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Neurosensory changes following orthognathic surgery.
N Chen1, C E Neal, P Lingenbrink
1University of California, Berkeley, USA.
The International Journal of Adult Orthodontics and Orthognathic Surgery
|July 15, 2000
Summary
Facial surgery can cause neurosensory changes, particularly in lower facial regions. Patient self-reports align with 2-point discrimination tests, but not pressure-pain tests for assessing sensory loss.
Area of Science:
- Oral and Maxillofacial Surgery
- Neurosurgery
- Sensory Neuroscience
Background:
- Significant variability exists in reported neurosensory disturbances after facial surgery.
- Differences in surgical techniques and assessment methods contribute to inconsistent findings.
- Orthognathic surgery, particularly bilateral sagittal split osteotomy, can impact facial sensation.
Purpose of the Study:
- To compare three methods for assessing neurosensory loss following orthognathic surgery.
- To evaluate the consistency between objective tests (2-point discrimination, pressure-pain thresholds) and subjective patient ratings.
- To identify which assessment method best reflects patient-reported sensory changes.
Main Methods:
- A study involving 24 patients undergoing orthognathic surgery.
- Preoperative and 4-week postoperative assessments using 2-point discrimination, pressure-pain thresholds, and subjective sensation mapping.
- Comparison of results across different surgical procedures (e.g., bilateral sagittal split osteotomy, combined maxillary and mandibular procedures).
Main Results:
- Postoperative 2-point discrimination worsened in lower facial regions for all patients, especially males undergoing bilateral sagittal split osteotomy.
- Pressure-pain thresholds showed significant impairment in specific groups (combined procedures, bilateral sagittal split osteotomy) but were generally less affected.
- Patient self-ratings of sensory changes in lower facial regions correlated with 2-point discrimination results but not pressure-pain thresholds.
Conclusions:
- 2-point discrimination testing is a reliable method for assessing neurosensory changes after orthognathic surgery, aligning well with patient self-reports.
- Pressure-pain threshold testing, as used in this study, was less sensitive in detecting postoperative neurosensory alterations.
- Subjective patient reporting of sensory changes, particularly in the lower face, is a crucial indicator following orthognathic procedures.