Electromyographic Study in Patients With Surgically Treated Facial Fractures

Abstract

This study, using surface electromyography, analyzed the activity of the masseter muscles of 30 patients with facial bone fractures that were surgically treated. Evaluations were made before surgery and in the 7th, 30th, and 60th days after surgery. The value of each measure and the average of 3 maximum voluntary isometric contractions lasting 5 seconds each were registered, and statistical analyses were performed. Patients had a mean age of 31 years and an average of 1.33 fractures. They were grouped according to the type of fracture as follows: mandibular (50%), zygomatic complex (33%), maxilla (10%), and associated fractures (6.7%). There was a lower masseter activity in the preoperative period, when compared with normal values in all groups of fractures. There was a sharp drop in the masseter activity in the postoperative period of 7 days, and all groups showed recovery of activity in 60 days but still below the normal value referenced in the literature. The mean values of the masseter activity, in descending order, were from the zygomatic complex, mandibular, maxillary, and associated fractures. The unilateral mandibular fractures showed higher values than the bilateral fractures in most of the evaluations. There was a highly significant difference in the comparison of the evolution of the masseter activity on both sides, for mandibular and zygomatic complex fractures, and the pairwise comparison showed significant difference between most groups. It was concluded that facial fractures and surgical procedures had negative effects in the muscle activity as observed using electromyography.

Electromyography assessment in zygomaticomaxillary complex fractures

“…This is consistent with the results of the study of Campolongo et al [5] but they studied masseter activity only and detected a marked drop at 7 days postoperatively.…”

“…All patients showed recovery of muscular activity in 6 weeks, near the value of the study of Campolongo et al (60 days) [5] but still significantly lower than the values of normal sides.…”

“…In the study of Campolongo et al [5], the mean values of the masseter activity, in descending order, were from the zygomatic complex, mandibular, maxillary, and associated fractures and they concluded that facial fractures and surgical procedures had negative effects in the muscle activity as observed using EMG [5]. However, trauma needed to cause fracture in a different facial bone is different, so muscle affection in trauma is also different, that is why we preferred to deal with one type of fracture.…”

“…Both the trauma and its repair procedure can change the masticatory muscle activity share in clinically observed diminished jaw muscle activity in facial fractures [5]. Recovery of normal mouth opening after the fixation of mandibular fractures was reported [6].…”

Trends in Le Fort Fractures at a South American Trauma Care Center: Characteristics and Management

“…Such cases represented 6.6 % of all facial fractures. Other studies have shown a higher frequency of these fractures in maxillofacial trauma, ranging from 10 to 18.2 % [9, [13][14][15]. However, these figures include maxillary dentoalveolar trauma, The total of approaches surpasses the number of patients surgically treated, as many presented with associated facial fractures which represents a significant proportion of cases [9,16].…”