On neurosensory disturbance after sagittal split osteotomy

Purpose

The purpose of this retrospective study was to assess the incidence of the neurosensory disturbance (NSD) after sagittal split osteotomy and evaluate NSD in relation to patient age, gender, satisfaction, and effect of steroids.

Patients and methods

Questionnaires were mailed to all patients (31 women, 19 men) who underwent bilateral sagittal split osteotomy between 1995 and 1999, at least 1 year after the operation. Patients were queried about perceived NSD in the distribution of both inferior alveolar and lingual nerves, duration of these changes, and any influence of these changes on their quality of life.

Results

Eighty-six percent of the mailed questionnaires were returned and analyzed (27 women, 16 men). Eight patients with 10 affected sides (11.6% of sides) reported long lasting NSD corresponding to the distribution of the inferior alveolar nerve. NSD was reported in 16.7% of the operated sides in women, while 3% of the operated sides in the men had such changes. Fifty percent of the operated sides in patients over 40 years of age were affected. Steroid treatment seemed to decrease NSD. Four patients (9%) were not satisfied, but only 1 attributed the dissatisfaction to sensory impairment.

Conclusion

The incidence of NSD after sagittal split osteotomy increases in patients over the age of 40. Steroid regimen might be beneficial in reducing NSD after sagittal split osteotomy, although further investigation is required. The discomfort of the nerve damage seems outweighed by the result of function and esthetics.