Effect of Oral and Maxillofacial Injuries on the Development of Post-Traumatic Stress Disorder: A Cross-Sectional Study

ABSTRACT Objective: To assess the influence of oral and maxillofacial trauma on the development of Post-Traumatic Stress Disorder (PTSD) and to determine the efficiency of the Impact of Event Scale-Revised (IES-R) as a diagnostic tool for detecting PTSD in patients with Oral and Maxillofacial injuries. Material and Methods: PTSD was assessed one month postoperatively by the diagnostic instrument, IES-R, to arrive at a provisional diagnosis. A structured clinician-administered PTSD Scale then assessed the patients for the Diagnostic and Statistical Manual of Mental Disorders-5th edition (CAPS-5) to establish a final diagnosis. The assessment of the severity of PTSD was done based on various types of oral and maxillofacial injuries. Results: The IES-R scale provisionally diagnosed 54 subjects with PTSD, out of which 42 were diagnosed to have PTSD by the CAPS-5 scale. Subjects with injuries involving the 'orbital complex,' those presenting with a perceptible scar in the maxillofacial region and with multiple avulsed/ luxated anterior teeth, showed a higher affinity to develop PTSD, and this was statistically significant. Conclusion: Higher levels of PTSD in patients with injuries to the maxillofacial region warrants correct diagnosis and detection, and hence the maxillofacial surgeon plays a vital role in this regard. The IES-R is a useful diagnostic tool to detect PTSD early.

Femoral Nerve in Femoral Triangle: A Morphometric Study with Clinical Relevance

Background: Femoral nerve is a nerve of choice forfemoral nerve blockade. It enters the femoral triangle atthe midinguinal point. However, this point of entry neednot be the same always. Aim and Objectives: This studyis aimed at measuring the morphometry of the femoralnerve with the help of bony landmarks. Material andmethods: Forty adult lower limbs were dissected andthe morphometry of the femoral nerve was studied.Results: The mean distance from the Anterior SuperiorIliac Spine (ASIS) to the pubic tubercle was 12.66 ±1.48 cm. We found the FN from the ASIS at a meandistance of 6.38 ± 1.45 cm. Also, the FN was at a meandistance of 6.76 ± 1.12 cm from the pubic tubercle. Themean length of the FN trunk below the inguinalligament, i.e., in the femoral triangle before the divisionwas 2.19 ± 0.34 cm. However, in 8 lower limbs, the FNtrunk was divided before entering the femoral triangle.Conclusion: The findings of our study serve as anenabling guide to the surgeons, neurologists andanesthetist's in detecting the FN for various clinical andsurgical procedures.