Long-term neurosensory disturbances after modified sagittal split osteotomy
| Autor: | Ivo Lambrichts, O. da Costa Senior, Eman Shaheen, Jimoh Olubanwo Agbaje, F. Van der Cruyssen, Constantinus Politis, G. De Temmerman, B. Gemels |
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| Přispěvatelé: | Lambrichts, Ivo/0000-0001-7520-0021, Van der Cruyssen, Frederic/0000-0002-6888-9219, da Costa Senior, O., Sr., Gemels, B., Van der Cruyssen, F., Agbaje, J. O., De Temmerman, G., Shaheen, E., LAMBRICHTS, Ivo, POLITIS, Constantinus |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Chin Mandibular Nerve Lower lip Osteotomy Sagittal Split Ramus Sagittal split osteotomy Mandible Inferior alveolar nerve Genioplasty Iliac crest Hypesthesia medicine Humans inferior alveolar nerve Aged Univariate analysis business.industry Neurosensory disturbances nerve detachment Surgery Osteotomy medicine.anatomical_structure Otorhinolaryngology hypoaesthesia Trigeminal Nerve Injuries Oral Surgery business Synthetic bone graft sagittal split osteotomy |
| Popis: | We have investigated the long-term incidence of neurosensory disturbances after modified bilateral sagittal split osteotomy, and identified associated risk factors. We prospectively studied 376 patients, and their self-reported neurosensory disturbances were evaluated six months, and one, two, and three years postoperatively. The correlations between the following risk factors and neurosensory disturbances were investigated using univariate analysis and stepwise multivariate analysis: age at operation, sex, type of movement (advancement, setback, or rotation), concurrent genioplasty, type of detachment, iliac crest bone graft, and use of dicalcium phosphate synthetic bone graft. Probabilities of less than 0.05 were accepted as significant. Three years postoperatively, 57 patients (15%) reported altered sensation of the lower lip or chin. Older age correlated significantly with neurosensory disturbances (p < 0.0001). Greater mandibular advancement correlated with postoperative "positive" neurosensory phenomena (right side p = 0.08; left side p = 0.03). Intraoperative surgical manipulation of the left inferior alveolar nerve was significantly associated with postoperative hypoaesthesia (p = 0.014). Older age at surgery, extensive mandibular advancement, and surgical manipulation of the left inferior alveolar nerve, were associated with long-term neurosensory disturbances after modified bilateral sagittal split osteotomy. The modified operation seems to safeguard the inferior alveolar nerve from transection, without causing damage to other nerves. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons. da Costa, O (corresponding author), Dept Oral & Maxillofacial Surg, Kapucijnenvoer 33,E91, B-3000 Leuven, Belgium. Oliver.dacosta@uzleuven.be |
| Databáze: | OpenAIRE |
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