Inferior alveolar nerve preservation during resection and reconstruction of the mandible for benign tumors as a factor improving patient's quality of life

• Published in: Journal of cranio-maxillo-facial surgery Vol. 50; no. 5; pp. 393 - 399
• Main Authors: Tereshchuk, S., Ivanov, S. Yu, Sukharev, V.
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.05.2022
• Subjects: Inferior alveolar nerve; Lip; Mandible; Mental nerve; Numbness; Quality of life; Lip; Mandible; Inferior alveolar nerve; Mental nerve; Numbness; Quality of life
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2022.02.008

This prospective study aimed to evaluate neurosensory disturbance and quality of life in patients who underwent mandibular resection for benign tumors and whose inferior alveolar nerve (IAN) was either preserved or sacrificed. Mandibular resection was indicated owing to the presence of osteoradionecrosis in 25 patients and ameloblastoma in 15 patients. Resection was unilateral in 24 patients and bilateral in 16 patients. The authors assessed the inferior alveolar nerve's sensory dysfunction by measuring the electroexcitability of skin receptors using an electro-odontometer. Study participants' quality of life was estimated with the oral health impact profile (OHIP)-14 and short-form (SF)-36 questionnaire. All the patients in whom the inferior alveolar nerve was sacrificed experienced persistent numbness in the area of innervation with mental nerve on the affected side. The average pain threshold reached preoperative levels (point 1–22.7 ± 2.5, p-value = .025; point 2–25.8 ± 2.7, p-value = .023) 6 months after the operation in patients in whom the IAN was preserved (point 1–23.7 ± 2.3, p-value = .022; point 2–25.4 ± 2.8, p-value = .025). The results of the OHIP-14 and SF-36 showed that patients with preserved IANs had a significantly better quality of life than the patients in whom the IAN was sacrificed. The results of OHIP-14 twelve months after the operation in unilateral resection: control group - 16.0 ± 1.6, p-value = .029; study group - 8.0 ± 0.8, p-value = .029, and in bilateral resection: control group - 26.0 ± 3.2, p-value = .044; study group - 9.0 ± 0.7, p-value = .027. The possibility of sparing the inferior alveolar nerve should not be ignored when planning mandibular resection and reconstruction.