Journal de traumatisme et de traitement

Treatment Strategy for Post-Traumatic Supraorbital and Supratrochlear Neuroma

Abstract

A Lee Dellon

Trauma to the supraorbital ridge is common and long-term sequalae of injury to the supraorbital and supratrochlea nerves is under-appreciated. Blunt trauma from motor vehicle accidents, sports injury, cosmetic surgery, and craniofacial surgery all represent potential sources of injury to these nerves, which are at risk as they traverse a path from intra-orbital to subcutaneous through a bony notch/foramen at the supraorbital ridge. Pain related to these nerves causes migraine headaches, dysesthesias in the forehead, and disability related to medication for chronic pain. A series of 5 patients are presented who represent post-traumatic pain related to these two nerves. Treatment strategies are reviewed. A new operative approach is described in which the proximal end of the supraorbital and the supratrochlear nerves are left within the orbit. Long-term follow-up documents no complications with regard to extraocular muscles and range of motion of the orbit, and significant relief of pain.