scholarly journals Blink reflex changes and sensory perception in infraorbital nerve-innervated areas following zygomaticomaxillary complex fractures

2020 ◽  
Vol 47 (6) ◽  
pp. 559-566
Author(s):  
Young Sook Park ◽  
Jaehoon Choi ◽  
Sang Woo Park

Background Infraorbital nerve dysfunction is commonly reported after zygomaticomaxillary complex fractures. We evaluated sensory changes in four designated areas (eyelid, nose, zygoma, and lip) innervated by the infraorbital nerve. This evaluation was conducted using the static two-point discrimination test and the vibration threshold test. We assessed the diagnostic significance of the blink reflex in patients with infraorbital nerve dysfunction.Methods This study included 18 patients, all of whom complained of some degree of infraorbital nerve dysfunction preoperatively. A visual analog scale, the infraorbital blink reflex, static two-point discrimination, and the vibration threshold were assessed preoperatively, at 1 month postoperatively (T1), and at a final follow-up that took place at least 4 months postoperatively (T4). The results were analyzed using a multilevel generalized linear mixed model.Results Scores on the visual analog scale significantly improved at T1 and T4. The infraorbital blink reflex significantly improved at T4. Visual analog scale scores improved more rapidly than the infraorbital blink reflex. Two-point discrimination significantly improved in all areas at T4, and the vibration perception threshold significantly improved in the eyelid at T4.Conclusions Recovery of the infraorbital blink reflex reflected the recovery of infraorbital nerve dysfunction. We also determined that the lip tended to recover later than the other areas innervated by the infraorbital nerve.

2020 ◽  
Vol 13 (2) ◽  
pp. 105-108
Author(s):  
Reza Tabrizi ◽  
Majid Neamati ◽  
Sara Rajabloo ◽  
Fatemeh Latifi

Study Design: A cross-sectional study. Objective: Neurosensory disturbances (NSDs) of the infraorbital nerve (ION) are common following orbito-zygomaticomaxillary complex (ZMC) fractures. This study aimed to evaluate the effect of lag time between injury and treatment on recovery of NSDs of the ION following open reduction internal fixation. Methods: Subjects who had ZMC fracture and paresthesia were studied. The lag time between injury and treatment was considered as the predictive factor. The level of NSDs according to the brush test and two-point discrimination (TPD) test and self-reported NSD were the outcomes of this study. Self-reported NSD was quantified using a visual analog scale. Results: Forty patients were studied. The lag time between injury and treatment had a significant correlation with the result of the TPD test and the self-reported level of NSD. In 73.6% of patients who had NSD following ZMC fracture, every 1-day delay in treatment increased the incidence of self-reported paresthesia by 0.44. Conclusions: It seems, a delay in treatment of ZMC fractures increased the risk of NSD.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jean-François Devoti ◽  
Romain Nicot ◽  
Thomas Roland-Billecart ◽  
Joël Ferri ◽  
Matthias Schlund

2008 ◽  
Vol 35 (12) ◽  
pp. 903-916 ◽  
Author(s):  
D. SAKAVICIUS ◽  
G. JUODZBALYS ◽  
R. KUBILIUS ◽  
G. P. SABALYS

2005 ◽  
Vol 24 (07) ◽  
pp. 626-639 ◽  
Author(s):  
V. Pfaffenrath ◽  
L. Pageler ◽  
H. Peil ◽  
B. Aicher ◽  
H. C. Diener

