Okochi Masayuki, Ueda Kazuki, Mochizuki Yasushi, Okochi Hiromi
Associate Professor, Department of Plastic and Reconstructive Surgery, Fukushima Medical University, Fukushima, Japan.
Professor, Department of Plastic and Reconstructive Surgery, Fukushima Medical University, Fukushima, Japan.
J Oral Maxillofac Surg. 2015 Aug;73(8):1554-61. doi: 10.1016/j.joms.2015.02.029. Epub 2015 Mar 18.
The aims of the present study were to analyze the effectiveness of current perception threshold (CPT) testing to determine patients' minor paresthesia of the infraorbital region after open reduction and internal fixation (ORIF) for unilateral zygomaticomaxillary bone fracture (UZF) and to clarify which nerve fiber was related to the paresthesia.
We conducted a retrospective cohort study of patients who had undergone ORIF after UZF. We also performed neurosensory testing for healthy volunteers who served as the control group. The predictor variables were the period of measurement of Semmes-Weinstein monofilament (S-W) testing and CPT testing (preoperatively and 1 and 5 years postoperatively), measurement side, and disease status (UZF or control). The outcome variables were paresthesia status of the infraorbital nerve region and the results of S-W and CPT testing in both UZF and control groups. The differences in the S-W and CPT values between the affected and unaffected sides in the UZF group and between the UZF and control groups were analyzed by t test (P < .05 was considered significant).
The present study included 10 patients (6 males and 4 females), with an average age of 25.0 ± 12.7 years, and 21 controls (10 males and 11 females), with an average age of 24.3 ± 1.7 years. In the control group, the CPT and S-W test results did not show any significant differences between the left and right sides. All 10 patients had paresthesia at 1 and 5 years postoperatively. At 5 years postoperatively, the S-W values in all patients showed normalization. From the results of CPT testing, only the A-β fiber function showed significant improvement at 5 years postoperatively.
The CPT test was an effective sensory test for determining minor paresthesia that could not be detected using S-W testing. Paresthesia of the infraorbital nerve region was caused by the damaged A-δ and C fibers.
本研究旨在分析电流感觉阈值（CPT）测试对于确定单侧颧骨上颌骨骨折（UZF）切开复位内固定（ORIF）术后患者眶下区域轻微感觉异常的有效性，并阐明与感觉异常相关的神经纤维。
我们对UZF后接受ORIF的患者进行了一项回顾性队列研究。我们还对作为对照组的健康志愿者进行了神经感觉测试。预测变量为Semmes-Weinstein单丝（S-W）测试和CPT测试的测量时间（术前、术后1年和5年）、测量侧以及疾病状态（UZF或对照组）。结局变量为UZF组和对照组眶下神经区域的感觉异常状态以及S-W和CPT测试结果。通过t检验分析UZF组患侧与未患侧以及UZF组与对照组之间S-W和CPT值的差异（P <.05被认为具有统计学意义）。
本研究纳入10例患者（6例男性和4例女性），平均年龄25.0±12.7岁，以及21例对照组（10例男性和11例女性），平均年龄24.3±1.7岁。在对照组中，CPT和S-W测试结果在左右两侧之间未显示任何显著差异。所有10例患者在术后1年和5年都有感觉异常。术后5年，所有患者的S-W值均恢复正常。从CPT测试结果来看，仅A-β纤维功能在术后5年有显著改善。
CPT测试是一种有效的感觉测试，可用于确定使用S-W测试无法检测到的轻微感觉异常。眶下神经区域的感觉异常是由受损的A-δ和C纤维引起的。
