Persistent infra‐orbital nerve hyperaesthesia after blunt orbital trauma

Tengtrisorn, Supaporn; McNab, Alan A.; Elder, James E

doi:10.1111/j.1442-9071.1998.tb01323.x

Cited by 14 publications

(9 citation statements)

References 7 publications

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“…The improvement in pain has been noted in only one study involving three patients with neuralgia. 9 The patients in our series did not meet the widely accepted criteria for surgical intervention for blowout fractures as they had insignificant inferior orbital wall fractures without extraocular muscle entrapment, no significant enophthalmos, no diplopia, and full ocular movements. However, they all benefited from infraorbital nerve decompression, whether done as a single procedure or as part of repair of the inferior orbital wall fracture.…”

Section: Discussionmentioning

confidence: 85%

“…Resolution of patients’ sensory symptoms and depression was noted in all cases. The improvement in pain has been noted in only one study involving three patients with neuralgia 9…”

Section: Discussionmentioning

confidence: 98%

“…Occasionally, patients can develop pain in the distribution of the infraorbital nerve months after the initial injury or after open reduction of the fracture. [9][10][11] The infraorbital nerve within this canal is vulnerable to damage in many orbital floor fractures due to its proximity to the typical fracture site. Persistent paraesthesia is likely to be due to compression of the infraorbital nerve in the collapsed canal, or irritation of the nerve by sharp fragments of bone, or adhesional bands.…”

Section: Discussionmentioning

confidence: 99%

“…There is a paucity of literature addressing the topic. Occasionally, patients can develop pain in the distribution of the infraorbital nerve months after the initial injury or after open reduction of the fracture 91011. The infraorbital nerve within this canal is vulnerable to damage in many orbital floor fractures due to its proximity to the typical fracture site.…”

Section: Discussionmentioning

confidence: 99%

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Infraorbital Nerve Decompression for Infraorbital Neuralgia/Causalgia following Blowout Orbital Fractures: A Case Series

Beigi

Niyadurupola

et al. 2017

Craniomaxillofacial Trauma & Reconstruction

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The purpose of this study was to present the management of a series of patients referred with infraorbital nerve paraesthesia that developed after insignificant orbital floor fracture without diplopia or exophthalmos, and that did not require initial surgical repair. This is a retrospective interventional case series. The main outcome and measures were assessment of preoperative symptoms including neuralgia and sensory symptoms; review of periorbital computed tomography (CT) scans; and assessment of postoperative effects of surgery for infraorbital nerve decompression. Nine patients were identified who developed neuralgia affecting the infraorbital nerve distribution from a cohort of 79 patients who presented with orbital floor fracture. Six were female and three were male. Age range was 22 to 73 years with a mean of 48 years. Six patients were clinically depressed due to the chronic pain. In addition, two patients had dizziness on upgaze; one patient had blurring of central vision on eye movements; and one patient had mood swings. Reviews of CT scans revealed subtle disruption of the infraorbital canal in all cases. All nine patients underwent infraorbital nerve decompression. Abnormal adhesions between the nerve and its bony canal were found in five of nine cases. Follow-up ranged from 3 to 37 months (mean: 18 months). Following surgery, after a variable period of time ranging from 1 day to 3 months, all patients had resolution of their symptoms. Mean follow-up was 18 months. Reconstructive surgeons should be aware that infraorbital nerve neuralgia, secondary to disruption of the nerve in the distorted bony canal, may be another indication for surgical intervention following orbital floor trauma in selected cases, in addition to more traditionally accepted indications. Neuralgia and causalgia are probably more common than previously thought and symptoms should be actively sought in the patient's history or else risk being overlooked and inappropriately managed. Long-term follow-up of such patients is unlikely to be practical. Patient and/or family practitioner education of possible sequelae may be one possible solution to detect this type of problem early. Nerve decompression, where indicated, may improve the patient's neuralgia and associated behavioral changes and quality of life. An optimal diagnostic and management algorithm is yet to be established.

show abstract

Section: Discussionmentioning

confidence: 85%

“…Resolution of patients’ sensory symptoms and depression was noted in all cases. The improvement in pain has been noted in only one study involving three patients with neuralgia 9…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Infraorbital Nerve Decompression for Infraorbital Neuralgia/Causalgia following Blowout Orbital Fractures: A Case Series

Beigi

Niyadurupola

et al. 2017

Craniomaxillofacial Trauma & Reconstruction

View full text Add to dashboard Cite

show abstract

“…It is important to stress to the patient that their pain may persist despite surgery, and this must be discussed with the patient prior to surgical intervention. 19,22,23 Cerebrospinal Fluid Leak Much more uncommon than medial wall and floor fractures, superior orbital wall fractures can occur from trauma to the orbital rim and forehead. Unlike fractures limited to the floor and medial wall, superior orbit fractures can provide a site of egress for cerebrospinal fluid (CSF).…”

Section: Infraorbital Nerve Entrapmentmentioning

confidence: 99%