Association between pain severity and clinicohistopathologic findings in the mandibular canal and inferior alveolar nerve of patients with advanced mandibular osteoradionecrosis
| Autor: | Satoshi Wanifuchi, Takumi Hasegawa, Junya Kusumoto, Yujiro Hiraoka, Manabu Shigeoka, Takahide Komori, Hiroto Terashi, Masaya Akashi, Kazunobu Hashikawa |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Osteoradionecrosis Mandibular Nerve Mandibular Osteotomy Mandibular canal Inferior alveolar nerve Free Tissue Flaps Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Free fibula stomatognathic system medicine Humans Pain Management Mandibular Diseases Radiology Nuclear Medicine and imaging Dentistry (miscellaneous) In patient Aged Pain Measurement business.industry 030206 dentistry Middle Aged medicine.disease Segmental Mandibulectomy Surgery medicine.anatomical_structure Debridement Coronal plane Pain severity Female Oral Surgery Tomography X-Ray Computed business 030217 neurology & neurosurgery |
| Zdroj: | Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 126(3):264-271 |
| ISSN: | 2212-4403 |
| Popis: | Objective Pain is one of the most problematic symptoms in patients with osteoradionecrosis of the jaws. This study investigated the associations between pain severity and morphologic alterations of the mandibular canal and inferior alveolar nerve, in respective computerized tomography images and resected specimens of mandibular osteoradionecrosis. Study Design We assessed 14 lesions in 13 patients who underwent segmental mandibulectomy for surgical debridement and simultaneous reconstruction with free fibula flap (1 patient exhibited bilateral lesions). The extent of the mandibular canal bone defect on preoperative coronal computerized tomography images and the number of inferior alveolar nerve fascicles in resected specimens were evaluated. Comparisons were made between the slight pain and extreme pain groups. In most of the patients in the extreme pain group, either mandibular canal bone defects were absent or entire circumferential defects were present; inferior alveolar nerve fascicles were either distinguishable or completely absent in the resected specimens. Results Although there was no statistically significant association between extreme pain and computerized tomography or histopathologic findings, the histopathologically indistinguishable inferior alveolar nerve fascicles was significantly associated with slight pain. Conclusions The degree of degeneration of mandibular canal and inferior alveolar nerve may be associated with pain severity in patients with mandibular osteoradionecrosis. |
| Databáze: | OpenAIRE |
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