Chronic Infraorbital Nerve Compression - 3 Years?

I have chronic minor compression of the infraorbital nerve (little paresthesia) due to originally overlooked zygomatic/maxillary fracture. My neurologist says, it's about 50% chance, that this nerve will fully recover after that long time when surgical decompression (by osteotomy) will be done. The ENG test was NOT performed. She said, that V2 branch of trigeminal nerve cannot be examined. This is gamble, but as she said, there is still a chance. Is she right? isn't she too optimistic?

Doctor Answers 2

Chronic Nerve Compression

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I would agree with your Neurologist.  The recovery chances are slim especially if the nerve has been compressed for 3 years.  The internal scarring of the nerve over that period of time is to great to overcome.

Dr. ES

Nerve Compression

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It is not uncommon for the infraorbital nerve to sustain damage with facial fractures, especially, orbital "blowout" fractures. This most common reason to intervene is chronic pain. However, the most common complaint after both injury and decompression is paresthesia. An electronystagmogram (ENG) tests the vestibulo-ocular pathways, among others, and has nothing to do with the infraorbital nerve. Because of the path the infraorbital nerve takes in the facial bones it is difficult to perform nerve conduction studies. In cases of chronic pain or the need to block it for surgical purposes, I will place local numbing medication near V2 as it exits the foramen rotundum at the skull base, but placing a an electrode would be very difficult.

John C. Ferguson, MD
Honolulu Facial Plastic Surgeon

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