Surgical management of inferior alveolar nerve injuries (part I): The case for early repair

Rb, Donoff

doi:10.1016/0278-2391(95)90595-2

Cited by 34 publications

(6 citation statements)

References 8 publications

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“…Vriens et al selected a minimum interval of three months because of the anticipation that most regenerative histologic reactions to trigeminal nerve injury would have recovered within this timeframe [ 16 ]. Donoff posited that if a nerve has not spontaneously recovered within six months, it is unlikely to do so [ 17 ]. When the IAN undergoes severance or impairment, it initiates an intrinsic reparative process.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Neurosensory Recovery of the Inferior Alveolar Nerve After Open and Closed Reduction for Mandibular Fractures: A Prospective Study

Mundepi,

Dora,

Sharma

et al. 2024

Cureus

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Introduction: Traumatic mandibular fractures are the most common fractures of the facial region and are associated with loss of neurosensation in the inferior alveolar nerve (IAN). The present study aimed to compare IAN recovery after traumatic mandibular fractures between the open and closed reduction methods. Materials and methods: The study included 90 patients with traumatic mandibular fractures of the body, angle, and symphysis, divided into two groups of 45 patients: group 1 was treated with closed reduction and fixation with rich arch-bar fixation under local anesthesia, and group 2 was treated with open reduction and rigid internal fixation with 2-mm titanium mini plates and monocortical screws (6 mm), and the plate was fixed to the fractured bony fragments. All patients underwent neurosensory testing using the Zuniga and Essick algorithm at baseline (preoperative), one week after surgery (postoperative), at three months, and at six months of follow-up. Results: No statistically significant differences were observed in IAN recovery between the groups. The most common site of fracture was the body (44% in group 1 and 56% in group 2). The maximum recovery was observed in the younger age group (25-30 years). At baseline, functional nerve recovery was observed in 40 cases (88%) in group 1 and 38 cases (84%) in group 2, and the difference was not statistically significant. Levels A and B tests were affected by surgical management and improved after three months. The total recovery in group 1 ranged from 60% to 80%, and that in group 2 ranged from 56% to 72%. Conclusion: Based on the findings of the current study, both methods are recommended for surgical management of traumatic mandibular fractures with IAN recovery in 60-80% of cases six months postoperatively.

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Section: Discussionmentioning

confidence: 99%

Comparison of Neurosensory Recovery of the Inferior Alveolar Nerve After Open and Closed Reduction for Mandibular Fractures: A Prospective Study

Mundepi,

Dora,

Sharma

et al. 2024

Cureus

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“…Prognosis, in this instance, refers to the possible return of sensation in a patient and the time period with which they can be expected to occur. 20 As a consequence of IAN injury, patients experience subjective disturbances of various intensities. 4 The IAN has good regenerative potential and recovers spontaneously as the nerve is encased in a bony canal which guides recovery.…”

Section: Discussionmentioning

confidence: 99%

“…The duration for sensory recovery depends on the rate of axonal regeneration and usually takes several months. 5,20 Kipp et al 38 examined IAN outcomes after odontectomy and found that most injuries resolved by 6 months. Osborn et al 39 in a prospective study, described similar results but grouped lingual and inferior alveolar nerve injuries together.…”

Section: Discussionmentioning

confidence: 99%

“…The healing of a damaged nerve is unique process and the prognosis for IAN injuries is more controversial. Prognosis, in this instance, refers to the possible return of sensation in a patient and the time period with which they can be expected to occur 20 …”

Section: Discussionmentioning

confidence: 99%

“…The duration for sensory recovery depends on the rate of axonal regeneration and usually takes several months 5,20 . Kipp et al 38 examined IAN outcomes after odontectomy and found that most injuries resolved by 6 months.…”

Section: Discussionmentioning

confidence: 99%

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Time-Lapse Between Presentation and Treatment of Mandibular Fractures: Is There a Correlation With Sensory Loss Recovery or No Recovery?

Yadav

Sachdeva²,

Shekhawat

et al. 2020

Journal of Craniofacial Surgery

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A possible disadvantage of the traction suture method is the tendency of caudal septum to return to the previous position due to the effect of cartilage memory. However, only 8.8% of patients in the present study were found to have residual deviation. This finding implies that pulling force established in traction suture method is stronger than the tendency of caudal septum to return to the previous position. Results with NOSE score (85.1 versus 22.4) and improved airway findings in 91.3% of the patients support such a conclusion.Patient outcomes from the operation were measured using NOSE score, endoscopic examination results, and patients' their own evaluations. NOSE scores (85.1 versus 22.4), patients their own evaluations and endoscopic results (91%) were similar. NOSE scores and endoscopic examinations were mentioned to be useful parameters to evaluate the patients' benefitting from the operation in the previous studies, and similar to our findings, improvement of the postoperative NOSE scores, and postoperative endoscopic findings were parallel in those studies. 2,3,12 Our study has some limitations. Retrospective nature of the research and lack of randomization are the main weaknesses of our report. Besides, we did not use methods that provide objective data such as acoustic rhinometry or rhinomanometry in our study. The use of this objective data could contribute to reveal the degree of improvement in nasal obstruction. In our study, we evaluated the postoperative status of the septum through endoscopy. Although such a practice carried a risk for bias, endoscopic examination findings were evaluated by another surgeon to minimize this problem. Similar to ours, some previous studies also used endoscopic examinations to evaluate the postoperative status of the caudal septum. 2,3,12 CONCLUSIONSAn ideal caudal septoplasty should be minimally invasive and eliminate the nasal obstruction. In the present study we showed that traction suture method efficiently improved nasal obstructions in patients with caudal septal deviation. This is a simple and safe alternative for surgeons to correct caudal septum deviations.

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Iatrogenous Injuries

Birch

2010

Surgical Disorders of the Peripheral Nerves

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Surgical management of inferior alveolar nerve injuries (part I): The case for early repair

Cited by 34 publications

References 8 publications

Comparison of Neurosensory Recovery of the Inferior Alveolar Nerve After Open and Closed Reduction for Mandibular Fractures: A Prospective Study

Comparison of Neurosensory Recovery of the Inferior Alveolar Nerve After Open and Closed Reduction for Mandibular Fractures: A Prospective Study

Time-Lapse Between Presentation and Treatment of Mandibular Fractures: Is There a Correlation With Sensory Loss Recovery or No Recovery?

Iatrogenous Injuries

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