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Ono K, Nishioka T, Obata K, Takeshita Y, Irani C, Kunisada Y, Yoshioka N, Ibaragi S, Tubbs RS, Iwanaga J. Lingual nerve revisited-A comprehensive review Part II: Surgery and radiology. Clin Anat 2024. [PMID: 39121363 DOI: 10.1002/ca.24211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/20/2024] [Accepted: 07/27/2024] [Indexed: 08/11/2024]
Abstract
The lingual nerve (LN) is a branch of the mandibular division of the fifth cranial nerve, the trigeminal nerve, arising in the infratemporal fossa. It provides sensory fibers to the mucous membranes of the floor of the mouth, the lingual gingiva, and the anterior two-thirds of the tongue. Although the LN should rarely be encountered during routine and basic oral surgical procedures in daily dental practice, its anatomical location occasionally poses the risk of iatrogenic injury. The purpose of this section is to consider this potential LN injury risk and to educate readers about the anatomy of this nerve and how to treat it.
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Affiliation(s)
- Kisho Ono
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
- Cancer Biology and Immunology Laboratory, Columbia University Irving Medical Center, New York, New York, USA
| | - Takashi Nishioka
- Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan
- Department of Dental Informatics and Radiology, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Kyoichi Obata
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yohei Takeshita
- Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Chista Irani
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Yuki Kunisada
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Norie Yoshioka
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Anatomical Sciences, St. George's University, West Indies, Grenada
- University of Queensland, Brisbane, Queensland, Australia
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Fukuoka, Japan
- Dental and Oral Medical Center, Kurume University School of Medicine, Fukuoka, Japan
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Vasegh Z, Bakhshaei P, Jahanbani M, Mahmoudi Anzabi R. Evaluation of anatomical relationships in the mandibular third molar region based on its angulation and depth of impaction: a CBCT-based study. Oral Maxillofac Surg 2024; 28:613-622. [PMID: 37620734 DOI: 10.1007/s10006-023-01178-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE The aim of this study is to evaluate the relationship between the inclination/impaction depth and root proximity to the inferior alveolar canal/lingual plate on a millimeter scale using CBCT scans. METHODS 340 CBCT scans of the mandibular third molar (M3) of 219 patients were evaluated for this cross-sectional study. After adjustment of the 3D orientation of the individual's jaws, the study variables including the angulation between M3 and second molar (M2)/occlusal plane (OP), and the distance of mesial (M)/distal (D) roots of M3 from the inferior alveolar canal (IAC) and lingual plate (LP) were measured. Winter's classification was used for the specification of teeth angulation. The vertical position of each M3 was then evaluated using the 3D view window (based on Pell & Gregory classification). The Spearman correlation coefficient was used for reporting the correlation between quantitative variables. The One-way ANOVA test and the Welch analysis were used for inter-group comparisons. Finally, a multivariant analysis of variances was performed. RESULTS Most third molars had a mesioangular inclination (52.1%), and vertical inclination (25.9%) was in second place. There was no significant correlation between angulation and age or the D/LP. A strong positive correlation between M3:M2 and M3:OP was observed (0.983). Furthermore, there was a weak negative correlation between M/IAC or M/LP and angulation (- 0.16 and - 0.13, respectively). Concerning Winter's classification, the relationship between D/IAC and angulation was statistically significant (P = 0.003). Furthermore, teeth in position A had lesser inclination compared to those with B or C positions. Multivariate analysis revealed that there was no statistically significant relationship between particular combinations of inclination-impaction depth and proximity of the M3 roots to the IAC or LP (P = 0.211). CONCLUSIONS The findings of the current study revealed that there is a strong correlation between M3:M2 and M3:OP. The D/IAC was the only variable that had a significant relationship with the angulation of these teeth. Moreover, the roots of horizontally inclined teeth with position A were the closest to the LP and the farthermost to the IAC.
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Affiliation(s)
- Zahra Vasegh
- Oral and Maxillofacial Radiology Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pedram Bakhshaei
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Jahanbani
- Orthodontics Department, School of Dentistry, Babol University of Medical Sciences, Babol, Iran.
