Effect of duration from lingual nerve injury to undergoing microneurosurgery on improving sensory and taste functions: retrospective study

Nakanishi, Takashi; Yamamoto, Yuta; Tanioka, Kensuke; Shintani, Yukari; Tojyo, Itaru; Fujita, Shigeyuki

doi:10.1186/s40902-019-0244-y

Cited by 12 publications

(13 citation statements)

References 27 publications

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“…Some surgeons have highlighted improved outcome with early repair, 20 others have shown no difference in outcome with delayed repair, 14 while others have demonstrated good outcomes with lengthy delay. 6,19,21 In the present study there was no correlation between delay to surgery and quality of outcome, and significant improvements occurred even after lengthy delay (more than three years). One study highlighted a reduced outcome for taste with longer delays, 6 but with no other adverse outcome, which is in keeping with our results.…”

Section: Discussioncontrasting

confidence: 52%

“…6,19,21 In the present study there was no correlation between delay to surgery and quality of outcome, and significant improvements occurred even after lengthy delay (more than three years). One study highlighted a reduced outcome for taste with longer delays, 6 but with no other adverse outcome, which is in keeping with our results. However, it is our belief that a more favourable result is likely, with less impact on a patient's quality of life, if repair is undertaken earlier (ideally before six months).…”

Section: Discussioncontrasting

confidence: 52%

“…This lack of improvement in taste contrasts with the study by Robinson et al 9 that showed a significant improvement in gustatory function, but correlates with the study by Riediger et al 22 that showed extremely poor recovery of taste following surgery. Nakanishi et al 6 observed a poorer return of gustatory function with an increase in delay to surgery, which may explain why we failed to demonstrate improvement, as many of our patients had a lengthy delay to surgery.…”

Section: Discussionmentioning

confidence: 66%

“…[2][3][4][5] In addition to lost or altered sensation, patients suffering these injuries may develop unpleasant neuropathic pain; they may also complain of reduced or altered taste, impaired speech, or unpleasant inadvertent tongue biting, all of which can have a serious, detrimental effect on quality of life. 6,7 Patients may experience temporary symptoms following lingual injury, but those who have no significant resolution by three months are unlikely to recover spontaneously.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of lingual nerve repair

Atkins

Kyriakidou

2021

British Journal of Oral and Maxillofacial Surgery

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Lingual nerve injury, a well-described complication of third molar removal, may result in permanent lingual sensory deficit leading to symptoms including lost or altered sensation, inadvertent tongue biting, and the development of unpleasant neuropathic pain, with consequent impaired quality of life. We analysed outcomes of a prospective case series to determine whether direct anastomosis of the lingual nerve results in improved sensory recovery and reduced neuropathic pain, and whether delayed surgery is worthwhile. In 114 patients who underwent nerve repair at our nerve injury clinic following damage sustained during mandibular third molar removal, sensory deficit was assessed before and after surgery using a questionnaire and visual analogue scales (VAS) to assess pain, tingling, and discomfort. Neurosensory tests were utilised to evaluate light touch, pin-prick, and two-point discrimination thresholds. Subjectively, 94% patients felt their sensation had improved following nerve repair, with significant reductions in the incidence of tongue biting (p < 0.0001), impaired speech (p < 0.0001), and neuropathic pain (p = 0.0017). Quantitative neurosensory data showed highly significant improvements in light touch, pin-prick, and two-point discrimination (all p < 0.0001), and VAS scores for pain (p = 0.0145), tingling (p < 0.0025), and discomfort (p < 0.0001) were significantly reduced. Patients with high levels of pain preoperatively (VAS > 40) showed highly significant reductions in pain (p < 0.0001). No correlation was found between surgical outcome and patient's age or delay until surgery. Lingual nerve repair results in good sensory outcomes and significant improvements in the incidence and degree of neuropathic pain, even when delayed.

