Timing of Trigeminal Nerve Microsurgery: A Review of the Literature

Injury to peripheral branches of the trigeminal nerve is a known sequelae of oral and maxillofacial surgery procedures. The most often studied and reported branches have been the inferior alveolar and lingual nerves. Many questions still remain unanswered concerning the appropriate timing of surgical repair. The literature frequently mentions specific timing guidelines, however, there is scant scientific evidence to support these guidelines. In fact, several authors of clinical series state that although many of their surgical procedures occurred fairly late due to the timing of referral and other issues such as insurance authorization, reasonable clinical results were still achieved in these patients. Various systems of nerve injury evaluation and testing methods make it difficult to draw specific timing recommendations. The consensus of literature reviewed indicates that more research is necessary in this area to better answer these questions.