Self-reported hypoesthesia of the lower lip after sagittal split osteotomy

Area of Science:

• Oral and Maxillofacial Surgery
• Neurosurgery
• Anatomy

Background:

• Sagittal split osteotomy (SSO) is a common procedure in orthognathic surgery.
• Sensory impairment of the inferior alveolar nerve is a known complication of SSO.
• Patient-reported outcomes regarding altered sensation in the lower lip after SSO vary significantly.

Purpose of the Study:

• To evaluate individual and intraoperative risk factors associated with sagittal split osteotomy.
• To correlate identified risk factors with self-reported postoperative changes in lower lip sensation.

Main Methods:

• Retrospective analysis of follow-up data from 163 consecutive patients undergoing bilateral sagittal split osteotomy.
• Assessment of self-reported lower lip sensibility disturbances categorized as normal, hypoesthesia, hyperesthesia, or slightly diminished sensation.
• Statistical analysis to identify predictors of altered sensation, including age, concurrent genioplasty, and intraoperative nerve status.

Main Results:

• Overall, 15.1% of patients reported altered lower lip sensation post-SSO.
• Hypoesthesia was reported by 9.9% on the right and 15.4% on the left, with 19.1% experiencing bilateral hypoesthesia.
• Advanced age at surgery (5% increased odds per year) and concurrent genioplasty (4.5 times higher odds) were significant predictors of hypoesthesia. Nerve detachment on the left side correlated with hypoesthesia.

Conclusions:

• Age at surgery and concurrent genioplasty are significant risk factors for developing lower lip hypoesthesia after sagittal split osteotomy.
• Nerve detachment during the procedure, particularly on the left side, is associated with altered sensation.
• Understanding these risk factors can help in patient counseling and surgical planning to mitigate sensory disturbances.