Inferior alveolar nerve function after open reduction and internal fixation of mandibular fractures

Abstract

a b s t r a c tPurpose: Mandibular fractures are amongst the most common facial fractures and are usually treated by open reduction and internal fixation (ORIF). Inferior alveolar nerve (IAN) injuries are seen frequently in mandibular fractures as well as after ORIF of these fractures due to the exposition and the close proximity of the nerve during fracture reduction. Therefore the continuity of the IAN can be disrupted. Permanent injury to the IAN can result in diminished quality of life. This retrospective study was designed to objectively analyse the incidence and the outcome of pre-and postoperative mental nerve hypoesthesia after ORIF of mandibular fractures. Results: 340 patients met the inclusion criteria. 27% of the study population presented with postinjury (preoperative) mental nerve hypoesthesia, 46% suffered from purely postoperative hypoesthesia and 27% showed no nerve damage. Complete recovery was seen in 70% of all cases, partial recovery in 20% of the cases and less than 10% suffered from a permanent (>12 months) IAN damage. Mandibular angle fractures were accompanied with significantly higher rates of hypoesthesia (79% vs. 68%). Recovery rate was significantly worse in older patients, when preoperative hypoesthesia was present (66% vs. 73%) and in patients with multiple fractures in proximity to the IAN (36% vs. 52%). Mandibular body fractures showed worse recovery rates than fractures that did not affect the body (44% vs. 52%).Conclusion: The present study shows that IAN injury is seen frequently in mandibular fractures. Mental nerve hypoesthesia may influence quality of life. Nerve continuity may not be preserved due to the initial trauma or may result as a postoperative complication. Nevertheless the results of this study show a high potential for full recovery.

The Use of Herbert Cannulated Bone Screw in the Treatment of Mandibular Fractures (A Clinical and Radiographic Study)

“…Boffano et al in 2014 (23) reported a 24.3%. A retrospective study done by Schenkel and Jacobsen in 2016 (24) reported that one-third of the population suffered from postoperative paraesthesia, however with a 70% of the affected cases returning to normal. Owing to the slow neural regeneration, extending the follow up period of Schenkel and Jacobsen study might have yielded in a 100% recovery.…”

Si̇ni̇r Yaralanmalari: Nedenleri̇, Teşhi̇s Ve Tedavi̇leri̇

“…Fraktür tamir tipi de nöropati oluşumunda etkili bir faktördür. Mandibula fraktürlerinin açık redüksiyonu sonrası kapalı redüksiyona kıyasla daha yüksek oranda uzun süreli nöropati oluştuğu rapor edilmiştir [17][18][19][20][21] .…”

Management of anterior mandibular fractures using four fixation methods: A clinical comparative study

“…Anterior mandibular fractures (AMFs) are defined as fractures that occur in the region between the lateral incisor and the second premolar (parasymphyseal region), or fractures that occur in the region between the lateral incisors (symphyseal region). 1 Although there is a wide variance in the recorded percentage of mandibular fractures that occur in the anterior region, the aggregate analysis places them at approximately 17% of all mandibular fractures. 2,3 Various types of plating systems have been evolved during the past decades to provide a stable anatomic reduction for AMFs, so the risk of the postoperative displacement of the fractured segments could be reduced and the early return to normal function is allowed.…”