The Assessment of Neurosensory Disturbance Following Bilateral Sagittal Split Osteotomy With Subjective and Three-Dimensional Evaluation

İşcan, Duygu; Özbilen, Elvan Önem; Uğurlu, Kemal; Açar, Abdullah

doi:10.1097/scs.0000000000008261

Cited by 2 publications

(1 citation statement)

References 41 publications

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“…NSD of the inferior alveolar nerve, a concern throughout all stages of surgery, is the main issue in mandibular osteotomies, especially BSSO [ 12 ]. The inferior alveolar nerve follows the course of the osteotomy during BSSO, increasing the likelihood of nerve damage.…”

Section: Discussionmentioning

confidence: 99%

Effect of betamethasone injection into the pterygomandibular space on the neurosensory disturbance after bilateral sagittal split ramus osteotomy: a pilot study

Hamad,

Khrwatany,

Mohammed

et al. 2024

Eur J Med Res

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Aim The aim of this study was to evaluate the effect of local betamethasone injection into the pterygomandibular space on postoperative neurosensory deficits. Materials and methods A prospective controlled clinical study was conducted on 16 patients (6 male, 10 female; mean age, 24.95 ± 9.22 years) who underwent bilateral sagittal ramus osteotomy for mandibular discrepancies. One side of each patient’s mandible was randomly selected as the control side, and the opposite side as the experimental side. On the experimental side, a solution of betamethasone (6 mg/1 ml) was injected into the pterygomandibular space after the completion of wound closure. Neurosensory tests, including light touch, two-point discrimination, direction of movement, thermal sensitivity, and pin-prick discrimination, were performed. The follow-up period ranged between 6 and 12 months, according to the particular sensory test. The Fisher exact test was used to analyse the data. Results The light touch sensation was abnormal in 75% of the control side and 31% of the study side, with the difference being significant (p = 0.03). However, at 6 months, all the study cases regained touch sensation, compared to 69% of the control side. No significant difference in direction movement discrimination was seen; however, at 3 months, the study side showed significantly less direction sensation (19%) compared to the control side (56%) (p = 0.02). There was no significant difference in the two-point discrimination; however, at 3 months, the study side had a significantly less abnormal two-point sensation (13%) than the control side (56%) (p = 0.02). In addition, no significant difference was noted in thermal sensitivity or pin-prick sensation. Conclusion Betamethasone injection into the pterygomandibular space reduces neurosensory disturbances after bilateral sagittal split ramus osteotomies nd leads to faster recovery of sensations.

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Section: Discussionmentioning

confidence: 99%

Effect of betamethasone injection into the pterygomandibular space on the neurosensory disturbance after bilateral sagittal split ramus osteotomy: a pilot study

Hamad,

Khrwatany,

Mohammed

et al. 2024

Eur J Med Res

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Parallel Osteotome Technique: New Approach to Reduce Neurosensory Disturbances following Bilateral Sagittal Split Osteotomy

Parameswaran,

Panneerselvam

2024

Plastic &Amp; Reconstructive Surgery

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Purpose: To determine clinically if parallel osteotome technique (POST) reduces incidence of neurosensory disturbances (NSD) following bilateral sagittal split osteotomy (BSSO), and to corroborate the findings with finite element analysis (FEA). Patients & methods: The investigation was a quasi-experimental study involving 30 patients requiring BSSO. The sample was divided into two groups: control undergoing conventional osteotomy technique and experimental using POST. An FEA simulation of the two advocated techniques were also generated for computational analysis. Primary outcome was clinical comparison of subjective and objective measures for NSD, while secondary outcome was comparison of stress, strain and deformation. Osteotomy technique was the exposure studied. Data was analyzed for differences in proportions and means. Results: Thirty patients (12 females and 18 males) with an age range of 18 to 28 (mean 21.6) years were recruited for the study. This provided 60 sides as sample for the study. The experimental group demonstrated significantly lower subjective scores for NSD for the 3 rd (p=0.03) and 6 th month reviews (p=0.025). Objective testing revealed lower incidence of NSD for the experimental group during the 3 rd (p=0.07), 6 th (p=0.007) and 12 th post-operative months (p=0.17). The computational analysis also revealed significantly lower stress (p=0.007), strain (p=0.009) and deformation (p=0.04) on the inferior alveolar nerve with the POST method. Conclusion: Incidence of NSD following BSSO is lower with POST. The technique also induces significantly lower deformational forces on the IAN when compared with the conventional osteotomy method.

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The Assessment of Neurosensory Disturbance Following Bilateral Sagittal Split Osteotomy With Subjective and Three-Dimensional Evaluation

Cited by 2 publications

References 41 publications

Effect of betamethasone injection into the pterygomandibular space on the neurosensory disturbance after bilateral sagittal split ramus osteotomy: a pilot study

Effect of betamethasone injection into the pterygomandibular space on the neurosensory disturbance after bilateral sagittal split ramus osteotomy: a pilot study

Parallel Osteotome Technique: New Approach to Reduce Neurosensory Disturbances following Bilateral Sagittal Split Osteotomy

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