| | - Reza Mahmoudi Anzabi
- Orthodontics Department, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Edetanlen EB, Lawani U, Akinniyi T, Ayanere E, Okechi UC, Fomete B, Osunde O, Aladelusi TO. The perception and practice of routine lingual flap retraction in lower third molar surgery among oral and maxillofacial surgeons in Nigeria. Niger Postgrad Med J 2023; 30:293-298. [PMID: 38037785 DOI: 10.4103/npmj.npmj_104_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Background Lingual nerve injury is a known complication of mandibular third molar (M3M) surgery, and retraction of the lingual flap is reported to reduce the incidence of this complication. However, there is no global consensus on the routine retraction of lingual flap. Aim The aim of the study was to assess the perception and practice of lingual flap retraction amongst oral and maxillofacial surgeons in Nigeria. Materials and Methods This cross-sectional national survey was conducted amongst 122 oral and maxillofacial surgeons in Nigeria from January 2023 to March 2023 using a validated, structured, self-administered questionnaire. The questionnaire had three sections and 14-item questions. Section A consists of the sociodemographic questions, Section B comprises questions on perception towards lingual flap retraction, whereas Section C consists of questions on the practice of lingual flap retraction. These questionnaires were deployed as an online survey and as hard copies. Both qualitative and quantitative data were analysed. A critical probability level (P < 0.05) was used as the cut-off level for statistical significance. Results Most of the participants (47.6%) belong to the age group of 31-40 years. The male-to-female ratio was 6:1. Only 12 (9.8%) participants had a positive perception towards routine lingual flap retractions following M3M surgery. Perception of lingual flap retraction was found not to be associated with the demographic variables of the participants (P > 0.05). A total of 95 participants (77.9%) did not raise nor retract the lingual flap during lower third molar surgery. The rate of practice of lingual flap retraction during third molar surgery was not influenced by any of the factors studied (P > 0.05). Conclusion The majority of oral and maxillofacial surgeons in Nigeria do not agree that routine retraction of the lingual flap is necessary to reduce lingual nerve injury and majority, too, do not practice this in their management of impacted lower third molar.
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Affiliation(s)
- Ekaniyere Benlance Edetanlen
- Department of Oral and Maxillofacial Surgery, University of Benin of Benin Teaching Hospital, Benin-City, Edo State, Nigeria
| | - Ufadime Lawani
- Department of Oral and Maxillofacial Surgery, University of Benin of Benin Teaching Hospital, Benin-City, Edo State, Nigeria
| | - Taofeek Akinniyi
- Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University Teaching Hospital, Ife, Osun State, Nigeria
| | - Esther Ayanere
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos, Lagos State, Nigeria
| | - Uchenna C Okechi
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - Benjamin Fomete
- Department of Oral and Maxillofacial Surgery, Amadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Otasowie Osunde
- Department of Oral and Maxillofacial Surgery, University of Calabar Teaching Hospital, Calabar, Cross-River State, Nigeria
| | - Timothy Olukunle Aladelusi
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Ostrowski P, Bonczar M, Wilk J, Michalczak M, Czaja J, Niziolek M, Sienkiewicz J, Szczepanek E, Chmielewski P, Iskra T, Gregorczyk-Maga I, Walocha J, Koziej M. The complete anatomy of the lingual nerve: A meta-analysis with implications for oral and maxillofacial surgery. Clin Anat 2023; 36:905-914. [PMID: 36864652 DOI: 10.1002/ca.24033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
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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Affiliation(s)
- Patryk Ostrowski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Jakub Wilk
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Michalczak
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Julia Czaja
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Martha Niziolek
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Justyna Sienkiewicz
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Elżbieta Szczepanek
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | | | - Tomasz Iskra
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | | | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
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Petroni G, Passaretti A, Zaccheo F, Nardo DD, Testarelli L, Cicconetti A. Lingual Flap Protection during Third Molar Surgery: A Literature Review. Eur J Dent 2021; 15:776-781. [PMID: 34388831 PMCID: PMC8630958 DOI: 10.1055/s-0041-1730042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The purpose of this review was to analyze how the retraction and protection of lingual flap (LF+) could influence the incidence of lingual nerve injury (LNI) during third molar extraction, as compared with protocols that do not involve handling of lingual tissue (LF). A literature review was performed from the “Medline” and “Scopus” medical databases, using the keywords “lingual nerve” and “third molar surgery.” From the selected articles, the mean values for transitory and permanent LNI’s incidence were elaborated, taking into account the group treated with LF+ technique and the group treated with LF technique. Of 480 articles, 11 studies were included in the review. The LF+ group counted 3,866 surgeries and it resulted in a transitory LNI’s mean incidence of 2.98 ± 0.03% and a mean incidence of 0.1 ± 0.003% for permanent LNI. The LF group counted 5,938 surgeries with, respectively, 1.92 ± 0.02 and 0.49 ± 0.006% of transitory and permanent LNI’s incidence mean values. The results of this study suggest that the application of LF+ techniques reduces the risk of damage and injuries of lingual nerve.
