Usefulness of the Blink Reflex Study as a Preoperative Evaluation in the Orbitozygomatic Complex Fracture

안와관골 복합체 골절에서 술전 평가로서 눈깜박반사 검사의 유용성

  • Kang, Dae-Il (Department of Plastic and Reconstructive Surgery, Changwon Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Sang-Woo (Department of Plastic and Reconstructive Surgery, Changwon Samsung Hospital, Sungkyunkwan University School of) ;
  • Choi, Jae-Hoon (Yeosu Public Health Center)
  • 강대일 (성균관대학교 의과대학 창원삼성병원 성형외과학교실) ;
  • 박상우 (성균관대학교 의과대학 창원삼성병원 성형외과학교실) ;
  • 최재훈 (여수보건소)
  • Received : 2010.01.14
  • Accepted : 2010.04.22
  • Published : 2010.11.10

Abstract

Purpose: As the evaluation of the preoperative sensibility in the orbitozygomatic complex fracture, used by most surgeons, depends on the patient's subjective judgements, it is difficult to make generalization and to use it as an objective evaluation method. We used the blink reflex study to objectively evaluate injury to the infraorbital nerve. Methods: From December 2008 to November 2009, a total of 16 patients underwent the patient's subjective report on sensory symptoms and the blink reflex study preoperatively. Among patients having orbitozygomatic complex fracture of type III or more according to Henderson's classification and simultaneously suspected as being injured along the infraorbital nerve pathway, patients who had difficulty in checking preoperative sensibility and said 'normal sensibility' were selected as candidates. Results: Fifteen patients showed abnormal R1 on the fracture side. These results suggested that most of patients had injury to the infraorbital nerve. Conclusion: Contrary to the existing tests, the blink reflex study is a useful diagnostic tool in reflecting injury to the infraorbital nerve objectively.

Keywords

References

  1. Ohki M, Takeuchi N: Objective evaluation of infraorbital nerve involvement in maxillary lesions by means of the blink reflex. Arch Otolaryngol Head Neck Surg 128: 952, 2002 https://doi.org/10.1001/archotol.128.8.952
  2. Ellis E 3rd, el-Attar A, Moos KF: An analysis of 2,067 cases of zygomatico-orbital fracture. J Oral maxillofac Surg 43: 417, 1985 https://doi.org/10.1016/S0278-2391(85)80049-5
  3. Fogaca WC, Fereirra MC, Dellon AL: Infraorbital nerve injury associated with zygoma fractures: documentation with neurosensory testing. Plast Reconstr Surg 113: 834, 2004 https://doi.org/10.1097/01.PRS.0000105335.41930.41
  4. Kwon YS, Kim MH, Lee JH, Heo J, Lee KC, Seok Kwun Kim: Infraorbital nerve function following tailoring of medpore in reconstruction of inferior orbital wall fracture. J Korean Soc Plast Surg 35: 675, 2008
  5. Taicher S, Ardekian L, Samet N, Shoshani Y, Kaffe I: Recovery of the infraorbital nerve after zygomatic complex fractures: a preliminary study of different treatment methods. J Oral maxillofac Surg 22: 339, 1993 https://doi.org/10.1016/S0901-5027(05)80662-9
  6. Schultze-Mosgau S, Erbe M, Rudolph D, Ott R, Neukam FW: Prospective study on post-traumatic and postoperative sensory disturbances of the inferior alveolar nerve and infraorbital nerve in mandibular and midfacial fractures. J Craniomaxillofac Surg 27: 86, 1999 https://doi.org/10.1016/S1010-5182(99)80019-5
  7. Ko YS, Lee SK, Han KT, Lim P: The diagnosis of trigeminal nerve injury in facial trauma by trigeminal somatosensory evoked potential. J Korean Soc Plast Surg 24: 1367, 1997
  8. Jaaskelainen SK, Peltola JK: Clinical application of the blink reflex with stimulation of the mental nerve in the lesions of the inferior alveolar nerve. Neurology 44: 2356, 1994 https://doi.org/10.1212/WNL.44.12.2356
  9. Ghali GE, Jones DL, Wolford LM: Somatosensory evoked potential assessment of the inferior alveolar nerve following third molar extraction. J Oral maxillofac Surg 19: 18, 1990 https://doi.org/10.1016/S0901-5027(05)80562-4
  10. kimura J: The blink reflex as a clinical test. In Aminoff MJ (ed): Electrodiagnosis in Clinical Neurology. 4th ed, Philadelphia, Churchill Livingstone, 1999, p 337