Objective
The aim of this study was to analyze several factors regarding their possible influence
on neurosensory disturbance (NSD) of the inferior alveolar nerve (IAN) after bilateral
sagittal split osteotomy (BSSO).
Study Design
We investigated the possible influence of sex, age at the time of surgery, total operating
time, intraoperative nerve encounter, advancement versus setback, fixation method,
additional genioplasty, side, and region (lower lip vs. chin) on subjective neurosensory
outcome a half-year after surgery. Results of a battery of neurosensory testing methods
are also presented; 103 out of the initial 128 patients were available for further
follow-up 1 year after surgery.
Results
Normal subjective sensibility was found in 74.6% and 77.2% of the regions after 6
and 12 months, respectively. Multiple regression models revealed significant effects
of age, region, and total operating time after 6 months, and significant effects of
age, region, and sex after 12 months.
Conclusions
NSD of the IAN after BSSO is influenced by age, total operating time (at 6 months),
and sex (at 12 months). Significantly higher rates of NSD were found in the chin region.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Ein Beitrag zur chirurgischen Kieferorthopädie unter Berücksichtigung ihrer Bedeutung für die Behandlung angeborener und erworbener Kieferdeformitäten bei Soldaten.Dtsch Zahn Mund Kieferheilkd. 1942; 9: 73-89
- The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty.Oral Surg Oral Med Oral Pathol. 1957; 10: 677-689
- The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty.Oral Surg Oral Med Oral Pathol. 1957; 10: 899-909
- The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. II. Operating methods for microgenia and distoclusion.Oral Surg Oral Med Oral Pathol. 1957; 10 (contd): 787-792
- Retromolar osteotomy for the correction of prognathism.J Oral Surg Anesth Hosp Dent Serv. 1961; 19: 42-47
- A modified intraoral sagittal splitting technic for correction of mandibular prognathism.J Oral Surg. 1968; 26: 250-253
- Modification of the sagittal ramus-split osteotomy for retrognathia.J Oral Surg. 1976; 34: 178-179
- Modifications in the sagittal osteotomy of the mandible.J Oral Surg. 1977; 35: 157-159
- Relationship between patients' perceptions of postsurgical sequelae and altered sensations after bilateral sagittal split osteotomy.J Oral Maxillofac Surg. 2007; 65: 597-607
- A prospective electromyographic and computer-aided thermal sensitivity assessment of nerve lesions after sagittal split osteotomy and Le Fort I osteotomy.J Oral Maxillofac Surg. 2001; 59 (discussion 138-9): 128-138
- Sagittal split osteotomy.in: Fonseca R.J. Marciani R.D. Turvey T.A. Oral and maxillofacial surgery. 2nd ed. Saunders, St. Louis, MO2009: 102-108
- Risk factors of nerve injury during mandibular sagittal split osteotomy.Int J Oral Maxillofac Surg. 2002; 31: 33-39
- Neurosensory deficits after bilateral sagittal split ramus osteotomy of the mandible—influence of soft tissue handling medial to the ascending ramus.Int J Oral Maxillofac Surg. 2004; 33: 543-548
- Intraoperative recording of trigeminal evoked potentials during orthognathic surgery.Int J Adult Orthodon Orthognath Surg. 1990; 5: 167-174
- Intraoperative monitoring of the inferior alveolar nerve during mandibular sagittal-split osteotomy.Muscle Nerve. 2000; 23: 368-375
- Tactile sensitivity of the phalanges.Percept Mot Skills. 1962; 14: 351-354
- Methodology of oral sensory tests.J Oral Rehabil. 2002; 29: 720-730
- An evaluation of clinical and electrophysiologic tests in nerve injury diagnosis after mandibular sagittal split osteotomy.Int J Oral Maxillofac Surg. 2003; 32: 15-23
- Assessment of recovery from injury to inferior alveolar and mental nerves.Oral Surg Oral Med Oral Pathol. 1987; 64: 519-526
- Inferior alveolar nerve injury following orthognathic surgery: a review of assessment issues.J Oral Rehabil. 2011; 38: 547-554
- Facial altered sensation and sensory impairment after orthognathic surgery.Int J Oral Maxillofac Surg. 2007; 36: 577-582
- Quantitative sensory tests before and 1(1/2) years after orthognathic surgery: a cross-sectional study.J Oral Rehabil. 2010; 37: 313-321
- Neurosensory disturbance of the inferior alveolar nerve after bilateral sagittal split osteotomy: a systematic review.J Oral Maxillofac Surg. 2007; 65: 1707-1715
- Prediction of recovery from neurosensory deficit after bilateral sagittal split osteotomy.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 90: 275-281
- Factors affecting neurosensory disturbance after mandibular bilateral sagittal split osteotomy.J Oral Maxillofac Surg. 2000; 58 (discussion 1239-40): 1234-1239
- Functional disturbances of the inferior alveolar nerve after sagittal osteotomy of the mandibular ramus: operating technique for prevention.J Maxillofac Surg. 1981; 9: 123-125
- Complications of orthognathic surgery: the inferior alveolar nerve.J Craniofac Surg. 2010; 21: 1189-1195
