Guidelines for Diagnosis and Treatment of Trigeminal Nerve Injuries

Ruggiero, Salvatore L.; Proothi, Michael

doi:10.1007/978-3-642-35539-4_20

Cited by 4 publications

(3 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These classifications can be used as prognostic indicators for spontaneous nerve recovery. Surgical intervention is indicated in Sunderland Grade IV and V, and may be indicated in Grade III 24 . The only suitable correlate for injury patterns of Sunderland Grade I–IV is quantification of differences in nerve thicknesses and nerve edema, presumably indicating presence and degree of nerve damage.…”

Section: Discussionmentioning

confidence: 99%

High resolution MRI for quantitative assessment of inferior alveolar nerve impairment in course of mandible fractures: an imaging feasibility study

Burian¹,

Sollmann²,

Ritschl³

et al. 2020

Sci Rep

View full text Add to dashboard Cite

The purpose of this study was to evaluate a magnetic resonance imaging (MRI) protocol for direct visualization of the inferior alveolar nerve in the setting of mandibular fractures. Fifteen patients suffering from unilateral mandible fractures involving the inferior alveolar nerve (15 affected IAN and 15 unaffected IAN from contralateral side) were examined on a 3 T scanner (Elition, Philips Healthcare, Best, the Netherlands) and compared with 15 healthy volunteers (30 IAN in total). The sequence protocol consisted of a 3D STIR, 3D DESS and 3D T1 FFE sequence. Apparent nerve-muscle contrast-to-noise ratio (aNMCNR), apparent signal-to-noise ratio (aSNR), nerve diameter and fracture dislocation were evaluated by two radiologists and correlated with nerve impairment. Furthermore, dislocation as depicted by MRI was compared to computed tomography (CT) images. Patients with clinically evident nerve impairment showed a significant increase of aNMCNR, aSNR and nerve diameter compared to healthy controls and to the contralateral side (p < 0.05). Furthermore, the T1 FFE sequence allowed dislocation depiction comparable to CT. This prospective study provides a rapid imaging protocol using the 3D STIR and 3D T1 FFE sequence that can directly assess both mandible fractures and IAN damage. In patients with hypoesthesia following mandibular fractures, increased aNMCNR, aSNR and nerve diameter on MRI imaging may help identify patients with a risk of prolonged or permanent hypoesthesia at an early time.

show abstract

Section: Discussionmentioning

confidence: 99%

High resolution MRI for quantitative assessment of inferior alveolar nerve impairment in course of mandible fractures: an imaging feasibility study

Burian¹,

Sollmann²,

Ritschl³

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…The ION is therefore vulnerable to these fractures. Indeed, neurological signs of sensitivity are described in 24% to 96% of these fractures 1–5 . Peripheral nerve injury varies greatly in terms of topography and severity, 2–4 with hypoesthesia in the ION territory being the most common symptom 6 .…”

mentioning

confidence: 99%

“…Indeed, neurological signs of sensitivity are described in 24% to 96% of these fractures. [1][2][3][4][5] Peripheral nerve injury varies greatly in terms of topography and severity, [2][3][4] with hypoesthesia in the ION territory being the most common symptom. 6 This injury can result from many causes such as trauma, tumors, surgical procedures, injections of local anesthetics, etc.…”

mentioning

confidence: 99%

Characterization of Infraorbital Nerve Sequelae After Orbital Floor or Zygomaticomaxillary Complex Fractures

Devoti

Nicot

Roland-Billecart³

et al. 2021

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Introduction: Neurological sequelae of infraorbital nerve (ION) lesion 6 months after orbital floor or zygomaticomaxillary complex (ZMC) fractures, associated with initial ION injury, were compared according to the treatment performed and the type of fracture. The topographic and symptomatic sequelae at 6 months were described. Materials and Methods: Patients with orbital floor or ZMC fracture associated with initial ION injury, between November 2018 and April 2020 and clinically reassessed 6 months after trauma were included. Detailed neurological symptomatology was assessed by a questionnaire. Results: A total of 81 patients were included. Forty-two patients (51.8%) showed persistent neurological signs, i.e., isolated hypoesthesia in 28 patients (66.7%), isolated pain in 10 patients (23.8%) and both in 5 patients (9.5%). The most affected area was the cheek (42.8%). Thirty-eight patients (46.9%) presented associated signs, which were intermittent in 78.9% of cases. A pronounced improvement happened for 65.1% of patients and 76.7% were not or only slightly hindered in their daily activities. There were significantly more neurologic symptoms at 6 months in the surgical group than in the observational group and more in the ZMC fracture group than in the orbital floor fracture group. Discussion: Neurological symptomatology was more frequent in patients treated surgically. Our results suggest the interest of a surgical decompression when orbital or ZMC fracture is associated with nerve damage but more data are needed. Neurological injury requires a careful initial clinical evaluation and regular follow-up to help patients coping, painful symptoms may benefit from specialized care.

show abstract