Prospective study on post-traumatic and postoperative sensory disturbances of the inferior alveolar nerve and infraorbital nerve in mandibular and midfacial fractures
In a prospective study (January 1999 to December 1997), 34 patients with 26 mandibular and 20 midfacial fractures were investigated. All the fractures were managed by osteosynthesis. To evaluate the incidence and duration of recovery of post-traumatic and postoperative sensory disturbaces, the follo...
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Veröffentlicht in: | Journal of cranio-maxillo-facial surgery 1999-04, Vol.27 (2), p.86-93 |
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description | In a prospective study (January 1999 to December 1997), 34 patients with 26 mandibular and 20 midfacial fractures were investigated. All the fractures were managed by osteosynthesis. To evaluate the incidence and duration of recovery of post-traumatic and postoperative sensory disturbaces, the following tests were carried out: sharp/blunt testing, and the two-point discrimination test as conventional clinical examination methods, and electromyographic recording of the masseter reflex to calibrate the clinical findings. To establish the sensory status of the inferior alveolar and the infraorbital nerves in the region of the fracture, and on the intact and control sides, the tests were performed pre-operatively and postoperatively on the seventh day, after 4 weeks and after 3, 6 and 12 months. The incidence of post-traumatic sensory disturbance was 46% for mandibular fractures and 65% for fractures to the midface (sharp/blunt test, two-point discrimination test). The rate of postoperative sensory disturbance in surgical treatment of mandibular fracture involving the region of the intra bony course of the inferior alveolar nerve, including the post-traumatic sensory disturbance, was 76.9%, and 55% following surgical treatment of midfacial fractures. The incidence of persistent sensory disturbances following surgical treatment was 7.7% in the case of mandibular fractures, and 15% in the case of midfacial fractures (sharp/blunt test, two-point discrimination test, masseter reflex). Recovery of neurological function is delayed in the presence of a displaced fracture (>1 mm) as compared with non-displaced fractures. For the postoperative calibration of sensory disturbances, electromyographic recording of the masseter reflex from the fourth postoperative week onwards has proved useful. |
doi_str_mv | 10.1016/S1010-5182(99)80019-5 |
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All the fractures were managed by osteosynthesis. To evaluate the incidence and duration of recovery of post-traumatic and postoperative sensory disturbaces, the following tests were carried out: sharp/blunt testing, and the two-point discrimination test as conventional clinical examination methods, and electromyographic recording of the masseter reflex to calibrate the clinical findings. To establish the sensory status of the inferior alveolar and the infraorbital nerves in the region of the fracture, and on the intact and control sides, the tests were performed pre-operatively and postoperatively on the seventh day, after 4 weeks and after 3, 6 and 12 months. The incidence of post-traumatic sensory disturbance was 46% for mandibular fractures and 65% for fractures to the midface (sharp/blunt test, two-point discrimination test). The rate of postoperative sensory disturbance in surgical treatment of mandibular fracture involving the region of the intra bony course of the inferior alveolar nerve, including the post-traumatic sensory disturbance, was 76.9%, and 55% following surgical treatment of midfacial fractures. The incidence of persistent sensory disturbances following surgical treatment was 7.7% in the case of mandibular fractures, and 15% in the case of midfacial fractures (sharp/blunt test, two-point discrimination test, masseter reflex). Recovery of neurological function is delayed in the presence of a displaced fracture (>1 mm) as compared with non-displaced fractures. For the postoperative calibration of sensory disturbances, electromyographic recording of the masseter reflex from the fourth postoperative week onwards has proved useful.</description><identifier>ISSN: 1010-5182</identifier><identifier>EISSN: 1878-4119</identifier><identifier>DOI: 10.1016/S1010-5182(99)80019-5</identifier><identifier>PMID: 10342144</identifier><identifier>CODEN: JCMSET</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Dentistry ; Electromyography ; Ent, stomatology, face, injuries. Foreign bodies. Diseases due to physical agents: otorhinolaryngology ; Facial Bones - injuries ; Facial Bones - surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal - adverse effects ; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics ; Humans ; Incidence ; Joint Dislocations - complications ; Joint Dislocations - surgery ; Male ; Mandibular Fractures - complications ; Mandibular Fractures - surgery ; Masseter Muscle - physiopathology ; Maxillofacial surgery. Dental surgery. Orthodontics ; Medical sciences ; Middle Aged ; Orbit - innervation ; Prospective Studies ; Reflex - physiology ; Sensation Disorders - etiology ; Sensory Thresholds - physiology ; Skull Fractures - complications ; Skull Fractures - surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Touch - physiology ; Traumas. 