INFRAORBITAL NERVE DECOMPRESSION

Infraorbital nerve is a branch of the maxillary nerve that comes out through a foramen known as infraorbital foramen located near to the lower bony margin of the eyeball. Its main function is to enable sensation to the lower eyelid, side of the nose and to the upper lip. It is present bilaterally below the bony margin housing the eyeball. Road traffic accidents in which facial injuries are sustained may frequently involve the cheekbones or the bony orbit. When there are fractures of the cheekbone (zygomatic bone) or the orbit, frequently there will be numbness of the areas that are supplied by the infraorbital nerve i.e in the region of the lower eyelid, side of the nose and the upper lip. This condition is known as infraorbital nerve paresthesia. This can be attributed to the entrapment of the infraorbital nerve between the fractured fragments of the bone. Accurate anatomical reduction of the fractured fragments relieves the patients of their symptoms. In some cases, there can be paresthesia following overzealous reduction and fixation of the fractured bones in this region. Care has to be taken by the operating surgeon so that there should not be any pressure on the infraorbital nerve following reduction and fixation. After relieving the nerve of the pressure created by the fractured bony fragments, there may be post-operative symptoms like swelling and pain which are usually relieved by the end of 1^st post-operative week. One such patient with a complaint of paresthesia in the infraorbital region has visited our hospital (Richardson’s dental & craniofacial hospital). He had a history of road traffic accident 1week back and had the symptoms of numbness in the lower eyelid and cheek region. On CT scan examination he had a depressed fracture of the anterolateral wall of the maxilla which caused compression of the infraorbital nerve. After a vestibular incision in the maxillary region, the fractured anterolateral wall of the maxilla is reduced anatomically and the infraorbital nerve was relieved of the pressure caused by the fractured fragments. The patient had minimal swelling and pain post-operatively and was relieved of his numbness symptoms completely. All types of facial trauma surgeries and facial cosmetic surgeries are being done at Richardson’s dental & craniofacial hospital by Dr.Sunil Richardson & his team.