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M. Anthony Pogrel - One of the best experts on this subject based on the ideXlab platform.
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Lingual Nerve damage due to inferior alveolar Nerve blocks: a possible explanation.
Journal of the American Dental Association (1939), 2003Co-Authors: M. Anthony Pogrel, Brian L. Schmidt, V. Sambajon, Richard C.k. JordanAbstract:ABSTRACT Background An explanation for the predominance of injuries to Lingual Nerves over those to inferior alveolar Nerves as a result of inferior alveolar Nerve blocks may be due to the Nerves' fascicular pattern. A unifascicular Nerve may be injured more easily than a multifascicular Nerve. Methods The authors unilaterally dissected Lingual and inferior alveolar Nerves from 12 cadavers. They cut the specimens 2 millimeters above the lingula for both the Lingual Nerve and inferior alveolar Nerve and opposite the site of the middle of the third molar for the Lingual Nerve, and they counted the number of fascicles at each site. Results For the Lingual Nerve at the lingula, the mean number of fascicles was three (range, one to eight). Four of the 12 Nerves (33 percent) were unifascicular at this point. Opposite the third molar, the Lingual Nerve had a mean of 20 fascicles (range, six to 39). In every case, there were more fascicles in the third molar region than above the lingula in the same Nerve. At the lingula, the inferior alveolar Nerve had a mean of 7.2 fascicles (range, three to 14). Conclusion This study may explain the observation that when an inferior alveolar Nerve block causes permanent Nerve impairment, the Lingual Nerve is affected about 70 percent of the time and the inferior alveolar Nerve is affected only 30 percent of the time. In 33 percent of cases, the Lingual Nerve had only one fascicle at the lingula; a unifascicular Nerve may be injured more easily than a multifascicular one. Clinical Implications There is no known way to avoid the remote possibility of Nerve damage resulting from an inferior alveolar Nerve block. The Lingual Nerve may be predominantly affected because of its fascicular pattern.
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Effects of transitory Lingual Nerve impairment on speech: An acoustic study of vowel sounds. Discussion
Journal of Oral and Maxillofacial Surgery, 2002Co-Authors: Matti Niemi, Juha-pertti Laaksonen, Olli Aaltonen, Risto-pekka Happonen, Kimmo Vähätalo, Jyrki Tuomainen, M. Anthony PogrelAbstract:Purpose: The purpose of the study was to evaluate the effects of the Lingual Nerve impairment on phonetic quality of speech by analyzing the main acoustic features of vowel sounds when the normal Lingual Nerve function was partly distorted by local anesthesia. Patients and Methods: The study group consisted of 7 men, whose right side Lingual Nerve was anesthetized with 0.8 mL of Ultracain D-Suprarenin (Aventis Pharma Deutschland GmpH, Frankfurt am Main, Germany). The speech material analyzed consisted of 8 vowels produced in sentence context by speakers. Every utterance was repeated 10 times with and without local anesthesia. After recording, the speech samples were analyzed with a computerized speech laboratory. In addition, the vowels of 1 man with permanent Nerve impairment were studied. Results: The results show that the deprived function of the tongue after Lingual Nerve impairment had various effects on vowel quality for every subject. The main acoustic determinants of different vowels, the lowest vocal tract resonances, changed in frequency. In addition, the total duration of vowels changed and the vowels had different fundamental frequencies. However, these effects were extremely individual and variable. Conclusions: According to the results of acoustic analysis, the distortion of Lingual Nerve function has effects on vowel production. Some of these changes were so extensive that they also could be perceptually detectable. Lingual Nerve impairment seems to have potential to change speech production.