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All the fractures were managed by osteosynthesis. To evaluate the incidence and duration of recovery of post-traumatic and postoperative sensory disturbaces, the following tests were carried out: sharp/blunt testing, and the two-point discrimination test as conventional clinical examination methods, and electromyographic recording of the masseter reflex to calibrate the clinical findings. To establish the sensory status of the inferior alveolar and the infraorbital nerves in the region of the fracture, and on the intact and control sides, the tests were performed pre-operatively and postoperatively on the seventh day, after 4 weeks and after 3, 6 and 12 months. The incidence of post-traumatic sensory disturbance was 46% for mandibular fractures and 65% for fractures to the midface (sharp/blunt test, two-point discrimination test). The rate of postoperative sensory disturbance in surgical treatment of mandibular fracture involving the region of the intra bony course of the inferior alveolar nerve, including the post-traumatic sensory disturbance, was 76.9%, and 55% following surgical treatment of midfacial fractures. The incidence of persistent sensory disturbances following surgical treatment was 7.7% in the case of mandibular fractures, and 15% in the case of midfacial fractures (sharp/blunt test, two-point discrimination test, masseter reflex). Recovery of neurological function is delayed in the presence of a displaced fracture (>1 mm) as compared with non-displaced fractures. For the postoperative calibration of sensory disturbances, electromyographic recording of the masseter reflex from the fourth postoperative week onwards has proved useful.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Dentistry</subject><subject>Electromyography</subject><subject>Ent, stomatology, face, injuries. Foreign bodies. Diseases due to physical agents: otorhinolaryngology</subject><subject>Facial Bones - injuries</subject><subject>Facial Bones - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fracture Fixation, Internal - adverse effects</subject><subject>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</subject><subject>Humans</subject><subject>Incidence</subject><subject>Joint Dislocations - complications</subject><subject>Joint Dislocations - surgery</subject><subject>Male</subject><subject>Mandibular Fractures - complications</subject><subject>Mandibular Fractures - surgery</subject><subject>Masseter Muscle - physiopathology</subject><subject>Maxillofacial surgery. Dental surgery. Orthodontics</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Orbit - innervation</subject><subject>Prospective Studies</subject><subject>Reflex - physiology</subject><subject>Sensation Disorders - etiology</subject><subject>Sensory Thresholds - physiology</subject><subject>Skull Fractures - complications</subject><subject>Skull Fractures - surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Touch - physiology</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Trigeminal Nerve Injuries</subject><issn>1010-5182</issn><issn>1878-4119</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkduq1TAQhoMo7oM-gpILEb2oJj2k7ZXIxq3CBgX1OkySKUbapibpgvVCPqfT1SV6500mzHxz4P8ZeyLFKymkev2FXlE0sitf9P3LTgjZF809dim7titqKfv79P-DXLCrlH4IIZTo-ofsQoqqLmVdX7Jfn2NIC9rsD8hTXt2Rh5kvIeUiR1gnyN5ymN0pFRaMsJM4pxCP3HnqiQZmi4mHgefvyP08YPQhchgPGEaIfMZIPdsUqkUI0fgM4zntZz5RyZt1Qzdo8m4A64kg2NJ8TI_YgwHGhI_P8Zp9u3339eZDcffp_cebt3eFrRuVCwmDVNY6MTgwtWxMhWAEqAbLCg0IbJU1xnWdaokqB-kkkiJD2VqsWmyqa_Z8n7vE8HPFlPXkk8VxhBnDmrTq27arq4rAZgct6ZciDnqJfoJ41FLozSB9Mkhv6uu-1yeD9Lbg6XnBaiZ0_3TtjhDw7AxAsjCSArP16S_X0vGVIuzNjiGpcfAYdbIeyQbnI7mpXfD_ueQ3fpCzaQ</recordid><startdate>19990401</startdate><enddate>19990401</enddate><creator>Schultze-Mosgau, Stefan</creator><creator>Erbe, Martin</creator><creator>Rudolph, Dirk</creator><creator>Ott, Rudolf</creator><creator>Neukam, Friedrich Wilhelm</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19990401</creationdate><title>Prospective study on post-traumatic and postoperative sensory disturbances of the inferior alveolar nerve and infraorbital nerve in mandibular and midfacial fractures</title><author>Schultze-Mosgau, Stefan ; Erbe, Martin ; Rudolph, Dirk ; Ott, Rudolf ; Neukam, Friedrich Wilhelm</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-1af16ccd0fdab415b3eab0a65e23eba0e76cbbd8867ccd2f1d1e089f27ce37e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Dentistry</topic><topic>Electromyography</topic><topic>Ent, stomatology, face, injuries. Foreign bodies. Diseases due to physical agents: otorhinolaryngology</topic><topic>Facial Bones - injuries</topic><topic>Facial Bones - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fracture Fixation, Internal - adverse