Frequency of infra-orbital nerve injury after a Zygomaticomaxillary complex fracture and its functional recovery after open reduction and internal fixation

Abstract

Background: Maxillofacial injuries are on the rise and the etiology of maxillofacial injuries varies from one country to another because of social, cultural and environmental factors. Road traffic accidents (RTAs) are still the most common cause of maxillofacial injuries. Nerve injury following fracture may involve traction, pressure, ischemia, inflammation and physical damage; therefore fractures of Zygomaticomaxillary complex (ZMC) are characterized by sensory neuropathy in the area of innervation of infra-orbital nerve both as presenting symptom and as a postop complication. The objectives of the study were to investigate the frequency of infra-orbital nerve paresthesia following ZMC fractures and determine the frequency of functional nerve recovery in patients with paresthesia treated with open reduction and internal fixation.Methods: Patients (n = 75) qualifying our inclusion criteria were selected, examined, reduced by surgery and followed up.Results: A total of 75 patients were included in the study with male: female ratio of 5:3. Mean age was 37.43±3.78 years, with majority of patients (72 %) presenting with RTAs. Infra-orbital nerve paraesthesia was found to be positive in 70.67% (n = 53) patients with 62.26% (n = 33) patients with functional nerve recovery after 3 months.Conclusions: Prognosis of infra-orbital nerve recovery after a Zygomaticomaxillary complex fracture can be enhanced by open reduction and internal fixation.

Comparison of infraorbital nerve recovery after open and closed reduction of zygomaticomaxillary complex fractures

“…21 Similar finding was also reported by Maria et al showing recovery of infraorbital nerve functions in 67% cases fixed with open reduction and intermal fixation. 22 The results of our study are in agreement with Benoliel R who recorded incidence of infraorbital nerve injury following ZMC fractures ranging from 18-83%. Benoliel documented the neurosensory changes managed in various ways and concluded that plate fixation allows for significantly better restoration of infraorbital nerve function.…”

Usefulness of the Blink Reflex in Diagnosing Isolated Infraorbital Neuropathy following Midface Augmentation with AlloPlastic Facial Implants: A Case Report

“…One of the most common causes of injury to trigeminal nerve branches, including the infraorbital nerve, is accidental or iatrogenic trauma. Approximately 30% to 80% of patients with midfacial fractures experience infraorbital nerve injuries [ 8 ]. Iatrogenic injury to the ION has also been reported in the setting of endoscopic sinus surgery, in which a canine fossa puncture for endoscope insertion is per-formed.…”

Sensory recovery after infraorbital nerve avulsion injury

“…One of the most common causes of injury to trigeminal nerve branches, including the infraorbital nerve, is accidental or iatrogenic trauma. Approximately 30% to 80% of patients with midfacial fractures experience infraorbital nerve injuries [ 3 ].…”