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The relationship of the Lingual Nerve to the mandibular third molar region: an anatomic study.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 1995Co-Authors: M. Anthony Pogrel, Brian L. Schmidt, Andrew Renaut, Awnie AmmarAbstract:Abstract Purpose : This study evaluated the relationship of the mandibular third molar to the Lingual Nerve. Materials and Methods : An anatomic dissection of the Lingual Nerve in the third molar region was done on 20 cadavers (40 sides). Results : The position of the Nerve on one side bore no statistical relationship to the position of the Nerve on the opposite side. The position of the Lingual Nerve was variable in both the sagittal and coronal planes. In two specimens the Nerve lay superior to the Lingual plate and in another the superior surface of the Nerve was level with the crest of the Lingual plate. Conclusion : These findings have implications for the avoidance of Lingual Nerve damage during surgery in the third molar and retromolar region of the mandible.
Shigeyuki Fujita - One of the best experts on this subject based on the ideXlab platform.
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Change in allodynia of patients with post-Lingual Nerve repair iatrogenic Lingual Nerve disorder
Oral and Maxillofacial Surgery, 2020Co-Authors: Yukari Shintani, Masamichi Ueda, Itaru Tojyo, Shigeyuki FujitaAbstract:Purpose Mandibular third molar extractions are common treatment in oral maxillofacial surgery, but risk disturbance of the Lingual Nerves causing anesthesia, eating difficulty and allodynia, which can seriously reduce patient quality of life. This study investigates the change in allodynia before and after repair in patients with Lingual Nerve disorder. Subjects and methods This retrospective cohort study comprises the 52 patients with affected Lingual Nerve after third molar extraction at our hospital over a 7-year period. Pre- and postoperative (6 months and 12 months) neurosensory records were analyzed. Results Fifty-two patients underwent Lingual Nerve repair and returned for at least 1 year of follow-up. Mean age was 36.8 ± 11.9. Median interval between injury and surgery was 5 (4, 8) months. In 92.9% of those with pain before surgery, allodynia disappeared postoperatively. Conclusions This study shows that microsurgical Lingual reconstructions are effective in patients with preoperative allodynia, but a small number of patients may have remaining allodynia after surgery. Large-scale, more detailed analysis of such cases is required.
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Change in allodynia of patients with post-Lingual Nerve repair iatrogenic Lingual Nerve disorder.
Oral and maxillofacial surgery, 2019Co-Authors: Yukari Shintani, Masamichi Ueda, Itaru Tojyo, Shigeyuki FujitaAbstract:Mandibular third molar extractions are common treatment in oral maxillofacial surgery, but risk disturbance of the Lingual Nerves causing anesthesia, eating difficulty and allodynia, which can seriously reduce patient quality of life. This study investigates the change in allodynia before and after repair in patients with Lingual Nerve disorder. This retrospective cohort study comprises the 52 patients with affected Lingual Nerve after third molar extraction at our hospital over a 7-year period. Pre- and postoperative (6 months and 12 months) neurosensory records were analyzed. Fifty-two patients underwent Lingual Nerve repair and returned for at least 1 year of follow-up. Mean age was 36.8 ± 11.9. Median interval between injury and surgery was 5 (4, 8) months. In 92.9% of those with pain before surgery, allodynia disappeared postoperatively. This study shows that microsurgical Lingual reconstructions are effective in patients with preoperative allodynia, but a small number of patients may have remaining allodynia after surgery. Large-scale, more detailed analysis of such cases is required.
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Risk of Lingual Nerve injuries in removal of mandibular third molars: a retrospective case-control study.
Maxillofacial plastic and reconstructive surgery, 2019Co-Authors: Itaru Tojyo, Yukari Shintani, Takashi Nakanishi, Kenjiro Okamoto, Yukihiro Hiraishi, Shigeyuki FujitaAbstract:Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic Lingual Nerve injuries in the removal of the mandibular third molar. A retrospective chart review was performed for patients who had undergone microsurgical repair of Lingual Nerve injuries. The following data were collected and analyzed: patient sex, age, Nerve injury side, type of impaction (Winter’s classification, Pell and Gregory’s classification). Ratios for the respective Lingual Nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar. The Lingual Nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic Lingual Nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual Nerve injury was significantly higher in the patient versus the control groups in age. The Lingual Nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our Lingual Nerve injury group. The distoangular impaction rate in our Lingual Nerve injury group was significantly higher than the rate for the control groups. Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe Lingual Nerve injury in the removal of mandibular third molars.
