Neurosensory Assessment of Infraorbital Nerve Injury Following Unilateral Zygomaticomaxillary Complex Fracture – A Prospective Study

This study aimed to assess the difference in the recovery pattern of branches of infraorbital nerve paraesthesia after zygomaticomaxillary complex (ZMC) fracture in both surgically and non-surgically managed patients.

A prospective, observational study involving 31 patients with unilateral ZMC fracture - 15 in the surgical group (Group A) and 16 in the non-surgical group (Group B) was evaluated. These patients were assessed at the time of injury, 3-months follow-up, and 6-months follow-up for the sensory function of the infraorbital nerve. The assessment of paraesthesia by cotton wisp test, light touch monofilament test, and the cold thermal test was subjected to intra-group and inter-group correlation by McNemar test and Fischer's exact test. Repeated Measures ANOVA with post-hoc Bonferroni test for intra-group correlation and independent sample t-test for inter-group correlation were used for two-point discrimination.

A statistically significant improvement was noted on both 3 and 6 months follow-up in the malar region in group A. Other statistically significant improvements were noted only on 6 months follow-up in the infraorbital region in group A. On the 2-point discrimination test, all the facial regions showed significant improvement in both the groups over 3 months and 6 months of follow-up.

There was a significant improvement in the infraorbital nerve sensory function following ZMC fracture over 6 months; however, the surgical intervention showed no statistical significance. Further, it can also be concluded that the inferior palpebral branch of the infraorbital nerve shows maximum functional disruption resulting in a higher incidence of paraesthesia in the infraorbital and malar region.