J Korean Ophthalmol Soc.  2017 Apr;58(4):373-379. 10.3341/jkos.2017.58.4.373.

Infraorbital Nerve Hypesthesia after Inferior Orbital Wall Fracture and Reconstruction Surgery

• Sung Y
• Lee BJ
• Lew H

• KMID: 2376590
• DOI: http://doi.org/10.3341/jkos.2017.58.4.373

Abstract

PURPOSE
To report the incidence of infraorbital nerve hypesthesia after inferior orbital wall fracture and reconstruction surgery and analyze the duration and factors to influence the occurence of the infraorbital nerve hypesthesia.
METHODS
From March, 2001 to March, 2016, the medical records of 171 patients with isolated orbital floor fracture reconstructed with porous polyethylene or titanium mesh was analyzed retrospectively. Injury mechanism, fracture type, time interval to surgery, fracture size, type and thickness of implant were analyzed. Orbit computed tomography scan was performed at preoperative and postoperative 6 weeks.
RESULTS
Mean age was 30.4 years (male:female = 130:41). The mean time interval to surgery was 9.5 days. Incidence of infraorbital hypesthesia was 9.9% preoperatively, 38% in a week of surgery, 13.5% in 6 weeks and 5.8% in 6 months. Infraorbital hypesthesia lasts 20.5 weeks and the length of infraorbital canal was the only risk factor of persistent infraorbital hypesthesia.
CONCLUSIONS
Postoperative infraorbital nerve hypesthesia presents in a week in most patients. It last about 20.5 weeks, then mostly recovers in 6 months. This study will be useful to predict the clinical course of the patients with infraorbital nerve hypesthesia. Therefore, full explanation about the facial sense change is necessary for the patients with inferior orbital wall fracture.

Keyword

Inferior orbital wall fracture; Infraorbital hypesthesia; Infraorbital nerve

MeSH Terms

Humans
Hypesthesia*
Incidence
Medical Records
Orbit*
Polyethylene
Retrospective Studies
Risk Factors
Titanium
Polyethylene
Titanium

Figure

• 

  Figure 1. Types of inferior orbital wall fractures in the images from the orbital CT scan. I: Fracture not involving the infraorbital ca-nal (I a: coronal view, I b: sagittal view). II: Fracture involving infraorbital canal and medial side from the canal. III: Fracture involving infraorbital canal and temporal side from the canal. IV: Large fracture involving infraorbital canal. V: Focal trap door fracture involving infraorbital canal. CT = computed tomography.

• 

  Figure 2. Infraorbital canal length and angle meas-urement in the sagittal view of the contralateral or-bits from the orbital computed tomography (CT) scan. The length of the infraorbital canal and the angle between the inferior orbital wall and the in-fraorbital canal were measured in the sagittal CT image that the infraorbital canal was well vi-sualized on the assumption that the orbits are symmetric.

• 

  Figure 3. Infraorbital nerve hypesthesia after inferior orbital wall fracture repair surgery. (A) Prevalence of infraorbital nerve hypesthesia. (B) Kaplan-Meier survival analysis for infraorbital hypesthesia following orbital fracture reconstruction surgery. POD = post operative days; CI = confidence interval; D =days; W = week(s); M = months.

• 

  Figure 4. Characteristics of the patients with infraorbital nerve hypesthesia. Early postoperative hypesthesia is a hypesthesia occurs in 10 days after reconstruction surgery. Persistent postoperative hypesthesia is a hypesthesia lasts more than 6 months. * p<0.05, Mann Whitney test; † p<0.05, Independent t-test.

• 

  Figure 5. Analysis according to the types of inferior orbital wall fracture. (A) Inferior orbital wall fracture types in the patients. (B) Patients with infraorbital nerve hypesthesia in postoperative status. POD = post operative days; D =days; W = week(s); M = months.

Reference

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