Evaluation of Infraorbital Nerve Recovery and its Effect on Quality of Life following Open Reduction and Internal Fixation of Zygomaticomaxillary Complex Fractures - An Evaluative Study.

Introduction: The zygomaticomaxillary complex (ZMC) fractures are the second most common fractures affecting the midfacial skeleton. Neurosensory disturbances of the infraorbital nerve are one of the most common signs of ZMC fractures. The aim of the study was to evaluate the neurosensory recovery of the infraorbital nerve and its effect on the quality of life (QoL) following open reduction and internal fixation of ZMC fractures. Methods: Thirteen patients clinically and radiologically diagnosed with unilateral ZMC fractures with neurosensory deficits of the infraorbital nerve were enrolled for this study. All patients were assessed presurgically for neurosensory deficits of the infraorbital nerve using the various neurosensory tests, followed by open reduction with two-point fixation under general anaesthesia. The patients were followed up at one, three and six months postoperatively to evaluate the recovery of neurosensory deficits. Results: Recovery of tactile and pain sensation was relatively complete in 84.62% and 76.92% of patients respectively by the end of six months postoperatively. The spatial mechanoreception of the affected side improved significantly. 61.54% of patients led an excellent QoL six months postoperatively. Discussion: The majority of the patients with ZMC fractures and neurosensory deficits of the infraorbital nerve, when treated with open reduction and internal fixation, have complete recovery of the neurosensory deficits by the end of six months postoperatively. However, some patients may continue to experience some long-term residual deficits, which can affect the patient's QoL.

Use of Marsupialisation for a Conservative Approach to Huge Cystic Lesions of the Jaws - A Report of three Cases.

Rationale: The management of cystic lesions of the jaws presents a challenge to the surgeon. Marsupialisation, one of the conservative management options, has been used as a single or combined surgical treatment modality for the cystic lesions of the jaws. Patient Concerns: All patients presented with a complaint of a firm swelling of the face with one of the patients presenting with paraesthesia in the affected area. Diagnosis: Clinical and radiographic examination was carried out followed by aspiration cytology. All lesions were provisionally diagnosed with odontogenic cystic lesions. Treatment: Marsupialisation under general anaesthesia was carried out for all patients. Postoperatively, a customised obturator was fabricated. Outcomes: All the patients showed good radiological ossification postoperatively. Take-Away Lessons: The approach to larger cysts remains controversial. The long-term results following the marsupialisation of extensive cysts of this report may help surgeons to opt for a conservative approach to such lesions before aggressive options.