Assessing Infraorbital Nerve Dysfunction in Zygomaticomaxillary Complex Fractures: A Clinical Perspective

Objective: This study investigates the prevalence, clinical patterns, and risk factors associated with infraorbital nerve dysfunction in zygomaticomaxillary complex (ZMC) fractures. Study Design: Cross-Sectional Study Place and Duration: January to December 2024, Department of Oral and Maxillofacial Surgery, Saidu Medical Complex, Swat. Methods: A retrospective observational study of 340 patients with ZMC fractures. Demographic data, clinical symptoms, fracture patterns, and treatment methods were analyzed using frequency distribution. Logistic regression identified predictors of chronic nerve dysfunction. Results: Hypoesthesia (61.8%) was the most common symptom, with 73.5% of patients experiencing infraorbital nerve impairment. In 54.4% of cases, only the infraorbital nerve was affected, while 19.1% had other cranial nerve involvement. Factors increasing the risk of dysfunction included age 45 or older (OR=1.85, p=0.005), road traffic accidents (OR=2.45, p<0.001), bilateral fractures (OR=3.1, p<0.001), and associated injuries (OR=2.25, p<0.001). Open reduction and internal fixation (ORIF) surgery was linked to a higher likelihood of dysfunction (OR=2.75, p<0.001), indicating more severe fractures requiring surgical intervention. Conclusion: Infraorbital nerve dysfunction is common in severe, bilateral ZMC fractures, with increased risk due to age, high-impact trauma, and widespread fracture patterns. Further research is needed to minimize nerve dysfunction following surgery.