Does Early Repair of Lingual Nerve Injuries Improve Functional Sensory Recovery?
Purpose
This study evaluated the relationship between timing of lingual nerve repair and functional sensory recovery.
Materials and Methods
Using a retrospective cohort study design, the investigators enrolled a sample of subjects who had lingual nerve repair. The predictor variable was time between injury and repair, categorized as early (<90 days after injury) or late (>90 days after injury). The outcome variable was the time to functional sensory recovery (FSR), measured in days. Other variables were categorized as demographic, anatomic, and operative. Uni- and multivariate Cox proportional hazards models were used to evaluate the association between the timing of the repair and time to FSR.
Results
The study sample was composed of 64 subjects who had lingual nerve repair between January 1998 and January 2005. The mean time between injury and repair was 153.2 (31–1606) days; 21.9% of subjects had early repair. The mean age was 28.4 ± 8.0 years, 62.5% of subjects were female; 77% of the injured nerves were repaired by direct suture, and 23% had surgical exploration with decompression/neurolysis. In bivariate analyses, early repair, method of repair, and neuroma were statistically or near-statistically associated with time to FSR (P ≤ .12). In a multiple Cox proportional hazards model, early repair was associated with time to FSR (P = .02). Ninety-three percent of subjects in the early repair group achieved FSR within 1 year, compared with 62.9% in the late group (P = .05).
Conclusions
Early repair of lingual nerve injuries results in FSR more frequently and earlier than late repair.
⁎Fellow in Clinical Investigation, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
†Walter C. Guralnick Professor and Chair, 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.
§Associate Professor and Director, Center for Applied Clinical Investigation, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
Address correspondence and reprint requests to Dr Dodson: Center for Applied Clinical Investigation, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit Street, Warren 1201, Boston, MA 02114
This study was supported by the Oral and Maxillofacial Surgery Foundation Fellowship in Clinical Investigation (S.M.S.), the Massachusetts General Hospital Department of Oral and Maxillofacial Surgery Education and Research Fund (S.M.S., T.B.D.), and the Center for Applied Clinical Investigation (T.B.D.).
ABSTRACT