J Korean Assoc Oral Maxillofac Surg.  2016 Oct;42(5):259-264. 10.5125/jkaoms.2016.42.5.259.

Post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve in mandibular fracture: a prospective study

• Yadav S
• Mittal HC
• Malik S
• Dhupar V
• Sachdeva A
• Malhotra V
• Singh G

• KMID: 2356251
• DOI: http://doi.org/10.5125/jkaoms.2016.42.5.259

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.

Keyword

Mandibular nerve; Nerve injury; Mandibular fractures

MeSH Terms

Cohort Studies
Follow-Up Studies
Humans
Mandibular Fractures*
Mandibular Nerve*
Prospective Studies*
Risk Factors

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