ZusammenfassungDie Wirksamkeit, Sicherheit und Verträglichkeit einer Einzelgabe von zwei Tabletten der fixen Dreierkombination mit 250 mg Azetylsalizylsäure (ASS) plus 200 mg Paracetamol plus 50 mg Koffein (Thomapyrin®) gegenüber zwei Tabletten mit 500 mg ASS, oder zwei Tabletten mit 500 mg Paracetamol, oder zwei Tabletten mit 50 mg Koffein beziehungsweise Plazebo wurde in einer klinischen Studie an 1 743 Patienten geprüft, die ihre episodischen Kopfschmerzen vom Spannungstyp oder ihre Migräne mit und ohne Aura üblicherweise erfolgreich mit verschreibungsfreien Analgetika behandeln. Die Dreierkombination war im a priori definierten primären Endpunkt “Zeit bis zu 50% Schmerzreduktion” sowohl der Zweierkombination aus ASS plus Paracetamol (p = 0,0181), als auch den Monoanalgetika ASS (p = 0,0398) und Paracetamol (p = 0,0016), sowie auch der Monotherapie mit Koffein (p < 0,0001) und Plazebo (p < 0,0001) überlegen. Alle Behandlungen außer der Koffein-Monotherapie waren der Plazebobehandlung überlegen (p < 0,0001). Die überlegene Wirksamkeit der Dreierkombination gilt auch für alle sekundären Endpunkte wie beispielsweise der “Verringerung der Kopfschmerzen auf 10 mm VAS (visual analog scale = visuelle Analogskala zur Schmerzmessung), dem gewichteten % SPID (sum of pain intensity difference = aufsummierte Schmerzintensitätsdifferenz gegenüber dem Ausgangsschmerz in Prozent), dem Ausmaß der Beeinträchtigung der alltäglichen Aktivitäten und der globalen Beurteilung der Wirksamkeit durch die Patienten. Alle Behandlungen waren gut verträglich, die Inzidenz von unerwünschten Begleiterscheinungen war gering.


2020 ◽  
Vol 37 (4) ◽  
pp. 298-322 ◽  
Author(s):  
Marco Costa ◽  
Mattia Nese

Perceived valence, tension, and movement of harmonic musical intervals (from the unison to the octave presented in a low- and high-register) and standard noises (brown, pink, white, blue, purple) were assessed in two studies that differed in the crossmodal procedure by which tension and movement were rated: proprioceptive device or visual analog scale. Valence was evaluated in both studies with the visual analog scale. In a preliminary study, the proprioceptive device was calibrated with a psychophysical procedure. Roughness of the stimuli was included as covariate. Tension was perceived higher in dissonant intervals and in intervals presented in the high register. The higher the high-pitch energy content in the standard noise, the higher the perceived tension. The visual analog scale resulted in higher tension ratings than the proprioceptive device. Perception of movement was higher in dissonant intervals, in intervals in the high register, and in standard noises than in musical intervals. High-pitch spectrum noises were associated with more sense of movement than low-pitch spectrum noises. Consonant intervals and low-register intervals were evaluated as more pleasant than dissonant and high-register intervals. High-pitch spectrum purple and blue noises were evaluated as more unpleasant than low-pitch spectrum noises.


2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Ahmed Shawky Ammar ◽  
Mohamed Ahmed El Tabl ◽  
Dalia Salah Saif

Abstract Background Various surgical options are used for the treatment of ulnar nerve entrapment at the elbow. In this study, anterior trans-muscular transposition of the ulnar nerve was used for the treatment of cubital tunnel syndrome. Objectives To evaluate the surgical results of anterior trans-muscular transposition technique for the treatment of cubital tunnel syndrome with particular emphasis on clinical outcome. Methods Forty patients with cubital tunnel syndrome were operated using anterior trans-muscular transposition technique. Patients were classified into post-operative clinical outcome grades according to the Wilson & Krout criteria, and they were followed up by visual analog scale (VAS), the Disability of Arm Shoulder and Hand (DASH) questionnaire, electrophysiological study, and post-operative clinical evaluation. Results Forty patients with cubital tunnel syndrome who underwent anterior trans-muscular transposition of the ulnar nerve show a significant clinical improvement at 24 months post-surgery regarding visual analog scale (VAS), the Disability of Arm Shoulder and Hand (DASH) questionnaire, electrophysiological study, and the Wilson & Krout grading as 87.5% of the patients recorded excellent and good outcome. Conclusion Anterior transmuscular transposition of the ulnar nerve is a safe and effective treatment for ulnar nerve entrapment at the elbow.


