Department of Oral and Maxillofacial Surgery (Head: Dr. C. Politis), Ziekenhuis Oost-Limburg, Campus St.-Jan, Genk, Belgium; Faculty of Medicine, Department of Morphology, Hasselt University, Diepenbeek, Belgium.
J Craniomaxillofac Surg. 2013 Oct;41(7):e137-45. doi: 10.1016/j.jcms.2012.12.001. Epub 2013 Feb 26.
A retrospective chart review of 387 patients with condylar and subcondylar fractures revealed 2 cases of inferior alveolar nerve (IAN) and lingual nerve (LN) anaesthesia following the subcondylar fracture. Only 5 cases have been reported previously. The mechanism of action remains unknown but a review of the literature and an analysis of 120 dry human skulls supported the hypothesis that compression of the mandibular nerve at a high level, close to the foramen ovale, could cause anaesthesia. This complication is rare, because it requires compression at a particular angle. The antero-median angulation of the condyle must be close to the foramen ovale, and the fracture must be a unilaterally displaced fracture. The presence of an enlarged lateral pterygoid plate appeared to enhance the risk of compression. The IAN and LN anaesthesia could be resolved after open reduction of the fracture and IAN and LN anaesthesia constitute a strict indication for an early open fracture reduction.
对 387 例髁突和髁突下骨折患者进行回顾性图表分析显示，2 例患者在下颌髁突骨折后出现下牙槽神经（IAN）和舌神经（LN）麻醉。此前仅有 5 例报道。作用机制尚不清楚，但对文献的回顾和对 120 个干人头骨的分析支持了这样一种假设，即下颌神经在靠近卵圆孔的高位受压可导致麻醉。这种并发症很少见，因为它需要在特定角度下进行压迫。髁突的前正中角度必须接近卵圆孔，且骨折必须为单侧移位骨折。翼外板增大似乎增加了受压的风险。IAN 和 LN 麻醉在骨折切开复位后可得到解决，IAN 和 LN 麻醉构成了早期骨折切开复位的严格适应证。
