Post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve in mandibular fracture: a prospective study.
10.5125/jkaoms.2016.42.5.259
- Author:
Sunil YADAV
1
;
Hitesh Chander MITTAL
;
Sunita MALIK
;
Vikas DHUPAR
;
Akash SACHDEVA
;
Vijaylaxmy MALHOTRA
;
Gurdarshan SINGH
Author Information
1. Department of Dental Surgery, BPS Government Medical College for Women, Sonepat, India. drsky1@gmail.com
- Publication Type:Original Article
- Keywords:
Mandibular nerve;
Nerve injury;
Mandibular fractures
- MeSH:
Cohort Studies;
Follow-Up Studies;
Humans;
Mandibular Fractures*;
Mandibular Nerve*;
Prospective Studies*;
Risk Factors
- From:Journal of the Korean Association of Oral and Maxillofacial Surgeons
2016;42(5):259-264
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVES: We evaluated and recorded post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve (IAN) in mandibular fracture in order to identify associated risk factors. MATERIALS AND METHODS: This was a prospective cohort study composed of 60 patients treated for mandibular fracture. The primary study variable was the change between the post-traumatic IAN neurosensory examination score and the score after fracture reduction. Risk factors were categorized as demographic, anatomic, fracture displacement, and treatment. Appropriate descriptive and bivariate statistics were computed. RESULTS: Sixty patients with unilateral mandibular fracture reported within 24 hours of injury were evaluated over a one-year period. A post-traumatic neurosensory deficit was observed in 52 patients (86.7%), the percentage of which was reduced to 23.3% over the follow-up period. Abnormal postoperative neurosensory scores were significantly higher in angle fracture cases (33.3%) compared to body fracture cases (11.1%). When recovered and non-recovered neurosensory scores were compared by fracture location, 88.9% of body fracture cases showed significant recovery compared to 66.7% of mandibular angle fracture cases. Cases with less than 5 mm fracture displacement showed statistically significantly higher neurosensory recovery scores (90.6%) compared to those with more than 5 mm fracture displacement (60.7%). CONCLUSION: Use of a miniplate with mono-cortical screws does not play a role in increasing IAN post-traumatic neurosensory deficit. Early management can reduce the chances of permanent neurosensory deficit. Mandibular fracture displacement of 5 mm or more and fracture location were found to be associated with an increased risk of post-traumatic IAN neurosensory score worsening.
