The effect of dexamethasone on neurapraxia following third molar surgery

Arx, D.P. Von; Simpson, M.T.

doi:10.1016/s0266-4356(89)80005-1

Cited by 38 publications

(3 citation statements)

References 10 publications

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“…The removal of mandibular third molars results in temporary disturbance of lingual nerve function in up to 22% of operations (von Arx and Simpson, 1989) and permanent damage in approximately 0.5% (Mason, 1988;Blackburn and Bramley, 1989). In many patients in this latter group, it is likely that the nerve has been sectioned.…”

Section: Introductionmentioning

confidence: 99%

A Quantitative Morphological Comparison of Cat Lingual Nerve Repair Using Epineurial Sutures or Entubulation

et al. 1996

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Since lingual nerves may be transected during a variety of oral surgical procedures, including third molar removal, we have investigated two possible methods of repair. Quantitative morphological observations were made on feline chorda tympani and lingual nerves proximal and distal to transection injuries repaired either by epineurial suturing or by insertion of the cut ends into a perforated silicon tube. Proximal to the repair, the most prominent difference was an increase in the number of myelinated axons in the lingual nerve following epineurial suturing but not entubulation. Proximal to the repair site, the number of nonmyelinated axons increased in comparison with controls in both chorda tympani and lingual nerves after both procedures, though the difference was statistically significant only in the lingual nerve proximal to entubulation. Distal to the injury, both types of repair showed a reduction in the number, size, and sheath thickness of myelinated axons in comparison with unoperated controls, but the difference in numbers was statistically signIficant only distal to repair by entubulation. The number of non-myelinated axons distal to the repair sites was much higher than that in controls, the difference being greater distal to entubulation repair. There were more axons per Remak bundle distal to entubulation repair than to epineurial suturing, suggesting, perhaps, that fewer axons would ultimately become myelinated. Though the morphological differences between the two repair techniques are not as striking as the parallel electrophysiological differences reported previously (Smith and Robinson, 1995a,b), they are consistent with them and support the conclusion that, for transected lingual and chorda tympani nerves, epineurial suturing is the preferred approach.

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Section: Introductionmentioning

confidence: 99%

A Quantitative Morphological Comparison of Cat Lingual Nerve Repair Using Epineurial Sutures or Entubulation

et al. 1996

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“…A previous report supported our results, demonstrating that dexamethasone was ineffective for neuropraxia of the inferior alveolar nerve and lingual nerve 24 hours following removal of the mandibular 3rd molar tooth. [ 32 ]…”

Section: Discussionmentioning

confidence: 99%

Effect of single-dose intravenous dexamethasone on subjective voice quality after thyroidectomy

Kim

Kwon

Lee³

et al. 2018

Medicine

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Background:Corticosteroids are widely used to treat voice change after thyroidectomy. In this study, we evaluated the effect of a single dose of intravenous dexamethasone after thyroidectomy using a metaanalysis.Methods:Relevant studies were identified by searching the following databases: Medline, Embase, and Cochrane through February 2017. We followed PRISMA guidelines. The following search terms were used: “thyroidectomy,” “voice,” “steroid.” Random-effects models were used to estimate standardized mean differences (SMDs) and 95% confidence intervals.Results:Our search yielded one retrospective cohort study involving 122 thyroidectomy patients and 3 randomized controlled studies involving 242 thyroidectomy patients. The pooled SMD for voice quality after thyroidectomy was −0.80 (P < .05). Subgroup analysis showed significant voice quality change 1 day after administration of dexamethasone.Conclusions:Single-dose intravenous dexamethasone after thyroidectomy significantly improves subjective voice quality on day 1. The effect was not different significantly after day 1.Level of evidence:Level 2a.

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“…The lingual nerve is primarily a sensory branch of the mandibular division of the trigeminal nerve (Vc) and, owing to its anatomical location adjacent to the mandible, is vulnerable to injury during some surgical procedures ( Kiesselbach and Chamberlain, 1984 ; Pogrel et al, 1995 ; Behnia et al, 2000 ) . For example, during the removal of lower third molar teeth, the incidence of lingual nerve damage ranges from 0.5 to 23% ( Rood, 1983 ; Von Arx and Simpson, 1989 ; Robinson, 1997 ; Bataineh, 2001 ) . This results in ipsilateral sensory loss from the anterior two‐thirds of the tongue and from the mucosa and gingivae lingual to the mandibular teeth.…”

Section: Introductionmentioning

confidence: 99%

Close apposition and exposure of non‐myelinated axons in traumatic neuromas of the human lingual nerve

Vora

Loescher

Boissonade

et al. 2004

J Peripheral Nervous Sys

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Peripheral nerve injury is sometimes followed by the development of persistent painful sensory disorders, such as dysaesthesia. The aetiology of these disorders is not clear, but abnormal behaviour of damaged axons at the injury site is likely to be involved. In this study, we quantified some ultrastructural characteristics that may be related to the development of abnormal spontaneous activity, sympathetic interactions, and fibre-to-fibre crosstalk. Using electron microscopy, we have determined the frequency and extent of axonal exposure and close apposition among non-myelinated axons from 34 traumatic neuromas of the human lingual nerve. These specimens were removed at the time of microsurgical nerve repair, and the presence or absence of symptoms of dysaesthesia was determined pre-operatively. Comparisons were also made with eight normal control lingual nerve specimens obtained from patients undergoing organ donor retrieval. More non-myelinated axons showed signs of axonal exposure in traumatic neuromas (26%) than in controls (5%), and exposure was higher in nerve-end neuromas (31%) than in neuromas-in-continuity (22%). In addition, the proportion of the non-myelinated axolemma that was exposed was significantly higher in neuromas (32%) than in controls (21%). The frequency of close apposition between neighbouring non-myelinated axons was also higher in neuromas (11%) than in controls (0.35%). The majority of axons showing signs of exposure or close apposition had diameters <1 mm. These ultrastructural changes may account for some of the altered electrophysiological properties of axons within neuromas. However, no significant correlations were found between these ultrastructural characteristics and the patients' reported symptoms of dysaesthesia.

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The effect of dexamethasone on neurapraxia following third molar surgery

Cited by 38 publications

References 10 publications

A Quantitative Morphological Comparison of Cat Lingual Nerve Repair Using Epineurial Sutures or Entubulation

A Quantitative Morphological Comparison of Cat Lingual Nerve Repair Using Epineurial Sutures or Entubulation

Effect of single-dose intravenous dexamethasone on subjective voice quality after thyroidectomy

Close apposition and exposure of non‐myelinated axons in traumatic neuromas of the human lingual nerve

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