Does the Lag Time Between Injury and Treatment Affect Recovery of Infraorbital Nerve Disturbances in Zygomaticomaxillary Complex Fractures?

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

Introduction

The zygomaticomaxillary complex (ZMC) fractures are the second most common fractures affecting the midfacial skeleton. Neurosensory disturbances of the infraorbital nerve are one of the most common signs of ZMC fractures. The aim of the study was to evaluate the neurosensory recovery of the infraorbital nerve and its effect on the quality of life (QoL) following open reduction and internal fixation of ZMC fractures.

Methods

Thirteen patients clinically and radiologically diagnosed with unilateral ZMC fractures with neurosensory deficits of the infraorbital nerve were enrolled for this study. All patients were assessed presurgically for neurosensory deficits of the infraorbital nerve using the various neurosensory tests, followed by open reduction with two-point fixation under general anaesthesia. The patients were followed up at one, three and six months postoperatively to evaluate the recovery of neurosensory deficits.

Results

Recovery of tactile and pain sensation was relatively complete in 84.62% and 76.92% of patients respectively by the end of six months postoperatively. The spatial mechanoreception of the affected side improved significantly. 61.54% of patients led an excellent QoL six months postoperatively.

Discussion

The majority of the patients with ZMC fractures and neurosensory deficits of the infraorbital nerve, when treated with open reduction and internal fixation, have complete recovery of the neurosensory deficits by the end of six months postoperatively. However, some patients may continue to experience some long-term residual deficits, which can affect the patient's QoL.