Functional Sensory Recovery After Trigeminal Nerve Repair
Purpose
The aim of this study was to estimate the proportion of subjects who achieved functional sensory recovery (FSR) 1 year after inferior alveolar or lingual nerve repair and to identify risk factors associated with failure to achieve FSR.
Methods
Using a retrospective cohort study design, we developed a sample composed of subjects who underwent lingual or inferior alveolar nerve repair. Eligible subjects had at least 1 postoperative visit. For subjects having bilateral nerve repair, 1 side was selected randomly for analysis. Predictor variables were categorized as demographic, anatomic, and operative. The outcome variable was the time to FSR, measured in days. Kaplan-Meier survival methods were used to estimate the proportion of subjects with FSR at 1 year. Uni- and multivariate Cox proportional hazard models were used to identify risk factors for the failure to reach FSR at 1 year.
Results
The study sample was composed of 60 subjects with a mean age of 28.7 ± 8.3 years; 68.3% were female. The majority (86.7%) of subjects presented with a preoperative chief complaint of altered sensation and had lingual nerve damage (93.3%) that was repaired by direct suturing (75%). The mean interval between injury and repair was 145.9 ± 200.0 days. At 1 year postoperatively, 75% of the subjects had achieved FSR (95% confidence interval [CI]: 64% to 86%).
Conclusions
The majority of subjects undergoing trigeminal (V3) nerve repair achieved functional sensory recovery within 1 year of surgical repair. Patients with evidence of neuroma formation were less likely to achieve FSR at 1 year in a multivariate model.
⁎Fellow in Clinical Investigation, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
†Professor of Oral and Maxillofacial Surgery and Dean, Harvard School of Dental Medicine, Boston, MA.
‡Walter C. Guralnick Professor and Chair, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
§Associate Professor and Director of Center for Applied Clinical Investigation, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
Address correspondence and reprint requests to Mr Susarla: Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115
This study was supported by Oral and Maxillofacial Surgery Foundation Fellowship in Clinical Investigation (S.M.S.), and the Massachusetts General Hospital Department of Oral and Maxillofacial Surgery Education and Research Fund (S.M.S., T.B.D.).
ABSTRACT