- A comparison of questionnaire versus monofilament assessment of neurosensory deficit.J Oral Maxillofac Surg. 1996; 54 (discussion 459-60): 454-459
- Inferior alveolar nerve impairment after mandibular sagittal split osteotomy: an analysis of spontaneous recovery patterns observed in 60 patients.J Craniofac Surg. 2002; 13: 315-320
- Inferior alveolar nerve function after sagittal split osteotomy of the mandible: correlation with degree of intraoperative nerve encounter and other variables in 496 operations.Br J Oral Maxillofac Surg. 1998; 36: 429-433
- Cutaneous sensibility impairment after mandibular sagittal split osteotomy: a prospective clinical study of the spontaneous recovery.J Oral Maxillofac Surg. 2011; 70: 696-702
- Neurosensory and functional impairment in sagittal split osteotomies: a longitudinal and long-term follow-up study.Eur J Orthod. 2007; 29: 263-271
- Relationship between inferior alveolar nerve canal position at mandibular second molar in patients with prognathism and possible occurrence of neurosensory disturbance after sagittal split ramus osteotomy.J Oral Maxillofac Surg. 2010; 68: 3022-3027
- Correlation of mandibular bone quality with neurosensory disturbance after sagittal split ramus osteotomy.Br J Oral Maxillofac Surg. 2011; 49: 552-556
- Effect of bone quality and position of the inferior alveolar nerve canal in continuous, long-term, neurosensory disturbance after sagittal split ramus osteotomy.J Craniomaxillofac Surg. 2011; 40 (Nos.: e178-e183)
- Effects of age, amount of advancement, and genioplasty on neurosensory disturbance after a bilateral sagittal split osteotomy.J Oral Maxillofac Surg. 2002; 60: 1012-1017
- Sensibility following sagittal split osteotomy in the mandible: a prospective clinical study.Plast Reconstr Surg. 1998; 102: 325-333
- A 3-year patient-centred follow-up of 516 consecutively treated orthognathic surgery patients.Eur J Orthod. 2008; 30: 24-30
- Neurosensory function of the inferior alveolar nerve after bilateral sagittal ramus osteotomy: a retrospective study of 68 patients.Int J Oral Maxillofac Surg. 2005; 34: 495-498
- On neurosensory disturbance after sagittal split osteotomy.J Oral Maxillofac Surg. 2004; 62: 1472-1476
- Neurosensory disturbance with rigid fixation of the bilateral sagittal split osteotomy.J Oral Maxillofac Surg. 1987; 45: 20-26
- Neurosensory deficit and functional impairment after sagittal ramus osteotomy: a long-term follow-up study.J Oral Maxillofac Surg. 1998; 56 (Discussion:6): 1231-1235
- Experience with the sagittal osteotomy of the mandibular ramus: a 13-year review.J Maxillofac Surg. 1981; 9: 151-165
- Altered sensation after orthognathic surgery.J Oral Maxillofac Surg. 2011; 69: 893-898
- Masticatory function and neurosensory disturbance after mandibular correction by bilateral sagittal split ramus osteotomy: a comparison between miniplate and bicortical screw rigid internal fixation.Int J Oral Maxillofac Surg. 2007; 36: 118-122
- Neurosensory recovery following the mandibular bilateral sagittal split osteotomy.J Oral Maxillofac Surg. 1995; 53 (discussion 1306-7): 1300-1306
- Risk factors affecting somatosensory function after sagittal split osteotomy.J Oral Maxillofac Surg. 2008; 66: 469-474
- The role of intraoperative positioning of the inferior alveolar nerve on postoperative paresthesia after bilateral sagittal split osteotomy of the mandible: prospective clinical study.Int J Oral Maxillofac Surg. 2011; 40: 901-906
- Incidence of neurosensory disturbance after sagittal split osteotomy alone or combined with genioplasty.Br J Oral Maxillofac Surg. 2004; 42: 105-111
- Mechanism of transient mental nerve paraesthesia in sagittal split mandibular ramus osteotomy.Br J Oral Maxillofac Surg. 1994; 32: 105-108
- A long-term comparative study of two rigid internal fixation techniques in terms of masticatory function and neurosensory disturbance after mandibular correction by bilateral sagittal split ramus osteotomy.Int J Oral Maxillofac Surg. 2011; 40: 360-365
- Qualitative descriptors used by patients following orthognathic surgery to portray altered sensation.J Oral Maxillofac Surg. 2006; 64: 1751-1760
- Perioperative complications in corrective facial orthopedic surgery: a 5-year retrospective study.J Oral Maxillofac Surg. 2000; 58: 754-760
- Alteration in facial sensibility in adolescents following sagittal split and chin osteotomies of the mandible.Plast Reconstr Surg. 1996; 97: 920-927
- Neurosensory disturbances one year after bilateral sagittal split osteotomy of the mandibula performed with separators: a multi-centre prospective study.J Craniomaxillofac Surg. 2012;
- Sagittal split advancement osteotomies stabilized with miniplates.Int J Oral Maxillofac Surg. 1994; 23: 127-131
- Inferior alveolar nerve function after mandibular osteotomies.Br J Oral Maxillofac Surg. 1998; 36: 425-428
Article info
Publication history
Published online: November 22, 2012
Accepted:
August 27,
2012
Received in revised form:
August 5,
2012
Received:
May 31,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
