Prediction of neurosensory alterations after sagittal split ramus osteotomy

Kuroyanagi, Norio; Miyachi, Hitoshi; Ochiai, Shigeki; Kamiya, Noboru; Kanazawa, Teruyuki; Nagao, Toru; Shimozato, Kazuo

doi:10.1016/j.ijom.2012.11.016

Cited by 29 publications

(30 citation statements)

References 34 publications

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“…This finding is supported by some previously reported studies which showed that the occurrence of postoperative NSD of the IAN after SSRO is actually not limited to only one variable, but certainly one of the major and frequent reported causes is surgical manipulation during medial dissection of soft tissues related to the lingula [2,11,12,15].On the contrary, a study carried out by Teerijoki-Oksa et al [16] to detect the risk factors of nerve injury during mandibular sagittal split osteotomy concluded that exposure or manipulation of the IAN usually had no effect on nerve function, but the IAN conduction tended to be more disturbed in cases with nerve laceration.…”

Section: Discussionsupporting

confidence: 77%

“…Kuroyanagi and Shimozato [11], in a study for prediction of neurosensory alterations after SSRO, reported that the development of NSD is related to the surgical space on the medial side of the mandibular ramus and subsequent manipulation of the IAN in that region. Limited periosteal degloving prevents excessive stretching of the IAN during SSRO, thus lowering NSD incidence.…”

Section: Discussionmentioning

confidence: 99%

“…During this surgical manipulation, the IAN is likely to be stretched excessively by the channel retractor to allow better visualization in this narrow surgical field. This relationship between the surgical space located medial to the mandibular ramus and the development of NSD remains to be evaluated [11].…”

Section: Introductionmentioning

confidence: 99%

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Incidence of inferior alveolar nerve affection with and without nerve exposure during bilateral sagittal split osteotomy

Sadakah

Elshall

2018

OMX

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Objective: The aim of this study was to determine the presence and severity of inferior alveolar nerve (IAN) affection during bilateral sagittal split osteotomy (BSSO) in two groups of patients with and without direct exposure and visualization of the nerve during surgical procedure. Patients and Methods: In this prospective randomized clinical study, 14 patients (28 sides) indicated for BSSO were included. The sides were randomly divided into two groups with equal number of sides (14 sides). Group I with wide soft tissue dissection of the medial side of the ramus and exposure of IAN above the ligula and group II with minimal soft tissue dissection of the medial side of the ramus without exposure of IAN. For evaluation of neurosensory function of IAN, two methods were used including subjective evaluation and two-point discrimination test. Results: According to the subjective evaluation, there was a statistically significant difference between both groups in favor of group II in all follow-up recalls except in the final one at 12 months postoperatively. Considering the results of two-point discrimination test, the improvement obviously continued during the successive follow-up periods in both groups, with a statistically significant difference in favor of group II until the ninth month, and then in the last follow-up at the 12 th month, the records were almost equal. Conclusion: To markedly reduce the postoperative neurosensory disturbances of IAV and to accelerate the full recovery of sensation of the lower lip and chin regions following BSSO, limited exposure and dissection of the medial soft tissues of the ramus should be practiced with avoidance of direct exposure and manipulation of IAN.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Incidence of inferior alveolar nerve affection with and without nerve exposure during bilateral sagittal split osteotomy

Sadakah

Elshall

2018

OMX

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“…The NSD caused by damage to the IAN is reportedly 9-84.6% [39,40]. Even with careful surgery, injury to the IAN appears unpredictable.…”

Section: Neurosensory Disturbancementioning

confidence: 99%

“…Even with careful surgery, injury to the IAN appears unpredictable. Multiple factors are considered responsible for the development of NSD after SSO, including fixation methods, patient age and surgical procedures, improper splinting, magnitude of mandibular movement, experience of the surgeon, and timing of the postoperative neurosensory evaluation [40]. Injury to the IAN may happen with direct and indirect intraoperative trauma and results in change of sensibility or altered sensation of the lower lip and/or mental region.…”

Section: Neurosensory Disturbancementioning

confidence: 99%

Complications in Orthognathic Surgery

Capone¹,

Sykes²

2012

Complications in Facial Plastic Surgery

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Orthognathic surgery is a common approach for treatment of maxillofacial deformities. Sagittal split ramus osteotomy (SSRO) is one of the most common techniques used to treat various mandibular deformities. A LeFort I osteotomy is suggested in deformities of the maxilla and can be used along with SSRO or intra-oral vertical ramus osteotomy (IVRO).The aim of orthognathic surgery is to improve function and facial appearance; this benefits the patient psychologically and socially. Common complications which may occur in orthognathic surgery include vascular disease, temporomandibular joints (TMJ) problems, nerve damage, infection, bone necrosis, periodontal disease, vision impairment, hearing problems, hair loss, and neuropsychiatric problems. Rarely complications could be fatal. Because of the wide range of complications the surgeon should keep prevention protocols in mind and be prepared to treat them should they occur. In this chapter, common complications of various osteotomies in the mandible and maxilla are discussed.

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