Does dexamethasone facilitate neurosensory function regeneration after zygomatic fracture? A randomized and controlled trial

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Publication date: Available online 12 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Aleksi Haapanen, Hanna Thorén, Satu Apajalahti, Anna Liisa Suominen, Johanna Snäll
PurposeThis study sought to clarify the rate of neurosensory disturbance (NSD) after zygomatic complex (ZC) fractures in general, and the effect of perioperatively administered dexamethasone on neurosensory recovery.MethodsThis was a single-blinded randomized study aiming to clarify the benefits of perioperative dexamethasone after surgery. The patients were randomly assigned to receive either dexamethasone (up to a total dose of 10 mg or 30 mg) or to act as a control (no glucocorticoid treatment). The outcome variable was NSD, the presence of which was established when patients experienced any sensory disturbance of the infraorbital nerve. Other predictor variables included in the analysis were age, gender, timespan from accident to surgery, surgical approach to the fracture line, and the relation of the fracture to the infraorbital foramen. The statistical significance of associations was evaluated with chi-squared tests.Results64 patients were included in the analyses. Of the patients in the dexamethasone group (either 10 mg or 30 mg), 58.3% had NSD six months post-operatively, whereas in the control group 66.7% of the patients suffered from NSD. This finding was not statistically significant (p=0.565). At the one-month interval, the patients without a fracture through the infraorbital foramen (IOF) had less NSD (p=0.009); this finding was not significant at three and six months postoperatively. Age, gender, injury mechanism, surgical approach, or timespan from accident to surgery were not significant predictors for NSD. In total, 64.4% of the patients still suffered from NSD at six months post operatively.ConclusionThis study showed no benefits of short-term high-dose dexamethasone administration in the neurosensory recovery of patients with ZC fractures. The type of primary trauma is the main cause for NSD, but the precise predictors remain unknown.

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