Usefulness of the Blink Reflex Study as a Preoperative Evaluation in the Orbitozygomatic Complex Fracture

PURPOSE: As the evaluation of the preoperative sensibility in the orbitozygomatic complex fracture, used by most surgeons, depends on the patient's subjective judgements, it is difficult to make generalization and to use it as an objective evaluation method. We used the blink reflex study to objectively evaluate injury to the infraorbital nerve. METHODS: From December 2008 to November 2009, a total of 16 patients underwent the patient's subjective report on sensory symptoms and the blink reflex study preoperatively. Among patients having orbitozygomatic complex fracture of type III or more according to Henderson's classification and simultaneously suspected as being injured along the infraorbital nerve pathway, patients who had difficulty in checking preoperative sensibility and said 'normal sensibility' were selected as candidates. RESULTS: Fifteen patients showed abnormal R1 on the fracture side. These results suggested that most of patients had injury to the infraorbital nerve. CONCLUSION: Contrary to the existing tests, the blink reflex study is a useful diagnostic tool in reflecting injury to the infraorbital nerve objectively.

A Retrospective Study on the Injury of Infraorbital Nerve According to Types of Orbitozygomatic Complex Fracture

In the orbitozygomatic complex fracture, sensory impairment due to the damage of the infraorbital nerve is one of the most common symptom and complication. In this report, we have the assumption that surgical approach for rigid fixation method may have correlations to the damage and regeneration of the nerve. Among patients who had open reduction and internal fixation for unilateral orbitozygomatic complex fracture in our hospital from March 1997 to August 2000, we selected 40 cases. The pin-prick test and the 2-point discrimination test on the infraorbital nerve regions were done for testing the sensory impairments. Two different fracture classification methods were used in this research. First, Henderson's method was used. The results of preoperative test results showed that 17 patients out of 40 patients were abnormalities. More specifically, type IV patients had the highest sensory impairments. In a comparison of the approach methods, the patients who adopted both method showed higher tendency of recovery of sensory impairments. From these results, the degree of deviation in the fracture and the type of approach may be an important prognostic factor for the sensory impairments due to the orbitozygomatic complex fracture.