The Use of Sensory Action Potential to Evaluate Inferior Alveolar Nerve Damage After Orthognathic Surgery

Abstract

To assess and monitor the common event of neurosensory disturbance to the inferior alveolar nerve (IAN) after bilateral sagittal split osteotomy, we used clinical sensory tests and neurophysiologic test sensory action potentials. The diagnostic value of these tests was evaluated by comparing them with the degree of nerve damage reported by patients. Fourteen patients undergoing bilateral sagittal split osteotomy were analyzed preoperatively and 2 years postoperatively. Patients were evaluated bilaterally for positive and negative symptoms: light touch sensation, paraesthesia, hyperesthesia, and dysaesthesia; a "sensation score" was then calculated for each patient. Patients were also asked if they would be willing to repeat the procedure knowing the sensation loss they had now. Next, the right and left IAN were evaluated using sensory action potential and correlated with the other results. Before surgery, the medium latency difference between left and right was lower compared with postsurgery, with all patients having some deficit. The reduction in medium amplitude of 67% after the intervention was statistically significant. The frequency of abnormal findings in the electrophysiologic tests indicating IAN injury correlated with subjective sensory alteration. All patients said that they would repeat the surgery. Electrophysiologic testing is recommended for the evaluation of nerve dysfunction and seems a sensitive method for accurately assessing postsurgical nerve conduction.

Systematic review of preoperative mandibular canal position as it relates to postoperative neurosensory disturbance following the sagittal split ramus osteotomy

“…However, previous publications have discussed the variability in the reporting of the percentage of NSD depending on the method of assessment 3 . Patient self-report findings indicate that more than 60% of patients report NSD 6 months after surgery 16 and the alteration can persist for up to 2 years in more than 10% of the patients 17–19 . Currently, there is no generally accepted, standard method of assessing sensory disturbances in the distribution of the IAN following mandibular osteotomy or on the sites to be assessed, which makes the comparison of findings from published reports difficult 3,20 .…”

Identifying criteria for diagnosis of post-traumatic pain and altered sensation of the maxillary and mandibular branches of the trigeminal nerve: a systematic review

“…All of the above-mentioned tests were carried out in 19 (68%) of the 28 studies included. 6,[12][13][14][15][16]18,[20][21][22][23][24][25][26]29,31,32,35,36 Light touch sensation was measured by Calabria et al 17 light touch and pinprick sensation by Jääskeläinen et al, 27 and de Siquiera et al, 19 and sharp-blunt sensation was reported by Benoliel et al 8 Patients were asked to complete the Ten Test-a selfreported measure of subjective function on the injured side by comparing touch sensation on the injured and uninjured sides and rating sensation on the injured side from 0 to 10 by Mundinger et al 28 Neurosensory function was assessed via questionnaires in 2 studies 7,34 and by patient self-reports only in 1 study. 30 The equipment used to carry out these tests varied among the studies.…”

Influence of Electroacupuncture and Laser-Acupuncture on Treating Paresthesia in Patients Submitted to Combined Orthognathic Surgery and Genioplasty

“…Three findings of self-reports of patients indicated that >60% of patients reported neurosensory disorders that persisted up to 6 months after surgery, 72 and that the same change could remain for up to 2 years in >10% of patients. 73,74 Therefore, the current findings suggest that the proposed treatment techniques were more efficient in relation to spontaneous improvement.…”