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Outcome following Lingual Nerve repair with vein graft cuff: a preliminary report.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 2014Co-Authors: Shigeyuki Fujita, Itaru Tojyo, Masai Yamada, Takashi Matsumoto, Norifumi KigaAbstract:Purpose The object of this study was to assess the effects of an inside-out vein graft as a cuff after direct suture on human Lingual Nerve regeneration and recovery after iatrogenic Lingual Nerve injury. Patients and Methods Ten patients with unilateral Lingual Nerve anesthesia as a complication of iatrogenic injury after third molar extraction underwent microneurosurgical procedures for the injured Lingual Nerve under general anesthesia. The patients were randomized into 2 groups. In group A, after removing the neuromas and peripheral scars surrounding the torn Nerves, the 2 Nerve ends were sutured without tension. In group B, after the same procedure, including the same suturing procedure, an inside-out vein graft was placed as a cuff after the direct suture. Each group was followed at least once every 6 months for 1 year after the procedure. Postoperative outcomes were evaluated using the Pogrel criteria, the Sunderland grade, and the British Medical Research Council Scale (MRCS). Results There were no particular differences between groups A and B at 6 and 12 months after the operation. However, based on the MRCS criteria, there was a clearly better result in group B than in group A at 6 and 12 months after the operation, and the recovery of gustatory sensation tended to be better in group B than in group A 1 year after the operation. Conclusion This inside-out vein graft as a cuff after direct suturing may facilitate faster Lingual Nerve regeneration than the traditional direct suture approach. The inside-out vein graft as a cuff may provide the advantages of preventing axonal escape at the suture lines, minimizing Nerve entrapment, and preventing neuroma formation in the space between the sutured Nerves.
Risto-pekka Happonen - One of the best experts on this subject based on the ideXlab platform.
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Acoustic and neurophysiologic observations related to Lingual Nerve impairment.
International journal of oral and maxillofacial surgery, 2009Co-Authors: Matti Niemi, Juha-pertti Laaksonen, Heli Forssell, Satu K. Jääskeläinen, Olli Aaltonen, Risto-pekka HapponenAbstract:The purpose of this study was to determine the acoustic effects of Lingual Nerve impairment on speech. Neurophysiologic examination and thermal quantitative sensory testing (QST) were carried out to determine if the profile, type or severity of sensory Nerve impairment had effects on the degree of speech changes. The study group consisted of 5 women and 5 men with Lingual Nerve damage following an oral and maxillofacial surgery procedure. Time interval between the examination and the Nerve damage ranged from 1 month to 20 years. Formants and fundamental frequency and duration of vowel sounds were analyzed. The patients underwent sensory tests, blink reflex and thermal QST of the Lingual Nerve area. The Lingual Nerve impairment had effects on the central acoustic features of vowel sounds. A relationship was observed between warm detection threshold values and the magnitude of second formant changes in men. It is concluded that Lingual Nerve impairment has gender-specific effects on speech. The variability in the acoustic changes of vowel sounds between different patients indicates individual compensatory manners of speech production following Lingual Nerve impairment.
