[Nerve injuries following nerve blocking in the pterygomandibular space]

In a prospective study 506 patients with nerve blocks in the pterygomandibular space were examined before and 3-7 days after local anaesthesia. Clinical neurosensory testing including two-point discrimination revealed no differences between the neurological status before and after injection. Between December 1987 and April 1991 8 patients with 9 nerve injuries (lingual nerve n = 8, inferior alveolar nerve n = 1) after nerve blocks in the pterygomandibular space were treated. In addition to hypaesthesia or anaesthesia 5 out of 8 patients with injection damages of the lingual nerve suffered from a loss of taste sensations. Only 2 of the total of 9 nerve lesions showed a complete recovery of the neurological deficit. One patient with a persistent pain syndrome of the lingual nerve after an injection damage underwent partial nerve resection and microsurgical reconstruction after intraoperative monitoring of somatosensitive-evoced-potentials. The operation was successful for only a few weeks, afterwards a relapse of the pain syndrome took place.