Advances in Oral and Maxillofacial Surgery (Oct 2021)
Neurosensory evaluation of inferior alveolar nerve following mandibular fracture fixation using modified Zuniga and ESSICK’S protocol
Abstract
Introduction: Mandible is most common bone of the craniofacial skeleton to receive impact from various aetiologies, vehicular mishaps being the most common. The injury to the neurovascular bundle damages the inferior alveolar nerve which manifests as neurosensory deficit. The present study evaluates these changes to assess the outcome and recovery time of such nerve injury. Material and methods: After taking the inclusion and exclusion criteria, neurosensory evaluation was carried out using 4 parametes corresponding to leve A,B,C of neurosensory evaluation. The basis of evaluation was done utilising modified Zuniga and Essicks protocol. The samples were divided in three groups based on location of fracture. The intervals of evaluation was done at pre-operative/post-trauma, 3,6,12 months period. Results: A total of 214 cases were considered for the study. There was a homogenous distribution of samples with regards to age and near homogenous distribution of cases with the three groups. The univariate analysis suggests that there is deterioration of nerve response in post-trauma and immediately following fracture fixation. Mutivaraite analysis shows that there is significant change of scrore indicating deterioration of nerve function immediately and 3 months post-op and overall improvement takes place at 12 months post-operative period. Conclusion: The ultimate goal of fracture fixation is to achieve stability in form, function and aesthetics, nerve regeneration after such injuries is seldom being discussed. It is vital that a robust data be available which can throw light on the course of nerve regeneration.