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Effects of transitory Lingual Nerve impairment on speech: an acoustic study of vowel sounds.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 2004Co-Authors: Matti Niemi, Juha-pertti Laaksonen, Olli Aaltonen, Kimmo Vähätalo, Jyrki Tuomainen, Risto-pekka HapponenAbstract:Abstract Purpose: The purpose of the study was to evaluate the effects of the Lingual Nerve impairment on phonetic quality of speech by analyzing the main acoustic features of vowel sounds when the normal Lingual Nerve function was partly distorted by local anesthesia. Patients and Methods: The study group consisted of 7 men, whose right side Lingual Nerve was anesthetized with 0.8 mL of Ultracain D-Suprarenin (Aventis Pharma Deutschland GmpH, Frankfurt am Main, Germany). The speech material analyzed consisted of 8 vowels produced in sentence context by speakers. Every utterance was repeated 10 times with and without local anesthesia. After recording, the speech samples were analyzed with a computerized speech laboratory. In addition, the vowels of 1 man with permanent Nerve impairment were studied. Results: The results show that the deprived function of the tongue after Lingual Nerve impairment had various effects on vowel quality for every subject. The main acoustic determinants of different vowels, the lowest vocal tract resonances, changed in frequency. In addition, the total duration of vowels changed and the vowels had different fundamental frequencies. However, these effects were extremely individual and variable. Conclusions: According to the results of acoustic analysis, the distortion of Lingual Nerve function has effects on vowel production. Some of these changes were so extensive that they also could be perceptually detectable. Lingual Nerve impairment seems to have potential to change speech production. © 2002 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 60:647-652, 2002
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Effects of transitory Lingual Nerve impairment on speech: an acoustic study of vowel sounds.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 2002Co-Authors: Matti Niemi, Juha-pertti Laaksonen, Olli Aaltonen, Kimmo Vähätalo, Jyrki Tuomainen, Risto-pekka HapponenAbstract:The purpose of the study was to evaluate the effects of the Lingual Nerve impairment on phonetic quality of speech by analyzing the main acoustic features of vowel sounds when the normal Lingual Nerve function was partly distorted by local anesthesia. The study group consisted of 7 men, whose right side Lingual Nerve was anesthetized with 0.8 mL of Ultracaine D-Suprarenin (Aventis Pharma Deutschland GmpH, Frankfurt am Main, Germany). The speech material analyzed consisted of 8 vowels produced in sentence context by speakers. Every utterance was repeated 10 times with and without local anesthesia. After recording, the speech samples were analyzed with a computerized speech laboratory. In addition, the vowels of 1 man with permanent Nerve impairment were studied. The results show that the deprived function of the tongue after Lingual Nerve impairment had various effects on vowel quality for every subject. The main acoustic determinants of different vowels, the lowest vocal tract resonances, changed in frequency. In addition, the total duration of vowels changed and the vowels had different fundamental frequencies. However, these effects were extremely individual and variable. According to the results of acoustic analysis, the distortion of Lingual Nerve function has effects on vowel production. Some of these changes were so extensive that they also could be perceptually detectable. Lingual Nerve impairment seems to have potential to change speech production. Copyright 2002 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 60:647-652, 2002
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Effects of transitory Lingual Nerve impairment on speech: An acoustic study of vowel sounds. Discussion
Journal of Oral and Maxillofacial Surgery, 2002Co-Authors: Matti Niemi, Juha-pertti Laaksonen, Olli Aaltonen, Risto-pekka Happonen, Kimmo Vähätalo, Jyrki Tuomainen, M. Anthony PogrelAbstract:Purpose: The purpose of the study was to evaluate the effects of the Lingual Nerve impairment on phonetic quality of speech by analyzing the main acoustic features of vowel sounds when the normal Lingual Nerve function was partly distorted by local anesthesia. Patients and Methods: The study group consisted of 7 men, whose right side Lingual Nerve was anesthetized with 0.8 mL of Ultracain D-Suprarenin (Aventis Pharma Deutschland GmpH, Frankfurt am Main, Germany). The speech material analyzed consisted of 8 vowels produced in sentence context by speakers. Every utterance was repeated 10 times with and without local anesthesia. After recording, the speech samples were analyzed with a computerized speech laboratory. In addition, the vowels of 1 man with permanent Nerve impairment were studied. Results: The results show that the deprived function of the tongue after Lingual Nerve impairment had various effects on vowel quality for every subject. The main acoustic determinants of different vowels, the lowest vocal tract resonances, changed in frequency. In addition, the total duration of vowels changed and the vowels had different fundamental frequencies. However, these effects were extremely individual and variable. Conclusions: According to the results of acoustic analysis, the distortion of Lingual Nerve function has effects on vowel production. Some of these changes were so extensive that they also could be perceptually detectable. Lingual Nerve impairment seems to have potential to change speech production.
