Neurosensory recovery after trauma to the orbital floor: a prospective trial with dexamethasone

• Main Authors: Apajalahti, S. (Author), Haapanen, A. (Author), Snäll, J. (Author), Suominen, A.L (Author), Thorén, H. (Author)
• Format: Article
• Language: English
• Published: Churchill Livingstone 2018
• Subjects: adult; Adult; aged; Aged; Aged, 80 and over; Article; blowout fracture; clinical article; controlled study; convalescence; corticosteroid therapy; dexamethasone; Dexamethasone; facial trauma; female; Female; follow up; glucocorticoid; Glucocorticoids; human; Humans; infraorbital nerve; innervation; male; Male; middle aged; Middle Aged; Neurosensory disturbance; orbit; Orbit; orbit fracture; orbital fracture; Orbital Fractures; peripheral neuropathy; postoperative complication; Postoperative Complications; Prospective Studies; prospective study; randomized controlled trial; randomized controlled trial (topic); Recovery of Function; single blind procedure; Single-Blind Method; somatosensory disorder; Somatosensory Disorders; treatment outcome; Treatment Outcome; very elderly
• Online Access: View Fulltext in Publisher

 Our aims were to document the occurrence of neurosensory disturbances of the infraorbital nerve six months after operation for an orbital blow-out fracture, and to find out whether dexamethasone facilitates neurosensory regeneration. Patients were randomly assigned to one of two groups: the study group was given a total of dexamethasone 30 mg, whereas the control group were given neither glucocorticoid nor placebo. Each patient's infraorbital neurosensory state was recorded preoperatively, immediately postoperatively, and six months later. A total of 18 patients were included, eight of whom had neurosensory disturbances six months after the initial trauma that was not affected by dexamethasone. Six of the seven patients who had a delay of seven days or more between trauma and operation had significantly prolonged disturbance at the 180-day clinical follow up compared with those in whom it was less than seven days (p = 0.005). Other possible predictors made no significant difference. Although dexamethasone did not facilitate sensory recovery, its benefits in the management of pain and reduction of swelling may justify its use in the management of facial trauma in selected patients. © 2018 The British Association of Oral and Maxillofacial Surgeons