title: Long-term sensory disturbances after orbitozygomatic fractures.
abstract: BACKGROUND
  Orbitozygomatic fractures often lead to infraorbital nerve (ION) injury, and affected sensibility is a common long-term complaint within this patient group. We present a long-term follow-up study where the validated von Frey filament system was used for testing ION sensibility. Furthermore, we examined the incidence of persistent nerve injury and whether more complex fractures led to more pronounced ION sensibility disturbances.
  
  
  METHODS
  Patients treated for facial fractures involving the orbitozygomatic complex were included and the follow-up time was 3 years or more. Depending on the location and severity of the fractures, the patients were divided into 4 groups. The patients answered a questionnaire before ION sensibility testing with von Frey filaments.
  
  
  RESULTS
  Eighty-one patients were examined: 65 males (80%) and 16 females (20%). Examinations were conducted between 3.0 and 7.6 years (mean 4.9 years) after injury. Sixteen patients (20%) had affected and 6 patients (7.4%) had severely affected ION sensibility according to von Frey testing. No statistically significant differences were found in terms of questionnaire score between the groups. There was also no statistically significant correlation between questionnaire results and log von Frey values. Although the effect of groups could not be statistically verified using the log von Frey values, a larger proportion of patients with complex fractures had higher log von Frey values than the other groups.
  
  
  CONCLUSIONS
  Patients with complex fractures report more permanent sensory disturbance of the ION after surgery than those with isolated orbitozygomatic fractures, although this could not be verified statistically with von Frey filament testing at several locations. Hence, a validated method for testing facial sensibility such as von Frey filaments, although sensitive, is inadequate to determine all aspects of sensory malfunction after orbitozygomatic fractures. This suggests that the patient's experience of long-term sensation after trauma may not be correlated with objective measures.
authors: Stockholm Craniofacial Center, Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden. Electronic address: erik.neovius@karolinska.se.
authors: Erik
authors: E
authors: Neovius
authors: Department of General Surgery, Sundsvall-Härnösand County Hospital, Sundsvall, Sweden.
authors: Maria
authors: M
authors: Fransson
authors: Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, Sweden.
authors: Cecilia
authors: C
authors: Persson
authors: Department of Oral- & Maxillofacial Surgery, Örebro University Hospital, Sweden.
authors: Sophie
authors: S
authors: Clarliden
authors: Stockholm Craniofacial Center, Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
authors: Filip
authors: F
authors: Farnebo
authors: Stockholm Craniofacial Center, Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
authors: T Kalle
authors: TK
authors: Lundgren
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009917:Orbital Fractures / Q000150:complications* / Q000601:surgery; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000175:diagnosis / Q000453:epidemiology*; D013997:Time Factors; D015051:Zygomatic Fractures / Q000150:complications* / Q000601:surgery
keywords: Infraorbital nerve; Long-term follow-up; Orbitozygomatic fractures; Sensibility; von Frey filament