Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve in mandibular fracture: a prospective study

  • Yadav, Sunil (Department of Dental Surgery, BPS Government Medical College for Women) ;
  • Mittal, Hitesh Chander (Department of Dental Surgery, BPS Government Medical College for Women) ;
  • Malik, Sunita (Department of Dental Surgery, BPS Government Medical College for Women) ;
  • Dhupar, Vikas (Department of Maxillofacial Surgery, Goa Dental College) ;
  • Sachdeva, Akash (Department of Maxillofacial Surgery, Inderprastha Dental College & Hospital) ;
  • Malhotra, Vijaylaxmy (Department of Dental Surgery, SHK Government Medical College) ;
  • Singh, Gurdarshan (Department of Dental Surgery, BPS Government Medical College for Women)
  • Received : 2016.05.27
  • Accepted : 2016.08.26
  • Published : 2016.10.31
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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.

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References

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