How to mange infraorbital nerve injury following a fracture?

Question

Hello doctor,

The infraorbital nerve was damaged with subsequent numbness in its distribution following a fracture of the maxillary sinus and infraorbital canal that occurred five years back. The fracture was managed conservatively because it was only mildly dislocated.

However, I have been experiencing numbness and paraesthesia in the territory of the left intraorbital nerve so far.

Please evaluate whether surgery would have cured the numbness or if it would have appropriately addressed this issue.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand the pain and concern. The dentist or the surgeon's first attempt will always address a fracture conservatively. However, while operating on a fractured segment, the nerve decompression is a sensitive and tactile aspect.

In addition, the nerve has anatomic variations and implications that vary from individual to individual. I saw the image enclosed (attachments removed to protect the patient's identity). Still, we cannot pinpoint any iatrogenic error because nerve decompression or injury is a possible consequence in deep fracture cases.

However, the solution to correct the long-term damage would be to consult a reputable maxillofacial surgeon, preferably in a clinic, who can provide practical assistance.

I would suggest supplemental Topiramate therapy. Usually, if needed, they can surgically reverse paresthesia at times in an infraorbital nerve block with zygomatic buttress mini plate fixation. That is what traditional research suggests.

Also, multivitamin supplementation like Neurobion Forte (vitamin B) and antioxidants like SM Fibro (vitamins, minerals , and antioxidants) can be taken daily after food. It will help you reverse the nerve sensation (not always, but worth a try for a few months).

I would suggest a chat on iCliniq for 50 hours or 100 hours if you need further advice from me regarding the same in detail, or about addressing the long-term complications associated with this nerve injury or decompression.

Take care.