Inferior alveolar nerve function after mandibular osteotomies

Westermark, Anders; Bystedt, H; Konow, L. von

doi:10.1016/s0266-4356(98)90457-0

Cited by 207 publications

(97 citation statements)

References 18 publications

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“…Posnick et al [13] and Lindquist [14] reported more neurosensory disturbance after SSO with additional GP than SSO alone [12]. They related this to a double crush of the IAN.…”

Section: Discussionmentioning

confidence: 96%

Evaluation of Neurosensory Disturbance Following Orthognathic Surgery: A Prospective Study

Degala

Shetty

Bhanumathi

2013

J. Maxillofac. Oral Surg.

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Aim and Objectives The prospective study was to evaluate the incidence, type of neurosensory disturbance (NSD), grade its severity and monitor its recovery occurring in the lower lip and chin due to damage to inferior alveolar nerve following orthognathic surgery involving mandible. Materials and Methods The study included 10 patients who have undergone sagittal split osteotomy, genioplasty, and anterior subapical osteotomy (ASO). All the patients examined preoperatively and post operatively 1 week, 1 and 6 months according to standardized test to clarify the subjective and objective neurosensory status of the injured nerve. Pin prick test, blunt test, two-point discrimator test, brush stoke direction, light touch test, warm and cold test were used bilaterally to lower lip and chin area. Results Seven patients underwent bilateral sagittal split osteotomy (BSSO) (70 %), one patient had BSSO with genioplasty (10 %), two patients had BSSO with ASO (20 %). During the operation none of the nerves were transectioned, in 60 % of patients nerve was not visible and in 40 % of patients nerve was seen in distal segment. 70 % of patients underwent setback, 30 % of patients underwent advancement. The subjective evaluation of the patients revealed the incidence of 90 % at 1 week, 30 % at 1 month, 20 % at 6 months and 10 % at 1 year post operatively. The altered sensation reported subjectively was hypoesthesia in 50 % of the patients, anaesthesia in 40 % of the patients.There was 100 % recovery in advancement cases and 93.5 % recovery in setback cases. Conclusion There is a high incidence of NSD of the lower lip and chin after BSSO related to advancement, setback, intraoperative nerve encounter and surgical skill. However, recovery of sensation occurs with increasing frequency during the follow-up period. The clinical neurosensory tests are effective guides to study the neurosensory deficit.

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“…Posnick et al [13] and Lindquist [14] reported more neurosensory disturbance after SSO with additional GP than SSO alone [12]. They related this to a double crush of the IAN.…”

Section: Discussionmentioning

confidence: 96%

Evaluation of Neurosensory Disturbance Following Orthognathic Surgery: A Prospective Study

Degala

Shetty

Bhanumathi

2013

J. Maxillofac. Oral Surg.

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“…Trigeminal hypoesthesia is indicated by a prolonged detection of changes in the potential on the scalp after peripheral electrical stimulation (a latency delay) and may be induced by various causal factors such as compression or decompression injury, bone cut, fixation method, patient age, or the amount of segmental movement. [16][17][18][19] In simple sensory test such as 2-point sensory discrimination, collection of output data depends on patient's view with their bias, even if input data such as stimulating pressure is objective. However, TSEP data is directly collected from their electroencephalography derived from cerebral cortex so that data of TSEP could be more objective and reliable.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of upper lip hypoesthesia with a trigeminal somatosensory-evoked potential following Le Fort I osteotomy in combination with mandibular osteotomy

Ueki

Nakagawa

Marukawa

et al. 2007

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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“…Moreover, 2-3.5% of cases with transected nerves never completely recover from paralysis (Turvey, 1985, van Merkesteyn et al, 1987, Nishioka et al, 1987, Westemark et al, 1998. Therefore, it is important to confirm the anatomical position of the inferior alveolar nerve by CT imaging before surgery (Yoshioka et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Assessment of skeletal stability of intraoral vertical ramus osteotomy with one-day maxillary–mandibular fixation followed by early jaw exercise

Ohba

Tasaki

Tobita

et al. 2013

Journal of Cranio-Maxillofacial Surgery

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Purpose: Intraoral vertical ramus osteotomy (IVRO) is an effective surgical technique for cases of mandibular setback, and is simpler and has a lower incidence of mentalis paresthesia compared to sagittal split ramus osteotomy (SSRO), another well-known orthognathic surgical technique for the mandible. However, IVRO has a disadvantage in the prolonged duration of postoperative maxilla-mandibular fixation (MMF) required due to the absence of rigid bone fixation. To avoid an extended MMF period, we developed a postoperative management protocol for our IVRO patients, which includes jaw exercises with elastic bands starting on the second day after surgery.Methods: We evaluated the cephalometric skeletal and dental stabilities of 16 IVRO patients as they followed our protocol.Results: The stabilities were confirmed and were similar to those of previous reports.Conclusion: One-day MMF and early initiation of jaw exercise after IVRO did not affect the jaw position stability. Moreover, our findings suggest that starting jaw exercise earlier after IVRO surgery is beneficial, as it allows patients to avoid a long period of rigid MMF so that they can resume their normal daily activities sooner.

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Inferior alveolar nerve function after mandibular osteotomies

Cited by 207 publications

References 18 publications

Evaluation of Neurosensory Disturbance Following Orthognathic Surgery: A Prospective Study

Evaluation of Neurosensory Disturbance Following Orthognathic Surgery: A Prospective Study

Evaluation of upper lip hypoesthesia with a trigeminal somatosensory-evoked potential following Le Fort I osteotomy in combination with mandibular osteotomy

Assessment of skeletal stability of intraoral vertical ramus osteotomy with one-day maxillary–mandibular fixation followed by early jaw exercise

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