Factors affecting neurosensory disturbance after mandibular bilateral sagittal split osteotomy

• Published in: Journal of oral and maxillofacial surgery Vol. 58; no. 11; pp. 1234 - 1239
• Main Authors: Ylikontiola, Leena, Kinnunen, Jorma, Oikarinen, Kyösti
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2000
• Subjects: Adolescent; Adult; Age Factors; Dentistry; Female; Humans; Male; Mandible - surgery; Middle Aged; Oral Surgical Procedures - adverse effects; Oral Surgical Procedures - psychology; Osteotomy - adverse effects; Osteotomy - methods; Prognathism - surgery; Range of Motion, Articular; Retrognathia - surgery; Self-Assessment; Sensation Disorders - etiology; Statistics, Nonparametric; Surveys and Questionnaires; Trigeminal Nerve Injuries
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1053/joms.2000.16621

Purpose: The current study evaluated the incidence of subjective neurosensory disturbances after bilateral sagittal split osteotomy (BSSO) in relation to gender, age, indication for osteotomy, magnitude of mandibular movement, degree of manipulation of the inferior alveolar nerve at operation, side of the mandible operated, and complications during and after surgery. Patients and Methods: Thirty patients (60 sides) who had undergone a BSSO were followed up for 1 year after operation. The patients were classified into different groups according to gender, age, indication for osteotomy, magnitude of mandibular movement, degree of manipulation of the nerve, and complications during or after surgery. A self-administered questionnaire was used at every follow-up to evaluate the sensations in the mental region. Results: A statistically significant positive correlation was found between subjective neurosensory loss and the patient's age (P =.039), magnitude of mandibular movement (P =.044), and degree of manipulation of the nerve (P =.0007). However, no significant correlation was found between disturbances of sensation and gender, indication for osteotomy, side of the operated mandible, or intraoperative and postoperative complications. Even if all patients evaluated their sensation as “normal” 1 year postoperatively, 31% of them reported slightly altered sensation in the mental region. Conclusions: After BSSO, a prolonged neurosensory deficit is strongly related to age, the intraoperative magnitude of mandibular movement, and the degree of manipulation of the inferior alveolar nerve. However, a long-term sensory loss is very rare, and patients seem to adapt to a mild neurosensory deficit and report sensory function as “normal” despite slightly altered sensation. © 2000 American Association of Oral and Maxillofacial Surgeons