Clinical Study Of Trimethoprim Combined With Murine Nerve Growth Factor As An Adjunct To The Treatment Of Infraorbital Nerve Injury After Infraorbital Wall Fracture

Objective:To evaluate the clinical efficacy of local application of trimethoprim combined with murine nerve growth factor in the treatment of infraorbital nerve injury after infraorbital wall fracture by quantitative sensory testing of the infraorbital nerve.Methods:Prospective randomised controlled study.Forty-three patients(43 eyes)with infraorbital wall fractures who underwent revision of infraorbital wall fractures at the Eye Hospital of Nanchang University from April 2020 to March 2021 were included.The patients were divided into two groups using the random number table method.20 patients(20 eyes)in the experimental group had gelatin sponges infiltrated with tretinoin and murine nerve growth factor placed on the nerve injury;23 patients(23eyes)in the control group had no special treatment during the operation.The results were expressed as an asymmetry index(AI),and the recovery of the infraorbital nerve injury was assessed by observing the change in the area of sensory deficit and the quantitative sensory testing.Results:The baseline results showed no differences in gender,age,time of injury,or preoperative sensory testing between the two groups(all P > 0.05).Compared with the preoperative period,the AI values of two-point localization sensation,tactile sensation and nociception were higher in both groups at 1 week after surgery(all P <0.05);all improved to different degrees at 1 month after surgery;the difference in nociception was statistically significant at 3 months after surgery(P < 0.05);and all sensations were significantly improved at 6 months after surgery compared with the pre-treatment period(all P < 0.01).Comparison between groups: the differences in localization and nociception at two points were statistically significant at 1 month after surgery(all P < 0.05);the differences in nociception at 3 months after surgery were statistically significant(P < 0.05),and the nerve recovery efficiency of the test group was better than that of the control group(P < 0.05);at 6 months after surgery,there was no statistical significance compared with the two groups(P > 0.05).Conclusion:1.quantitative sensory tests can be performed on different branches of the infraorbital nerve,with different healing times for different nerve branches.2.local application of tretinoin combined with murine nerve growth factor for the early recovery of infraorbital nerve injury after infraorbital wall fracture was better than that of the group without special intraoperative treatment.