Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study

Abstract

Objectives: To assess the prevalence and recovery of inferior alveolar nerve dysfunction (IAND) in mandibular fractures. Materials and Methods: This was a prospective cohort study. Clinical neurosensory testing was done preoperatively and the IAND was categorized as mild, moderate or severe. Postoperatively, neurosensory testing was repeated at 1 day, 1 week, 1 month, 3 months and every 3 months thereafter. Results: A total of 257 patients with 420 fractures were included in the study with a mean age of 31.7 years. Body fractures (95.9%) had the highest incidence of IAND, followed by the angle fractures (90.1%) and symphysis fractures (27.6%). The condyle and coronoid fractures did not have any IAND and hence were excluded from further study. After eliminating those cases, 232 patients remained in the study with 293 fractures. The overall prevalence of IAND in fractures occurring distal to the mandibular foramen was 56.3%. The changes until 1 week were minimal. From 1 month to 6 months, there was a significant reduction in the severity of IAND. A significant number of cases (60.0%) were lost to follow-up between 6 and 9 months. At 6 months, 23.9% of cases still had some form of IAND and 95.0% of the symphysis, 59.0% of the angle and 34.8% of the body fractures with IAND had become normal. Conclusion:This study documents the reduction in the degree of severity of IAND in the first six months and provides the basis for future studies with longer periods of follow-up.

Comparison of Neurosensory Recovery of the Inferior Alveolar Nerve After Open and Closed Reduction for Mandibular Fractures: A Prospective Study

“…Damage to the IAN can occur due to an accident or a surgical procedure. The occurrence of post-traumatic or pre-treatment dysfunction of the IAN following a fracture of the mandible varies between 5.7% and 58.5%, whereas the occurrence of IAND following treatment varies between 0.9% and 66.7% [ 2 ]. The vast array of prevalence estimates provides evidence for the absence of consistency in both documented occurrences and methodologies employed to evaluate neurosensory impairment [ 3 ].…”

“…The occurrence of inferior alveolar nerve damage (IAND) following the treatment of fractures varies between 0.4% and 91.3%. Assessments of enduring IAN neurosensory impairments following mandibular fractures fall within the range of 0.9%-66.7% [ 2 ]. The wide array of prevalence estimates serves as evidence for the absence of consistency in both recorded occurrences and methodologies employed to evaluate deficiencies in neurosensory function [ 3 ].…”