Infraorbital Foramen Decompression Surgery for the Infraorbital Nerve Hypoesthesia in Patients With Isolated Fracture of Maxillary Sinus Anterior Wall

Abstract

Isolated fracture of maxillary sinus anterior wall is relatively uncommon. If the extent of fracture is minimal, only conservative care is amenable, however, there is no agreement on whether infraorbital nerve dysfunction can be used as an indication for surgical intervention. This study was conducted to verify the effect of decompression surgery of infraorbital foramen for recovery of hypoesthesia. A total of 26 patients with unilateral fracture of maxillary sinus anterior wall were enrolled. Ten who received only conservative therapy were allocated in the control group, while sixteen patients were assigned to the decompression group. Pre- and post-treatment sensory assessment using visual analogue scale (VAS) was recorded. Overall treatment satisfaction was also evaluated by means of global assessment scale (GAS). Both absolute VAS value and score increment showed statistical difference only at 4 weeks (P = 0.010 and P = 0.021, respectively), but no significant difference at 1, 12, and 24 weeks. GAS score also showed no statistical significance (P = 0.386). Decompression surgery of infraorbital foramen does not have a significant effect on hypoesthesia recovery in isolated fracture of maxillary sinus anterior wall. Therefore, it is not recommended to perform the operation when the infraorbital nerve hypoesthesia is the only indication for the open reduction.

Evaluation of Infraorbital Nerve Recovery and its Effect on Quality of Life following Open Reduction and Internal Fixation of Zygomaticomaxillary Complex Fractures – An Evaluative Study

“…studied the incidence of various signs and symptoms associated with mid-face fractures and noted that the incidence of neurosensory deficits of the infraorbital nerve was the second most common symptom (80%), thus, making it one of the typical characteristic clinical features for diagnosis of ZMC fractures. [ 2 ]…”

“…The incidence of infraorbital nerve injury following ZMC fracture ranges from 80% to 94%. [ 2 , 3 ] Infraorbital nerve damage can produce neurosensory disturbances such as hyperaesthesia, hypoaesthesia, paraesthesia, or anaesthesia of the structures innervated by the nerve including lower eyelid, cheek, the skin of lateral wall of the nose, upper lip and intraorally, the mucous membrane of the upper lip, cheek, and anterior as well as posterior teeth of the affected side. [ 4 ] Healing of these neurosensory disturbances takes place over a period of time.…”

“…[ 1 ] It has been reported that mild to moderately displaced fractures of the ZMC result in Sunderland’s grade I-II/mild nerve injury of the infraorbital nerve. [ 2 ] Benoliel et al , conducted a study to investigate the sensory changes in the infraorbital nerve following zygomatico-maxillary complex fractures in which they concluded that nerve recovery is faster and better after open reduction and internal fixation (ORIF). [ 5 ] It was found that 77.9% of patients showed complete nerve recovery after ORIF.…”

Συμβολή Στη Μελέτη Συσχέτισης Μεταξύ Της Χρήσης Ζωνών Ασφαλείας-Κράνους Και Του Βαθμού Βαρύτητας Καταγμάτων Του Σπλαχνικού Κρανίου

“…ΤαΝ εα Ϊΰηα αΝ κυΝ πλσ γδκυΝ κδξυηα κμ κυΝ δΰηκλ έκυΝ Ϊθ λκυ έθαδΝ πέ βμΝ υθάγβΝ η Ν πδγαθάΝ βΝ υηη οχάΝ ουΝ υποεσΰχδουΝ χ έζουμ,Ν εα ΪΝ βθΝ οβζΪφβ βΝ ουΝ οποέουΝ ηπολ έΝ θαΝ παλα βλβγ έΝ βΝ δεσθαΝ εαζοπα δοτέΝ ΗΝ αθ δη υπδ βΝ αυ υθΝ έθαδΝ υθάγωμΝ υθ βλβ δεάΝσ αθΝβΝπαλ ε σπδ βΝ έθαδΝηδελάΝάΝσ αθΝαυ ΪΝ έθαδΝη ηοθωηΫθαΝ εαδΝ ηβΝ υθ λδπ δεΪέΝ Ν ζέΰ μΝ π λδπ υ δμ,Ν σ αθΝ αΝ εα Ϊΰηα αΝ έθαδΝ υθ λδπ δεΪΝ άΝ η ΰΪζβμΝ παλ ε σπδ βμΝ η Ν υθάγβΝ υηη οχάΝ ουΝ υποεσΰχδουΝ χ έζουμ,Ν ΰέθ αδΝ αθοδε άΝ αθΪ αιβΝ αυ οτ,Ν οπογΫ β βΝ ω λδεάμΝ ο ο τθγ βμΝ η Ν mini-plate,Ν άΝ υληα ο έα-ο ολλαφά,Ν θυΝ Ν εΪποδ μΝ π λδπ υ δμΝ ηπολ έΝ θαΝ ΰέθ δΝ χλά βΝ ηο χ τηα ομΝ πλομΝ αποεα Ϊ α βΝ ουΝ πδγαθοτΝ ο δεοτΝ ζζ έηα ομέΝ ΟδΝ πδγαθΫμΝ χ δλουλΰδεΫμΝ πλο π ζΪ δμΝ έθαδΝ οδΝ ιάμμΝ δ πδπ φυεο δεά,Ν υποίζ φαλδ δεά,Ν υπο Ϊλ δα,Ν υποεσΰχδα,Ν πλο οηδαεάΝ ΧΪθωΝ ουζοχ δζδεάΝ ήΝ ουζοπαλ δαεάΨέΝ Ν εΪγ Ν π λέπ ω βΝπλΫπ δΝθαΝ έθ αδΝπλο οχάΝυ ΝθαΝηβΝ λαυηα έα αδΝ οΝυποεσΰχδοΝθ τλο άΝθαΝαπο υηφολ έ αδΝ Νπ λδπ υ δμΝσπουΝ υηπδΫα αδΝαπσΝο δεΪΝ ηΪχδα (Cho HM et al, 2018, Shin J et al, 2020, Watkinson JC et al, 2018.…”