Matti Niemi - One of the best experts on this subject based on the ideXlab platform.
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Acoustic and neurophysiologic observations related to Lingual Nerve impairment.
International journal of oral and maxillofacial surgery, 2009Co-Authors: Matti Niemi, Juha-pertti Laaksonen, Heli Forssell, Satu K. Jääskeläinen, Olli Aaltonen, Risto-pekka HapponenAbstract:The purpose of this study was to determine the acoustic effects of Lingual Nerve impairment on speech. Neurophysiologic examination and thermal quantitative sensory testing (QST) were carried out to determine if the profile, type or severity of sensory Nerve impairment had effects on the degree of speech changes. The study group consisted of 5 women and 5 men with Lingual Nerve damage following an oral and maxillofacial surgery procedure. Time interval between the examination and the Nerve damage ranged from 1 month to 20 years. Formants and fundamental frequency and duration of vowel sounds were analyzed. The patients underwent sensory tests, blink reflex and thermal QST of the Lingual Nerve area. The Lingual Nerve impairment had effects on the central acoustic features of vowel sounds. A relationship was observed between warm detection threshold values and the magnitude of second formant changes in men. It is concluded that Lingual Nerve impairment has gender-specific effects on speech. The variability in the acoustic changes of vowel sounds between different patients indicates individual compensatory manners of speech production following Lingual Nerve impairment.
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Effects of transitory Lingual Nerve impairment on speech: an acoustic study of vowel sounds.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 2004Co-Authors: Matti Niemi, Juha-pertti Laaksonen, Olli Aaltonen, Kimmo Vähätalo, Jyrki Tuomainen, Risto-pekka HapponenAbstract:Abstract Purpose: The purpose of the study was to evaluate the effects of the Lingual Nerve impairment on phonetic quality of speech by analyzing the main acoustic features of vowel sounds when the normal Lingual Nerve function was partly distorted by local anesthesia. Patients and Methods: The study group consisted of 7 men, whose right side Lingual Nerve was anesthetized with 0.8 mL of Ultracain D-Suprarenin (Aventis Pharma Deutschland GmpH, Frankfurt am Main, Germany). The speech material analyzed consisted of 8 vowels produced in sentence context by speakers. Every utterance was repeated 10 times with and without local anesthesia. After recording, the speech samples were analyzed with a computerized speech laboratory. In addition, the vowels of 1 man with permanent Nerve impairment were studied. Results: The results show that the deprived function of the tongue after Lingual Nerve impairment had various effects on vowel quality for every subject. The main acoustic determinants of different vowels, the lowest vocal tract resonances, changed in frequency. In addition, the total duration of vowels changed and the vowels had different fundamental frequencies. However, these effects were extremely individual and variable. Conclusions: According to the results of acoustic analysis, the distortion of Lingual Nerve function has effects on vowel production. Some of these changes were so extensive that they also could be perceptually detectable. Lingual Nerve impairment seems to have potential to change speech production. © 2002 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 60:647-652, 2002
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Effects of transitory Lingual Nerve impairment on speech: an acoustic study of vowel sounds.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 2002Co-Authors: Matti Niemi, Juha-pertti Laaksonen, Olli Aaltonen, Kimmo Vähätalo, Jyrki Tuomainen, Risto-pekka HapponenAbstract:The purpose of the study was to evaluate the effects of the Lingual Nerve impairment on phonetic quality of speech by analyzing the main acoustic features of vowel sounds when the normal Lingual Nerve function was partly distorted by local anesthesia. The study group consisted of 7 men, whose right side Lingual Nerve was anesthetized with 0.8 mL of Ultracaine D-Suprarenin (Aventis Pharma Deutschland GmpH, Frankfurt am Main, Germany). The speech material analyzed consisted of 8 vowels produced in sentence context by speakers. Every utterance