How Can Paresthesia After Zygomaticomaxillary Complex Fracture Be Determined After Long-Term Follow-Up? A New and...

Area of Science:

• Neurosurgery
• Sensory Neurophysiology

Background:

• Unilateral zygomaticomaxillary bone fractures (UZF) often require open reduction and internal fixation (ORIF).
• Post-surgical paresthesia in the infraorbital region can occur, necessitating sensitive diagnostic tools.

Purpose of the Study:

• To evaluate the efficacy of Current Perception Threshold (CPT) testing in detecting minor infraorbital paresthesia post-ORIF for UZF.
• To identify the specific nerve fiber types implicated in this post-surgical paresthesia.

Main Methods:

• A retrospective cohort study involving UZF patients and healthy controls.
• Neurosensory testing using Semmes-Weinstein (S-W) monofilaments and CPT was performed preoperatively and at 1 and 5 years postoperatively.
• Statistical analysis (t-test) compared test results between affected and unaffected sides, and between patient and control groups.

Main Results:

• All 10 UZF patients reported paresthesia at 1 and 5 years postoperatively.
• While Semmes-Weinstein (S-W) test values normalized by 5 years, CPT testing revealed persistent deficits.
• CPT results indicated significant improvement in A-beta fiber function at 5 years, but not for A-delta and C fibers.

Conclusions:

• CPT testing is superior to S-W testing for detecting subtle infraorbital nerve paresthesia after UZF.
• Paresthesia in this region following ORIF is primarily associated with damage to A-delta and C nerve fibers.