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Section: Discussioncontrasting

confidence: 52%

Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of lingual nerve repair

Atkins

Kyriakidou

2021

British Journal of Oral and Maxillofacial Surgery

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“…One of these studies reveals that an early repair is 2.3 times more likely to result in FSR at 1 year but the outcome between early and late repair groups at final follow up show no difference (24). Yet there are several other studies failing to identify the time to repair as a significant factor influencing the neurosensory recovery (1,(26)(27)(28).…”

Section: Contradictory Information Hinders the Proper Decisionmentioning

confidence: 99%

Inferior alveolar and lingual nerve injuries: an overview of diagnosis and management

Selvi¹,

Yıldırımyan²,

Zuniga³

2022

Front Oral Maxillofac Med

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Oral and maxillofacial surgery operations are susceptible to cause injury to terminal branches of the trigeminal nerve. The mandibular division is more prone to injury than ophthalmic and maxillary nerves. Inferior alveolar branch of the trigeminal nerve is the most commonly injured branch, followed by the lingual nerve. These nerves may be subjected to neurosensorial disturbance during third molar surgery, followed by sagittal split ramus osteotomy, endodontic therapy and dental implant placement. Local anesthetic injections, pre-prosthetic surgery, various other types of orthognathic surgery, ablative tumor surgery involving mandibular resections, osteoradionecrosis, osteomyelitis or maxillofacial trauma are among other potential etiologic factors. If an inferior alveolar or lingual nerve injury occurs, a timely diagnosis and a proper management are key factors to avoid further or permanent damage. A wide range of therapeutic modalities are available in managing nerve injuries, ranging from simple observation to complex grafting, depending on various factors. Data regarding nerve injuries may not always be reliable since most are based upon personal experience and in a retrospective nature. It is also challenging to draw proper conclusions from studies on nerve injuries due to the differences in outcome criteria and assessment methods. Still, an accurate knowledge of anatomy should be combined with both clinical and radiological data to avoid any nerve-related complications. Thus, this article will present a narrative review of the current literature on the inferior alveolar and lingual nerve injuries, focusing on the functional assessment methods, factors influencing recovery, the contemporary management protocols as well as future trends in nerve repairs.

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The complete anatomy of the lingual nerve: A meta‐analysis with implications for oral and maxillofacial surgery

et al. 2023

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Lingual nerve (LN) injury during surgical procedures in the third molar region warrants a detailed study of its common pathway and important variations. Therefore, the objective of this study was to analyze and compile the multiple anatomical variations of the LN for use in oral and maxillofacial surgery. It is anticipated that the results of the present meta-analysis may help to minimize the possible complications when performing procedures associated with this anatomical entity. Major online databases such as PubMed, Web of Science, Scopus, Embase were used to gather all relevant studies regarding the LN anatomy. The results were established based on a total of 1665 LNs. The pooled prevalence of the LN being located below the lingual/ alveolar crest was found to be 77.87% (95% CI: 0.00%-100.00%). The LN was located above the lingual/ alveolar crest in 8.21% (95% CI: 4.63%-12.89%) of examined nerves. The most common shape of the LN was established to be round with a prevalence of 40.96% (95% CI: 23.96%-59.06%), followed by oval at 37.98% (95% CI: 23.98%-53.02%) and flat at 25.16% (95% CI: 12.85%-39.77%). In conclusion, we believe that this is the most accurate and up-to-date study regarding the anatomy of the LN. The LN was found to be located below the lingual/alveolar crest in 77.87% of the cases. Furthermore, the LN was found to enter the tongue under the submandibular duct in 68.39% of the cases. Knowledge about the anatomy of the LN is crucial for numerous oral and maxillofacial procedures such as during the extraction of the third molar.

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Effect of duration from lingual nerve injury to undergoing microneurosurgery on improving sensory and taste functions: retrospective study

Cited by 12 publications

References 27 publications

Clinical outcomes of lingual nerve repair

Clinical outcomes of lingual nerve repair

Inferior alveolar and lingual nerve injuries: an overview of diagnosis and management

The complete anatomy of the lingual nerve: A meta‐analysis with implications for oral and maxillofacial surgery

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