Retrospective Review of Microsurgical Repair of 222 Lingual Nerve Injuries

Bagheri, Shahrokh C.; Meyer, Roger A.; Khan, Husain Ali; Kuhmichel, Amy; Steed, Martin B.

doi:10.1016/j.joms.2009.09.111

Cited by 107 publications

(38 citation statements)

References 39 publications

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“…In the MRCS, grades S3, S3+, and S4 are useful in sensory recovery [12]. In our study, 45 patients (86.5%) improved to S3, S3+, and S4 postoperation (Table 1).…”

Section: Resultssupporting

confidence: 51%

Comparison of Subjective and Objective Assessments of Neurosensory Function after Lingual Nerve Repair

et al. 2019

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Objective: Mandibular third molar extractions are important in oral maxillofacial surgery. Damage to the lingual nerves, although rare, is a possible complication. There are reports of postoperative recovery after lingual nerve repair, but few reports have compared subjective and objective assessments of neurosensory function. Therefore, this study aims to compare subjective and objective assessments of neurosensory function after lingual nerve repair. Subjects and Methods: This retrospective cohort study comprised 52 patients with lingual nerve anesthesia after third molar extraction at the Department of Oral and Maxillofacial Surgery, Wakayama Medical University Hospital, Wakayama, Japan, between December 2008 and December 2015. We recorded pre- and postoperative (6 months and 12 months) neurosensory examinations. Results: Patient’s subjective assessments of neurosensory function suggested improvement between the preoperative period and 12 months postoperation, although this difference was not significant. Objective assessment based on examination and testing, on the other hand, showed a significant difference in improvement (p < 0.05). Conclusions: There was no evidence that improvement of subjective preoperative and postoperative assessments was significantly associated with improvement of objective neurosensory assessments after lingual nerve repair. Overall physical condition and background were thought to affect subjective evaluation. Subjective assessment is important in conjunction with objective evaluation because it may reveal dysesthesia that would otherwise be missed. In the future, we will examine those cases in whom subjective assessments showed no improvement although objective assessments showed improvement.

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“…In the MRCS, grades S3, S3+, and S4 are useful in sensory recovery [12]. In our study, 45 patients (86.5%) improved to S3, S3+, and S4 postoperation (Table 1).…”

Section: Resultssupporting

confidence: 51%

Comparison of Subjective and Objective Assessments of Neurosensory Function after Lingual Nerve Repair

et al. 2019

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“…Injuries >9 months showed a significantly higher risk of non‐improvement. Overall, they observed a 5·8% decrease in the odds of improvement for each month repair was delayed . A study of LN‐injury repair timing in 64 patients showed that patients undergoing surgery within 90 days had 93% FSR versus 62·9% for those treated after 90 days.…”

Section: Resultsmentioning

confidence: 99%

“…Altered sensation following IAN and LN injury is a diagnostic and management challenge for dental clinicians who treat these patients. Correct diagnosis, management and appropriate intervention timing are essential for optimising treatment and prognosis following neurosensory deficiency (6,8,16,19,27,30,47,48). Altered sensation associated with trigeminal nerve branch injury is often easily diagnosed; however, the symptoms are frequently far less definitive and can cause significant difficulties in providing the correct advice to patients (14,17,41,42).…”

Section: Resultsmentioning

confidence: 99%

“…However, it should be noted that increased time to repair does not necessarily preclude sensory recovery. Many studies had fairly high FSR rates, even in patients who delayed surgery and patients undergoing surgery rarely experienced worsening symptoms (8,10,(18)(19)(20). Thus, patients who were referred late may still have a chance for sensory recovery.…”

Section: Resultsmentioning

confidence: 99%

“…LN reconstruction with autogenous grafts. Generally, grafting is unnecessary for LN repair because the nerve path is tortuous enough to mobilise without tension (19); however, it is occasionally used. In injuries in ten patients.…”

Section: Reconstructive Methodsmentioning

confidence: 99%

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Evidence‐based outcomes following inferior alveolar and lingual nerve injury and repair: a systematic review

Kushnerev

Yates

2015

J of Oral Rehabilitation

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The inferior alveolar nerve (IAN) and lingual (LN) are susceptible to iatrogenic surgical damage. Systematically review recent clinical evidence regarding IAN/LN repair methods and to develop updated guidelines for managing injury. Recent publications on IAN/LN microsurgical repair from Medline, Embase and Cochrane Library databases were screened by title/abstract. Main texts were appraised for exclusion criteria: no treatment performed or results provided, poor/lacking procedural description, cohort <3 patients. Of 366 retrieved papers, 27 were suitable for final analysis. Treatment type for injured IANs/LNs depended on injury type, injury timing, neurosensory disturbances and intra-operative findings. Best functional nerve recovery occurred after direct apposition and suturing if nerve ending gaps were <10 mm; larger gaps required nerve grafting (sural/greater auricular nerve). Timing of microneurosurgical repair after injury remains debated. Most authors recommend surgery when neurosensory deficit shows no improvement 90 days post-diagnosis. Nerve transection diagnosed intra-operatively should be repaired in situ; minor nerve injury repair can be delayed. No consensus exists regarding optimal methods and timing for IAN/LN repair. We suggest a schematic guideline for treating IAN/LN injury, based on the most current evidence. We acknowledge that additional RCTs are required to provide definitive confirmation of optimal treatment approaches.

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Treatment of recurrent lingual nerve end‐neuroma: A case report

et al. 2013

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A neuroma is a collection of disorganized nerve sprouts emanating from an interruption of axonal continuity, forming within a collagen scar as the nerve attempts to regenerate. Lingual neuroma formation secondary to iatrogenic trauma to the tongue is likely not uncommon; however, we could not find a report in the literature of treatment of a distal tongue end-neuroma treated by resection and implantation into muscle. Here we describe a patient who experienced debilitating chronic tongue pain after excision of a benign mass. After failing conservative management, the patient was taken to the operating room where an end-neuroma of the lingual nerve was identified and successfully treated by excision and burying of the free proximal stump in the mylohyoid muscle. At 17 months postoperatively, she remains pain free without dysesthesias.

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Retrospective Review of Microsurgical Repair of 222 Lingual Nerve Injuries

Cited by 107 publications

References 39 publications

Comparison of Subjective and Objective Assessments of Neurosensory Function after Lingual Nerve Repair

Comparison of Subjective and Objective Assessments of Neurosensory Function after Lingual Nerve Repair

Evidence‐based outcomes following inferior alveolar and lingual nerve injury and repair: a systematic review

Treatment of recurrent lingual nerve end‐neuroma: A case report

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