Sensitive nerve function measurement in facial trauma: An observational study.

E Cetira-Filho,Mj Mello,F Costa,Pb Silva,S Santos,A De Aguiar

doi:10.4317/jced.56830

Abstract

BackgroundFacial trauma is responsible for various types of health damage and may be functional or aesthetic. Depending on the degree of energy released in this type of trauma, sometimes an irreversibility degree is obtained. This study aimed to perform an objective evaluation of traumatic peripheral nerve injuries resulting from mandibular fractures and midface, using silicon monofilaments. Material and MethodsThis was an observational, cross-sectional study. All patients with maxillofacial fractures, who were hospitalized by the department of Oral and Maxillofacial Surgery of Instituto Dr. José Frota Hospital, were randomly recruited and screened for inclusion in the present study. Sixty patients, victims of automobile accidents or firearms, were evaluated using Semmes Weinstein monofilaments in the regions corresponding to the mental and infraorbital nerves, right and left. ResultsThe highest frequencies mandibular nerve changes were those that there was a loss protective sensation, but in which, the patient can feel deep pressure and pain; In which the worst sensory alterations occurred in patients’ victims of firearm. In the middle third of the face, the worst alterations were those that there was a loss of the protective and discriminating sensation for hot and cold. ConclusionsThe use of monofilaments is a support tool in oral and maxillofacial traumatology for the diagnosis and monitoring of peripheral sensory alterations. Key words:Peripheral nerve injuries, facial trauma, wounds and injuries, accidents, traffic, violence.

Highlights

The facial fractures occur in a significant proportion worldwide, and epidemiology varies according to the population, in which accidents with motor vehicles, physical aggressions, and falls are the main etiological agents [1,2,3,4]
An evaluation of the sensorial alterations was performed in 60 patients, of both sex, victims of traffic accident (TA) and interpersonal physical violence (IPV), who were assisted in the oral and maxillofacial surgery department
Mandibular sensorial alterations may be due in fractures that involve the inferior alveolar nerve or its branch, the mental nerve

Summary

Introduction

The facial fractures occur in a significant proportion worldwide, and epidemiology varies according to the population, in which accidents with motor vehicles, physical aggressions, and falls are the main etiological agents [1,2,3,4]. Signs and symptoms presented after facial fractures include the nerve lesions of the inferior alveolar nerve and its terminal ramifications - mental nerve, in cases of mandible fractures [5]; or infraorbital nerve, in cases of fractures of the middle third of the face [6], either in the maxillary and/or zygomatic bones. This work aimed to evaluate of sensory alterations of the mental and infraorbital nerves in patients with facial trauma in a public reference trauma hospital, using Semmes Weinstein® esthesiometer (Sorri, Bauru-SP, Brazil). Results: The highest frequencies mandibular nerve changes were those that there was a loss protective sensation, but in which, the patient can feel deep pressure and pain; In which the worst sensory alterations occurred in patients’ victims of firearm. Conclusions: The use of monofilaments is a support tool in oral and maxillofacial traumatology for the diagnosis and monitoring of peripheral sensory alterations

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Conclusion