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Orthognathic Injuries of the Trigeminal Nerve

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Trigeminal Nerve Injuries
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Abstract

Correction of cranio-maxillofacial deformity by means of orthognathic surgery includes procedures that may cause impaired sensory nerve function in the facial skin distribution. The most common site for such disturbance is the lower lip and chin area following a sagittal split ramus osteotomy of the mandible. Most often, however, such impaired sensitivity is tolerated well by the patient, but careful preoperative information about the risk of obtaining a neurosensory impairment is of primary importance in patient management. It is generally accepted that inferior alveolar nerve injury is the most common complication of mandibular orthognathic surgery, with immediate neurosensory dysfunction occurring in nearly 100 % of patients and long-term paresthesia occurring to a variable degree.

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References

  1. Aizenbud D, Ciceu C, Hazan-Molina H, Abu-El-Naj I (2012) Relationship between inferior alveolar nerve imaging and neurosensory impairment following bilateral sagittal split osteotomy in skeletal class III cases with mandibular prognathism. Int J Oral Maxillofac Surg 41:461–468

    Article  PubMed  CAS  Google Scholar 

  2. Al-Bishri A (2004) On neurosensory disturbance after sagittal split osteotomy. J Oral Maxillofac Surg 62:1472–1476

    Article  PubMed  Google Scholar 

  3. Al-Din OF, Coghlan KM, Magennis P (1996) Sensory nerve disturbance following Le Fort I osteotomy. Int J Oral Maxillofac Surg 25:13–19

    Article  PubMed  CAS  Google Scholar 

  4. Baas EM, Horsthuis RBG, de Lange J (2012) Subjective alveolar nerve function after bilateral sagittal split osteotomy or distraction osteogenesis of mandible. J Oral Maxillofac Surg 70:910–918

    Article  PubMed  Google Scholar 

  5. Doucet JC, Morrison AD, Davis BR, Gregoire CE, Goodday R, Precious DS (2012) The presence of mandibular third molars during sagittal split osteotomies does not increase the risk of complications. J Oral Maxillofac Surg 70(8):1935–1943

    Article  PubMed  Google Scholar 

  6. Hallikainen H (1992) Cross-sectional tomography in evaluation of patients undergoing sagittal split osteotomy. J Oral Maxillofac Surg 50:1269–1273

    Article  PubMed  CAS  Google Scholar 

  7. Hoenig JF (2007) Sliding osteotomy genioplasty for facial aesthetic balance: 10 years of experience. Aesthetic Plast Surg 31:384–391

    Article  PubMed  Google Scholar 

  8. Jones DL, Wolford LM, Hartog JM (1990) Comparisons to assess neurosensory alterations ­following orthognathic surgery. Int J Adult Orthodon Orthognath Surg 5:35–42

    PubMed  CAS  Google Scholar 

  9. Lindqvist CC, Obeid G (1988) Complications of genioplasty done alone or in combination with sagittal split ramus osteotomy. Oral Surg Oral Med Oral Pathol 66:13–16

    Article  Google Scholar 

  10. Miloro M, Repasky M (2000) Low level laser effect on neurosensory recovery following sagittal ramus osteotomy. Oral Surg Oral Med Oral Pathol 89:12–18

    Article  CAS  Google Scholar 

  11. Nardi P, Guarducci M, Cervinio M (2002) Orthognathic surgery. Study of nerve injuries. Minerva Stomatol 51:461–471

    PubMed  CAS  Google Scholar 

  12. Nesari N (2005) Neurosensory function of the inferior alveolar nerve after bilateral sagittal split osteotomy. Int J Oral Maxillofac Surg 34:495–499

    Article  PubMed  CAS  Google Scholar 

  13. Obwegeser H (1964) The indications for surgical correction of mandibular deformity by the sagittal splitting technique. Br J Oral Maxillofac Surg 7:157–171

    Google Scholar 

  14. Posnick JC, Al Qattan MM, Pron G (1994) Facial sensitivity in adolescents with and without clefts 1 year after undergoing Le Fort I osteotomy. Plast Reconstr Surg 94:431–435

    Article  PubMed  CAS  Google Scholar 

  15. Posnick JC, Al-Qattan MM, Stepner NM (1996) Alteration in facial sensibility in adolescents following sagittal split and chin osteotomies of the mandible. Plast Reconstr Surg 97:920–927

    Article  PubMed  CAS  Google Scholar 

  16. Rosenberg A, Sailer HF (1994) A prospective study on changes in the sensitivity of the oral mucosa and the mucosa of the upper lip after Le Fort I osteotomy. J Craniomaxillofac Surg 22:286–293

    Article  PubMed  CAS  Google Scholar 

  17. Schultze-Mosgau S, Krems H, Ott R, Neukam FW (2001) 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 59:128–138

    Article  PubMed  CAS  Google Scholar 

  18. Thygesen TH (2008) Somatosensory function after Le Fort I osteotomy xperimental and clinical studies. Thesis, Faculty of Health Sciences, University of Aarhus, Aarhus

    Google Scholar 

  19. Triplett G (1996) Lingual nerve injury due to overpenetration of bicortical screws for sagittal split osteotomy. J Oral Maxillofac Surg 54:1451–1453

    Article  PubMed  Google Scholar 

  20. Westermark A (1999) On inferior alveolar nerve function after sagittal split osteotomy of the mandible. Thesis, Karolinska Institute, Stockholm

    Google Scholar 

  21. Westermark A, Bystedt H, von Konow L (1998) Inferior alveolar nerve function after mandibular osteotomies. Br J Oral Maxillofac Surg 36:425–428

    Article  PubMed  CAS  Google Scholar 

  22. Westermark A, Bystedt H, von Konow L (1998) 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 36:429–433

    Article  PubMed  CAS  Google Scholar 

  23. Westermark A, Englesson L, Bongenhielm U (1999) Neurosensory function after sagittal split osteotomy of the mandible – a comparison between subjective evaluation and objective assessment. Int J Adult Orthodon Orthognath Surg 14:268–275

    PubMed  CAS  Google Scholar 

  24. Yoshioka I et al (2012) Comparison of material-related complications after bilateral sagittal split mandibular setback surgery: biodegradable ­versus titanium miniplates. J Oral Maxillofac Surg 70:919–924

    Article  PubMed  Google Scholar 

  25. Zuniga J (1990) Lingual nerve injury as a complication of sagittal split osteotomy. J Oral Maxillofac Surg 48:647–648

    Article  PubMed  Google Scholar 

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Correspondence to Anders Westermark DDS PhD .

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Westermark, A. (2013). Orthognathic Injuries of the Trigeminal Nerve. In: Miloro, M. (eds) Trigeminal Nerve Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35539-4_8

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  • DOI: https://doi.org/10.1007/978-3-642-35539-4_8

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-35538-7

  • Online ISBN: 978-3-642-35539-4

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