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Affiliation(s)
- Giulia Petroni
- Department of Oral and Maxillofacial Sciences, School of Dentistry, Sapienza University of Rome, Rome, Italy
| | | | - Fabrizio Zaccheo
- Department of Oral and Maxillofacial Sciences, School of Dentistry, Sapienza University of Rome, Rome, Italy
| | - Dario Di Nardo
- Department of Oral and Maxillofacial Sciences, School of Dentistry, Sapienza University of Rome, Rome, Italy
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, School of Dentistry, Sapienza University of Rome, Rome, Italy
| | - Andrea Cicconetti
- Department of Oral and Maxillofacial Sciences, School of Dentistry, Sapienza University of Rome, Rome, Italy
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Markiewicz MR, Callahan N, Miloro M. Management of Traumatic Trigeminal and Facial Nerve Injuries. Oral Maxillofac Surg Clin North Am 2021; 33:381-405. [PMID: 34116905 DOI: 10.1016/j.coms.2021.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the area of craniomaxillofacial trauma, neurosensory disturbances are encountered commonly, especially with regard to the trigeminal and facial nerve systems. This article reviews the specific microanatomy of both cranial nerves V and VII, and evaluates contemporary neurosensory testing, current imaging modalities, and available nerve injury classification systems. In addition, the article proposes treatment paradigms for management of trigeminal and facial nerve injuries, specifically with regard to the craniomaxillofacial trauma setting.
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Affiliation(s)
- Michael R Markiewicz
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, 3435 Main Street, 112 Squire Hall, Buffalo, NY 14214, USA; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA; Department of Neurosurgery, Division of Pediatric Surgery, Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA; Craniofacial Center of Western New York, John Oishei Children's Hospital, Buffalo, NY, USA.
| | - Nicholas Callahan
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Room 110, 801 S. Paulina Street, Chicago, IL 60612, USA; Department of Otolaryngology, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Michael Miloro
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Room 110, 801 S. Paulina Street, Chicago, IL 60612, USA
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Prescher H, Ling MX, Bigdelle V, Spiro CL, Lee RC. Scalpel edge roughness affects post-transection peripheral nerve regeneration. Surg Open Sci 2020; 4:1-6. [PMID: 33537665 PMCID: PMC7838729 DOI: 10.1016/j.sopen.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 11/29/2022] Open
Abstract
Background Gentle and precise tissue dissection reduces collateral tissue damage and preserves its structural quality for optimizing healing. This is particularly true for peripheral nerve neurorrhaphy. Axon regeneration kinetics across the repair is dependent on the amount of intraneural fibrosis. The purpose of this study was to determine whether scalpel blade smoothness was a deterministic factor in the kinetics of postneurorrhaphy peripheral axon regeneration. Methods Scalpel transection of the saphenous nerve was performed in 18 female Hartley guinea pigs either by a standard #15 stainless steel scalpel blade or a highly polished version of the same blade. Compound nerve action potential recordings and histochemical assay of neurofilament density proximal and 1 cm distal to the site of nerve transection were quantified postneurorrhaphy at postoperative weeks 5, 9, and 12. Results There was no action potential transmission observed in the distal axons immediately after neurorrhaphy. A substantial acceleration of axonal conduction recovery was observed in nerves transected with polished scalpel blades observed by high compound nerve action potential amplitudes at postneurorrhaphy weeks 5 and 9 (P < .05). In addition, an increased recovery of intra-axonal neurofilament density in nerves transected with polished scalpel blades was observed by postoperative week 5 (P < .05). Conclusion The quality of the scalpel blade is an important determinate of postsurgical healing. Gentle handling of tissue matters. Precise nerve resection reduces lateral axonal injury. Collateral nerve damage increases interneural fibrosis that slows regeneration. Smoother scalpel blades result in faster structural and functional nerve recovery.
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Affiliation(s)
- Hannes Prescher
- Laboratory for Molecular Regeneration, Section of Plastic and Reconstructive Surgery, The University of Chicago, Chicago, IL 60637
| | - Michelle X Ling
- Laboratory for Molecular Regeneration, Section of Plastic and Reconstructive Surgery, The University of Chicago, Chicago, IL 60637
| | - Victoria Bigdelle
- Laboratory for Molecular Regeneration, Section of Plastic and Reconstructive Surgery, The University of Chicago, Chicago, IL 60637
| | - Clifford L Spiro
- Laboratory for Molecular Regeneration, Section of Plastic and Reconstructive Surgery, The University of Chicago, Chicago, IL 60637
| | - Raphael C Lee
- Laboratory for Molecular Regeneration, Section of Plastic and Reconstructive Surgery, The University of Chicago, Chicago, IL 60637
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Pippi R, Spota A, Santoro M. Medicolegal Considerations Involving Iatrogenic Lingual Nerve Damage. J Oral Maxillofac Surg 2018; 76:1651.e1-1651.e13. [DOI: 10.1016/j.joms.2018.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/19/2018] [Accepted: 03/19/2018] [Indexed: 12/20/2022]
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Pippi R, Spota A, Santoro M. Prevention of Lingual Nerve Injury in Third Molar Surgery: Literature Review. J Oral Maxillofac Surg 2017; 75:890-900. [DOI: 10.1016/j.joms.2016.12.040] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 11/23/2016] [Accepted: 12/24/2016] [Indexed: 12/13/2022]
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Use of Fibrin Glue as an Adjunct in the Repair of Lingual Nerve Injury: Case Report. J Oral Maxillofac Surg 2016; 74:1899.e1-4. [PMID: 27235179 DOI: 10.1016/j.joms.2016.04.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 11/20/2022]
Abstract
This report describes a case of lingual nerve injury repair using a novel technique in which Tisseel fibrin glue was used to stabilize an Axoguard nerve conduit placed around the site of primary neurorrhaphy to decrease the number of sutures required for stabilization. Five months postoperatively, the patient subjectively had increased sensation and improved taste in the left lingual nerve distribution. At neurosensory examination, the patient exhibited functional neurosensory recovery (S3+ on the Medical Research Council Scale).
