A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Nerve Manipulation During Bilateral Sagittal Split Osteotomy Increases Neurosensory Disturbance and Decreases Patient Satisfaction
Tekijät: Kuhlefelt M, Laine P, Suominen AL, Lindqvist C, Thoren H
Kustantaja: W B SAUNDERS CO-ELSEVIER INC
Julkaisuvuosi: 2014
Journal: Journal of Oral and Maxillofacial Surgery
Tietokannassa oleva lehden nimi: JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
Lehden akronyymi: J ORAL MAXIL SURG
Vuosikerta: 72
Numero: 10
Sivujen määrä: 5
ISSN: 0278-2391
DOI: https://doi.org/10.1016/j.joms.2014.06.444
Tiivistelmä
Purpose: The extent to which neurosensory disturbance (NSD) affects patients after bilateral sagittal split osteotomy (BSSO) was investigated 1 year postoperatively. An additional aim was to identify related factors.Materials and Methods: In this prospective study, the fate of the mandibular nerve during BSSO was recorded. The predictor variable was the degree of nerve injury during BSSO, and the outcome variable was the effect of NSD 1 year postoperatively. Statistics were computed and a P value less than.05 was considered significant.Results: Forty-one patients (27 women; average age, 37 yr) completed the study. Of these patients, 90.2% had NSD, but most (89.2%) were satisfied with the treatment and would choose it again. The NSD was greater when the nerve had been manipulated more during surgery. The 4 patients with visible nerve lacerations had severe NSD and were unsatisfied with the treatment at the endpoint.Conclusions: Although NSD was frequent 1 year after BSSO, most patients were satisfied with the treatment. However, a risk for severe NSD or neuropathic pain does exist in a small group of patients. These patients should be identified at an early stage so that proper medical and supportive treatment can be initiated. If necessary, a multidisciplinary pain center should be consulted. The importance of accurate patient information preoperatively cannot be overstated. (C) 2014 American Association of Oral and Maxillofacial Surgeons
Purpose: The extent to which neurosensory disturbance (NSD) affects patients after bilateral sagittal split osteotomy (BSSO) was investigated 1 year postoperatively. An additional aim was to identify related factors.Materials and Methods: In this prospective study, the fate of the mandibular nerve during BSSO was recorded. The predictor variable was the degree of nerve injury during BSSO, and the outcome variable was the effect of NSD 1 year postoperatively. Statistics were computed and a P value less than.05 was considered significant.Results: Forty-one patients (27 women; average age, 37 yr) completed the study. Of these patients, 90.2% had NSD, but most (89.2%) were satisfied with the treatment and would choose it again. The NSD was greater when the nerve had been manipulated more during surgery. The 4 patients with visible nerve lacerations had severe NSD and were unsatisfied with the treatment at the endpoint.Conclusions: Although NSD was frequent 1 year after BSSO, most patients were satisfied with the treatment. However, a risk for severe NSD or neuropathic pain does exist in a small group of patients. These patients should be identified at an early stage so that proper medical and supportive treatment can be initiated. If necessary, a multidisciplinary pain center should be consulted. The importance of accurate patient information preoperatively cannot be overstated. (C) 2014 American Association of Oral and Maxillofacial Surgeons
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