Hong Woo Taik, Choi Jin-Hee, Kim Ji Hyun, Kim Yong Hun, Yang Chae-Eun, Kim Jiye, Kim Sug Won
Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Rehabilitation Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Arch Craniofac Surg. 2019 Aug;20(4):223-227. doi: 10.7181/acfs.2019.00234. Epub 2019 Aug 20.
Neurosensory changes are frequently observed in the patients with mid-face fractures, and these symptoms are often caused by infraorbital nerve (ION) damage. Although ION damage is a relatively common phenomenon, there are no established and objective methods to evaluate it. The aim of this study was to test whether trigeminal somatosensory evoked potential (TSEP) could be used as a prognostic predictor of ION damage and TSEP testing was an objective method to evaluate ION injury.
In this prospective TSEP study, 48 patients with unilateral mid-face fracture (only unilateral blow out fracture and unilateral zygomaticomaxillary fracture were included) and potential ION damages were enrolled. Both sides of the face were examined with TSEP and the non-traumatized side of the face was used as control. We calculated the latency difference between the affected and the unaffected sides.
Twenty-four patients recovered within 3 months, and 21 patients took more than 3 months to recover. The average latency difference between the affected side and unaffected side was 1.4 and 4.1 ms for the group that recovered within 3 months and the group that recovered after 3 months, respectively.
Patients who suffered ION damage showed prolonged latency when examined using the TSEP test. TSEP is an effective tool for evaluation of nerve injury and predicting the recovery of patients with ION damage.
在面中部骨折患者中经常观察到神经感觉变化,这些症状通常由眶下神经(ION)损伤引起。虽然ION损伤是一种相对常见的现象,但尚无成熟的客观方法来评估它。本研究的目的是测试三叉神经体感诱发电位(TSEP)是否可作为ION损伤的预后预测指标,并且TSEP检测是评估ION损伤的一种客观方法。
在这项前瞻性TSEP研究中,纳入了48例单侧面中部骨折(仅包括单侧爆裂骨折和单侧颧上颌骨折)且可能存在ION损伤的患者。使用TSEP对双侧面部进行检查,并将未受伤侧面部作为对照。我们计算了患侧与未患侧之间的潜伏期差异。
24例患者在3个月内恢复,21例患者恢复时间超过3个月。3个月内恢复组和3个月后恢复组患侧与未患侧之间的平均潜伏期差异分别为1.4毫秒和4.1毫秒。
遭受ION损伤的患者在使用TSEP检测时显示潜伏期延长。TSEP是评估神经损伤和预测ION损伤患者恢复情况的有效工具。