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Lingual nerve deficit following mandibular third molar removal: review of the literature and medicolegal considerations. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 113:e10-8. [PMID: 22669152 DOI: 10.1016/j.tripleo.2011.06.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 06/05/2011] [Accepted: 06/28/2011] [Indexed: 12/15/2022]
Abstract
The removal of mandibular third molars is probably the most frequently performed procedure in oral and maxillofacial surgery, and it is the most common surgical procedure associated with lingual nerve deficit. Lingual sensory impairment remains a clinical problem in oral and maxillofacial surgery and has serious medical and legal implications. In fact, damage to the lingual nerve is a common cause of litigation in dentistry. The purpose of this article was to review the literature about lingual nerve deficit following mandibular third molar removal and discuss the associated medicolegal aspects.
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Peñarrocha MA, Peñarrocha D, Bagán JV, Peñarrocha M. Post-traumatic trigeminal neuropathy. A study of 63 cases. Med Oral Patol Oral Cir Bucal 2012; 17:e297-300. [PMID: 22143689 PMCID: PMC3448319 DOI: 10.4317/medoral.17401] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 09/15/2011] [Indexed: 11/30/2022] Open
Abstract
Introduction. Trigeminal neuropathy is most often secondary to trauma. The present study explores the underlying causes and the factors that influence recovery.
Material and methods. A retrospective case study was made involving 63 patients with trigeminal neuropathy of traumatologic origin, subjected to follow-up for at least 12 months.
Results. Fifty-four percent of all cases were diagnosed after mandibular third molar surgery. In 37 and 19 patients the sensory defect was located in the territory innervated by the mental and lingual nerve, respectively. Pain was reported in 57% of the cases, and particularly among the older patients. Regarding patient disability, quality of life was not affected in three cases, while mild alterations were recorded in 25 subjects and severe alterations in 8. Partial or complete recovery was observed in 25 cases after 6 months, and in 32 after one year. There were few recoveries after this period of time. Recovery proved faster in the youngest patients, who moreover were the individuals with the least pain.
Conclusion. Our patients with trigeminal neuropathy recovered particularly in the first 6 months and up to one year after injury. The older patients more often suffered pain associated to the sensory defect. On the other hand, their discomfort was more intense, and the patients with most pain and the poorest clinical scores also showed a comparatively poorer course.
Key words:Post-traumatic trigeminal neuropathy.
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Affiliation(s)
- M-A Peñarrocha
- Clínica Odontológica, Gascó Oliag 1, 46021 - Valencia, Spain.
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Cruz JPP, de Oliveira RN, Braid ACM. Phonetic damage related to unilateral functional inhibition of the lingual nerve. J Oral Maxillofac Surg 2011; 69:1764-70. [PMID: 21256647 DOI: 10.1016/j.joms.2010.07.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Revised: 07/12/2010] [Accepted: 07/22/2010] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of this study was to analyze the effects of unilateral functional inhibition of the lingual nerve in phonetic function by perceptual and acoustic analyses of speech, which was recorded before and after neurosensory modification of the lingual nerve, and a comparison of results of these evaluations with a subject's self-perception. PATIENTS AND METHODS The sample consisted of 10 volunteers who had the lingual nerve of the right side anesthetized. The analyzed recordings consisted of terms directly dependent on the tongue for production. In the perceptual analysis, pitch and loudness behaviors were observed, in addition to coarticulation and intelligibility. The acoustic analysis of 5 vowels and sibilant /s/ was realized. A questionnaire about the discomfort level in speech production was applied. RESULTS Perceptual/auditive and acoustic parameters showed no significant differences. Although 3 informants declared some kind of discomfort related to speech production, they presented no acoustic or perceptual modification in sound quality. CONCLUSIONS Although inhibition of sensory function of the lingual nerve generated considerable annoyance, there was no specific damage to phonetic function in the group under study, because no differences were observed in the quality of the speech of subjects after applying anesthesia to the lingual nerve.
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