUDY DESIGN: 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. RESULTS: 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. CONCLUSIONS: 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.
OBJECTIVE: To document the neurosensory changes in the infraorbital nerve following zygomatic fractures managed in various ways. STUDY DESIGN: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Maria Peris-Celda; Carlos D Pinheiro-Neto; Tiago F Scopel; Juan C Fernandez-Miranda; Paul A Gardner; Carl H Snyderman Journal: J Neurol Surg B Skull Base Date: 2013-06-14