Short-term effects of orthognathic surgery on somatosensory function and recovery pattern in the early postoperative period

Dezawa, Ko; Noma, Noboru; Watanabe, Kosuke; Sato, Yuka; Kohashi, Ryutaro; Tonogi, Morio; Heir, Gary M.; Eliav, Eli; Imamura, Yoshiki

doi:10.2334/josnusd.15-0670

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…The sensitivity of MDT (P = 0.001) was significantly higher (lower threshold) after surgery than at the preoperative baseline. This was contrary to many studies, which reported that the sensitivity of MDT would decrease after surgery compared with before surgery [20,21,23,36,38]. Controversial results were found in QST tests after surgery [23].…”

Section: Qst Is a Sensitive Way To Detect Somatosensory Abnormalitiesmentioning

confidence: 60%

Somatosensory changes in Chinese patients after coronectomy vs. total extraction of mandibular third molar: a prospective study

Yan

Guo

et al. 2019

Clin Oral Invest

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Objectives This study aimed to quantitatively compare the somatosensory function changes of inferior alveolar nerve (IAN) after mandibular third molar extraction with a surgery protocol of coronectomy, as opposed to the conventional method. Materials and methods Patients with a lower third molar directly contacting IAN were recruited and assigned either to a test group (coronectomy group) or a control group (conventional extraction). A standardized quantitative sensory testing (QST) battery was performed for four times: one week before surgery and the second, seventh, and 28th days after surgery. Z-scores and the loss/gain coding system were applied for each participant. Results A total of 140 molars (test group: n = 91, control group: n = 49) were enrolled. The sensitivity of the mechanical detection threshold (MDT) and pressure pain threshold (PPT) significantly increased after surgery more than before surgery in both groups (P ≤ 0.001). After the surgery, the sensitivities of the cold detection threshold (CDT), cold pain threshold (CPT), and heat pain threshold (HPT) were significantly higher in the test group than in the control group (P ≤ 0.027). The risk of IANI was significantly larger (P = 0.041) in the test group than in the control group. Conclusions QST was a sensitive way to detect somatosensory abnormalities even with no subjective complaint caused by surgery. Coronectomy had less influence on IAN function than conventional total extraction. Clinical relevance The somatosensory function changes after mandibular third molar extraction were quantitatively studied, and coronectomy was proved a reliable alternation to reduce IAN injury rate.

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Section: Qst Is a Sensitive Way To Detect Somatosensory Abnormalitiesmentioning

confidence: 60%

Somatosensory changes in Chinese patients after coronectomy vs. total extraction of mandibular third molar: a prospective study

Yan

Guo

et al. 2019

Clin Oral Invest

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“…However, QST studies in this patient group are scarce, especially with long follow-up after surgery. Previous studies using DFNS QST for post-surgical NP in general have included both surgical and traumatic etiologies [18][19][20] or have had a small cohort [21]. Patients with orthognathic surgery showed postoperative sensory loss, but recovered well in three month follow-up [21].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies using DFNS QST for post-surgical NP in general have included both surgical and traumatic etiologies [18][19][20] or have had a small cohort [21]. Patients with orthognathic surgery showed postoperative sensory loss, but recovered well in three month follow-up [21]. To the best of our knowledge, no studies using the DFNS QST protocol have been conducted in the breast cancer surgery patient group before.…”

Section: Introductionmentioning

confidence: 99%

Sensory profiles in women with neuropathic pain after breast cancer surgery

Mustonen

Vollert

Rice

et al. 2020

Breast Cancer Res Treat

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Purpose We performed a detailed analysis of sensory function in patients with chronic post-surgical neuropathic pain (NP) after breast cancer treatments by quantitative sensory testing (QST) with DFNS (German Research Network on Neuropathic Pain) protocol and bed side examination (BE). The nature of sensory changes in peripheral NP may reflect distinct pathophysiological backgrounds that can guide the treatment choices. NP with sensory gain (i.e., hyperesthesia, hyperalgesia, allodynia) has been shown to respond to Na +-channel blockers (e.g., oxcarbazepine). Methods 104 patients with at least "probable" NP in the surgical area were included. All patients had been treated for breast cancer 4-9 years ago and the handling of the intercostobrachial nerve (ICBN) was verified by the surgeon. QST was conducted at the site of NP in the surgical or nearby area and the corresponding contralateral area. BE covered the upper body and sensory abnormalities were marked on body maps and digitalized for area calculation. The outcomes of BE and QST were compared to assess the value of QST in the sensory examination of this patient group. Results Loss of function in both small and large fibers was a prominent feature in QST in the area of post-surgical NP. QST profiles did not differ between spared and resected ICBN. In BE, hypoesthesia on multiple modalities was highly prevalent. The presence of sensory gain in BE was associated with more intense pain. Conclusions Extensive sensory loss is characteristic for chronic post-surgical NP several years after treatment for breast cancer. These patients are unlikely to respond to Na +-channel blockers.

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“…Postsurgical alterations of somatosensory functions gradually return to baseline thresholds depending on the severity of nerve damage. In the case of orthognathic surgery, this generally occurs three months after the procedure [7]. Although most nerve injury symptoms improve over time, many patients continue to have long-term problems that affect their overall quality of life.…”

Section: Introductionmentioning

confidence: 99%

Clinical observation of patients with inferior alveolar nerve sensory disturbance

et al. 2020

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Fifty-four patients diagnosed with paresthesia on one side of the lower lip or skin in the chin area, were examined by multiple sensory tests and assessed self-reported subjective symptoms and the psychological state through questionnaires. Additionally, they were followed over time. Each sensory test threshold was evaluated and classified according to the individual way of scoring system, and the average sensory score (ASS) was used to analyze the correlation between self-reported symptoms and psychological state. On the second visit, all sensory test results had improved. The ASS was positively correlated with the pain questionnaire on the first visit; however, it did not correlate with psychological state or personality. There was a positive correlation between neuroticism and anxiety scores. The index of change (IC) of the ASS over time did not correlate with the IC of patients' self-reported symptoms or mental state. The IC of ASS data improved in all patients, but self-reported subjective symptoms did not show signs of improvement in all patients. When patients were divided into two groups according to age or sex, older females showed significantly more improvement than younger males on the psychological test.

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Short-term effects of orthognathic surgery on somatosensory function and recovery pattern in the early postoperative period

Cited by 6 publications

References 21 publications

Somatosensory changes in Chinese patients after coronectomy vs. total extraction of mandibular third molar: a prospective study

Somatosensory changes in Chinese patients after coronectomy vs. total extraction of mandibular third molar: a prospective study

Sensory profiles in women with neuropathic pain after breast cancer surgery

Clinical observation of patients with inferior alveolar nerve sensory disturbance

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