was repeated 10 times with and without local anesthesia. After recording, the speech samples were analyzed with a computerized speech laboratory. In addition, the vowels of 1 man with permanent Nerve impairment were studied. The results show that the deprived function of the tongue after Lingual Nerve impairment had various effects on vowel quality for every subject. The main acoustic determinants of different vowels, the lowest vocal tract resonances, changed in frequency. In addition, the total duration of vowels changed and the vowels had different fundamental frequencies. However, these effects were extremely individual and variable. According to the results of acoustic analysis, the distortion of Lingual Nerve function has effects on vowel production. Some of these changes were so extensive that they also could be perceptually detectable. Lingual Nerve impairment seems to have potential to change speech production. Copyright 2002 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 60:647-652, 2002
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Effects of transitory Lingual Nerve impairment on speech: An acoustic study of vowel sounds. Discussion
Journal of Oral and Maxillofacial Surgery, 2002Co-Authors: Matti Niemi, Juha-pertti Laaksonen, Olli Aaltonen, Risto-pekka Happonen, Kimmo Vähätalo, Jyrki Tuomainen, M. Anthony PogrelAbstract:Purpose: The purpose of the study was to evaluate the effects of the Lingual Nerve impairment on phonetic quality of speech by analyzing the main acoustic features of vowel sounds when the normal Lingual Nerve function was partly distorted by local anesthesia. Patients and Methods: The study group consisted of 7 men, whose right side Lingual Nerve was anesthetized with 0.8 mL of Ultracain D-Suprarenin (Aventis Pharma Deutschland GmpH, Frankfurt am Main, Germany). The speech material analyzed consisted of 8 vowels produced in sentence context by speakers. Every utterance was repeated 10 times with and without local anesthesia. After recording, the speech samples were analyzed with a computerized speech laboratory. In addition, the vowels of 1 man with permanent Nerve impairment were studied. Results: The results show that the deprived function of the tongue after Lingual Nerve impairment had various effects on vowel quality for every subject. The main acoustic determinants of different vowels, the lowest vocal tract resonances, changed in frequency. In addition, the total duration of vowels changed and the vowels had different fundamental frequencies. However, these effects were extremely individual and variable. Conclusions: According to the results of acoustic analysis, the distortion of Lingual Nerve function has effects on vowel production. Some of these changes were so extensive that they also could be perceptually detectable. Lingual Nerve impairment seems to have potential to change speech production.
Itaru Tojyo - One of the best experts on this subject based on the ideXlab platform.
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Change in allodynia of patients with post-Lingual Nerve repair iatrogenic Lingual Nerve disorder
Oral and Maxillofacial Surgery, 2020Co-Authors: Yukari Shintani, Masamichi Ueda, Itaru Tojyo, Shigeyuki FujitaAbstract:Purpose Mandibular third molar extractions are common treatment in oral maxillofacial surgery, but risk disturbance of the Lingual Nerves causing anesthesia, eating difficulty and allodynia, which can seriously reduce patient quality of life. This study investigates the change in allodynia before and after repair in patients with Lingual Nerve disorder. Subjects and methods This retrospective cohort study comprises the 52 patients with affected Lingual Nerve after third molar extraction at our hospital over a 7-year period. Pre- and postoperative (6 months and 12 months) neurosensory records were analyzed. Results Fifty-two patients underwent Lingual Nerve repair and returned for at least 1 year of follow-up. Mean age was 36.8 ± 11.9. Median interval between injury and surgery was 5 (4, 8) months. In 92.9% of those with pain before surgery, allodynia disappeared postoperatively. Conclusions This study shows that microsurgical Lingual reconstructions are effective in patients with preoperative allodynia, but a small number of patients may have remaining allodynia after surgery. Large-scale, more detailed analysis of such cases is required.