effects</topic><topic>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</topic><topic>Humans</topic><topic>Incidence</topic><topic>Joint Dislocations - complications</topic><topic>Joint Dislocations - surgery</topic><topic>Male</topic><topic>Mandibular Fractures - complications</topic><topic>Mandibular Fractures - surgery</topic><topic>Masseter Muscle - physiopathology</topic><topic>Maxillofacial surgery. Dental surgery. Orthodontics</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Orbit - innervation</topic><topic>Prospective Studies</topic><topic>Reflex - physiology</topic><topic>Sensation Disorders - etiology</topic><topic>Sensory Thresholds - physiology</topic><topic>Skull Fractures - complications</topic><topic>Skull Fractures - surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Touch - physiology</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Trigeminal Nerve Injuries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schultze-Mosgau, Stefan</creatorcontrib><creatorcontrib>Erbe, Martin</creatorcontrib><creatorcontrib>Rudolph, Dirk</creatorcontrib><creatorcontrib>Ott, Rudolf</creatorcontrib><creatorcontrib>Neukam, Friedrich Wilhelm</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cranio-maxillo-facial surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schultze-Mosgau, Stefan</au><au>Erbe, Martin</au><au>Rudolph, Dirk</au><au>Ott, Rudolf</au><au>Neukam, Friedrich Wilhelm</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective study on post-traumatic and postoperative sensory disturbances of the inferior alveolar nerve and infraorbital nerve in mandibular and midfacial fractures</atitle><jtitle>Journal of cranio-maxillo-facial surgery</jtitle><addtitle>J Craniomaxillofac Surg</addtitle><date>1999-04-01</date><risdate>1999</risdate><volume>27</volume><issue>2</issue><spage>86</spage><epage>93</epage><pages>86-93</pages><issn>1010-5182</issn><eissn>1878-4119</eissn><coden>JCMSET</coden><abstract>In a prospective study (January 1999 to December 1997), 34 patients with 26 mandibular and 20 midfacial fractures were investigated. All the fractures were managed by osteosynthesis. To evaluate the incidence and duration of recovery of post-traumatic and postoperative sensory disturbaces, the following tests were carried out: sharp/blunt testing, and the two-point discrimination test as conventional clinical examination methods, and electromyographic recording of the masseter reflex to calibrate the clinical findings. To establish the sensory status of the inferior alveolar and the infraorbital nerves in the region of the fracture, and on the intact and control sides, the tests were performed pre-operatively and postoperatively on the seventh day, after 4 weeks and after 3, 6 and 12 months. The incidence of post-traumatic sensory disturbance was 46% for mandibular fractures and 65% for fractures to the midface (sharp/blunt test, two-point discrimination test). The rate of postoperative sensory disturbance in surgical treatment of mandibular fracture involving the region of the intra bony course of the inferior alveolar nerve, including the post-traumatic sensory disturbance, was 76.9%, and 55% following surgical treatment of midfacial fractures. The incidence of persistent sensory disturbances following surgical treatment was 7.7% in the case of mandibular fractures, and 15% in the case of midfacial fractures (sharp/blunt test, two-point discrimination test, masseter reflex). Recovery of neurological function is delayed in the presence of a displaced fracture (>1 mm) as compared with non-displaced fractures. For the postoperative calibration of sensory disturbances, electromyographic recording of the masseter reflex from the fourth postoperative week onwards has proved useful.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>10342144</pmid><doi>10.1016/S1010-5182(99)80019-5</doi><tpages>8</tpages></addata></record> |
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subjects | Adolescent Adult Aged Biological and medical sciences Dentistry Electromyography Ent, stomatology, face, injuries. Foreign bodies. Diseases due to physical agents: otorhinolaryngology Facial Bones - injuries Facial Bones - surgery Female Follow-Up Studies Fracture Fixation, Internal - adverse effects Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics Humans Incidence Joint Dislocations - complications Joint Dislocations - surgery Male Mandibular Fractures - complications Mandibular Fractures - surgery Masseter Muscle - physiopathology Maxillofacial surgery. Dental surgery. Orthodontics Medical sciences Middle Aged Orbit - innervation Prospective Studies Reflex - physiology Sensation Disorders - etiology Sensory Thresholds - physiology Skull Fractures - complications Skull Fractures - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Touch - physiology Traumas. Diseases due to physical agents Trigeminal Nerve Injuries |
title | Prospective study on post-traumatic and postoperative sensory disturbances of the inferior alveolar nerve and infraorbital nerve in mandibular and midfacial fractures |
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