Neuropathic pain after orthognathic surgery

Area of Science:

• Oral and Maxillofacial Surgery
• Neurosurgery
• Pain Medicine

Background:

• Orthognathic surgery aims to correct jaw and facial irregularities.
• Neuropathic pain can be a debilitating complication following such procedures.
• Understanding risk factors is crucial for patient management.

Purpose of the Study:

• To determine the incidence of neuropathic pain after orthognathic surgery.
• To identify potential risk factors associated with its development.
• To report on cases of chronic neuropathic pain post-surgery.

Main Methods:

• Retrospective review of orthognathic surgery patient records from 2001-2011.
• Data extraction from hospital information system and keyword searching.
• Isolation and examination of records detailing chronic pain development.

Main Results:

• The study included 982 bilateral sagittal split osteotomies, 536 LeFort I procedures, and 335 surgically assisted rapid palatal expansions.
• Six cases of debilitating chronic neuropathic pain were identified.
• The mean age of affected patients was 43 years.

Conclusions:

• Exposure or injury to the inferior alveolar nerve is a significant risk factor.
• Disruption of the inferior alveolar nerve's bony environment contributes to risk.
• Bilateral sagittal split osteotomy carries a risk of iatrogenic nerve injury leading to pain.