2021 ◽  
pp. neurintsurg-2020-017238
Author(s):  
Henri Salle ◽  
Alexandre Meynard ◽  
Emilie Auditeau ◽  
Clément Gantois ◽  
Aymeric Rouchaud ◽  
...  

BackgroundThere is no consensus on the treatment for spinal injuries resulting in thoracolumbar fractures without neurological impairment. Many trauma centers are opting for open surgery rather than a neurointerventional approach combining posterior percutaneous short fixation (PPSF) plus balloon kyphoplasty (BK).ObjectiveTo assess the safety and efficacy of PPSF+BK and to estimate the expected improvement by clarifying the factors that influence improvement.MethodsWe retrospectively reviewed patients who underwent PPSF+BK for the treatment of single traumatic thoracolumbar fractures from 2007 to 2019. Kyphosis, loss of vertebral body height (VBH), clinical and functional outcomes including visual analog scale and Oswestry disability index were assessed. We examined the overall effects in all patients by constructing a linear statistical model, and then examined whether efficacy was dependent on the characteristics of the patients or the fractures.ResultsA total of 102 patients were included. No patient experienced neurological worsening or wound infections. The average rates of change were 74.4% (95% CI 72.6% to 76.1%) for kyphosis and 85.5% (95% CI 84.4% to 86.6%) for VBH (both p<0.0001). The kyphosis treatment was more effective on Magerl A3 and B2 fractures than on those classified as A2.3, as well as for fractures with slight posterior wall protrusion on the spinal canal. A higher postoperative visual analog scale score was predictive of poorer outcome at 1 year.ConclusionsThis is the largest series reported to date and confirms and validates this surgical treatment. All patients exhibited improved kyphosis and restoration of VBH. We advise opting for this technique rather than open surgery.


2021 ◽  
pp. 194338752110225
Author(s):  
Kathia Dubron ◽  
Maarten Verbist ◽  
Eman Shaheen ◽  
Titiaan Jacob Dormaar ◽  
Reinhilde Jacobs ◽  
...  

Study Design: Retrospective study. Objective: Zygomaticomaxillary complex (ZMC) fractures are common facial injuries with heterogeneity regarding aetiologies, fracture types, infraorbital nerve (ION) involvement, and treatment methods. The aim of this study was to identify associations between aetiologies, fracture types, and neurological complications. Additionally, treatment methods and recovery time were investigated. Methods: Medical files of 272 patients with unilateral and bilateral ZMC fractures were reviewed, whose cases were managed from January 2014 to January 2019 at the Department of Oral and Maxillofacial Surgery, University hospitals Leuven, Belgium. History of ION sensory dysfunction and facial nerve motoric dysfunction were noted during follow-up. Results: ION hypoaesthesia incidence was 37.3%, with the main causes being fall accidents, road traffic accidents, and interpersonal violence. Significant predictors of ION hypoaesthesia were Zingg type B fractures ( P = 0.003), fracture line course through the infraorbital canal ( P < .001), orbital floor fracture ( P < 0.001), and ZMC dislocation or mobility ( P = 0.001). Conclusion: Of all ZMC fractures, 37.3% exhibited ION hypoaesthesia. Only ZMC Zingg type B fractures (74.0%) were significantly more associated with ION hypoaesthesia. ION hypoesthesia was more likely (OR = 2.707) when the fracture line course ran through the infraorbital canal, and was less dependent on the degree of displacement. Neuropathic pain symptoms developed after ZMC fractures in 2.2% patients, posing a treatment challenge. Neuropathic pain symptoms were slightly more common among women, and were associated only with type B or C fractures. No other parameters were found to predict the outcome of this post-traumatic neuropathic pain condition.


Sign in / Sign up

Export Citation Format

Share Document