Duplicate Infraorbital Nerve - An Uncommon Anatomical Variation

Infraorbital nerve, a terminal branch of maxillary division of the trigeminal nerve, exits the infraorbital foramen or notch, providing sensory innervations to the skin and soft tissue of the mid face. Adequate knowledge of the location of the nerve and assessment of its function are important in mid face surgeries and reaching optimal local anesthesia. The location of the infraorbital foramen and incidence of accessory infraorbital foramen have been studied and reported in the literature. The duplication of infraorbital nerve, however, is an uncommon occurrence rarely described in the literature. The case presentation here is a patient with a duplicated infraorbital nerve discovered during an operative repair of mid-facial fracture with access gained through gingivo-buccal incision. Both infraorbital foramina were observed to have their own individual neurovascular bundle. The knowledge of this rare incident is imperative for the trauma surgeon to dissect the area carefully during mid facial surgeries in order to avoid iatrogenic injury to the duplicated Infraorbital nerve and also gain sufficient local anesthesia.