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Change in allodynia of patients with post-Lingual Nerve repair iatrogenic Lingual Nerve disorder.
Oral and maxillofacial surgery, 2019Co-Authors: Yukari Shintani, Masamichi Ueda, Itaru Tojyo, Shigeyuki FujitaAbstract:Mandibular third molar extractions are common treatment in oral maxillofacial surgery, but risk disturbance of the Lingual Nerves causing anesthesia, eating difficulty and allodynia, which can seriously reduce patient quality of life. This study investigates the change in allodynia before and after repair in patients with Lingual Nerve disorder. This retrospective cohort study comprises the 52 patients with affected Lingual Nerve after third molar extraction at our hospital over a 7-year period. Pre- and postoperative (6 months and 12 months) neurosensory records were analyzed. Fifty-two patients underwent Lingual Nerve repair and returned for at least 1 year of follow-up. Mean age was 36.8 ± 11.9. Median interval between injury and surgery was 5 (4, 8) months. In 92.9% of those with pain before surgery, allodynia disappeared postoperatively. This study shows that microsurgical Lingual reconstructions are effective in patients with preoperative allodynia, but a small number of patients may have remaining allodynia after surgery. Large-scale, more detailed analysis of such cases is required.
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Risk of Lingual Nerve injuries in removal of mandibular third molars: a retrospective case-control study.
Maxillofacial plastic and reconstructive surgery, 2019Co-Authors: Itaru Tojyo, Yukari Shintani, Takashi Nakanishi, Kenjiro Okamoto, Yukihiro Hiraishi, Shigeyuki FujitaAbstract:Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic Lingual Nerve injuries in the removal of the mandibular third molar. A retrospective chart review was performed for patients who had undergone microsurgical repair of Lingual Nerve injuries. The following data were collected and analyzed: patient sex, age, Nerve injury side, type of impaction (Winter’s classification, Pell and Gregory’s classification). Ratios for the respective Lingual Nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar. The Lingual Nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic Lingual Nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual Nerve injury was significantly higher in the patient versus the control groups in age. The Lingual Nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our Lingual Nerve injury group. The distoangular impaction rate in our Lingual Nerve injury group was significantly higher than the rate for the control groups. Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe Lingual Nerve injury in the removal of mandibular third molars.
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Outcome following Lingual Nerve repair with vein graft cuff: a preliminary report.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 2014Co-Authors: Shigeyuki Fujita, Itaru Tojyo, Masai Yamada, Takashi Matsumoto, Norifumi KigaAbstract:Purpose The object of this study was to assess the effects of an inside-out vein graft as a cuff after direct suture on human Lingual Nerve regeneration and recovery after iatrogenic Lingual Nerve injury. Patients and Methods Ten patients with unilateral Lingual Nerve anesthesia as a complication of iatrogenic injury after third molar extraction underwent microneurosurgical procedures for the injured Lingual Nerve under general anesthesia. The patients were randomized into 2 groups. In group A, after removing the neuromas and peripheral scars surrounding the torn Nerves, the 2 Nerve ends were sutured without tension. In group B, after the same procedure, including the same suturing procedure, an inside-out vein graft was placed as a cuff after the direct suture. Each group was followed at least once every 6 months for 1 year after the procedure. Postoperative outcomes were evaluated using the Pogrel criteria, the Sunderland grade, and the British Medical Research Council Scale (MRCS). Results There were no particular differences between groups A and B at 6 and 12 months after the operation. However, based on the MRCS criteria, there was a clearly better result in group B than in group A at 6 and 12 months after the operation, and the recovery of gustatory sensation tended to be better in group B than in group A 1 year after the operation. Conclusion This inside-out vein graft as a cuff after direct suturing may facilitate faster Lingual Nerve regeneration than the traditional direct suture approach. The inside-out vein graft as a cuff may provide the advantages of preventing axonal escape at the suture lines, minimizing Nerve entrapment, and preventing neuroma formation in the space between the sutured Nerves.