Traumatic neuroma following sagittal mandibular osteotomy

Area of Science:

• Oral and Maxillofacial Surgery
• Neurology
• Radiology

Background:

• Sagittal osteotomy of the mandible can risk damage to the inferior alveolar nerve.
• Traumatic neuromas are a potential complication of nerve injury.
• Temporomandibular joint (TMJ) pain-dysfunction syndrome can present with overlapping symptoms.

Observation:

• A patient developed a painful traumatic neuroma originating from the inferior alveolar nerve after sagittal osteotomy.
• Radiological changes were evident, indicating the neuroma's presence.
• The patient also experienced TMJ pain-dysfunction syndrome, complicating diagnosis.

Findings:

• The co-existence of TMJ pain and a traumatic neuroma presented diagnostic difficulties.
• The report reviews the etiology, clinical presentation, diagnosis, and treatment of traumatic neuromas.
• Modified surgical techniques for sagittal osteotomy are proposed to minimize inferior alveolar nerve injury.

Implications:

• Understanding neuroma formation is crucial for surgeons performing mandibular osteotomies.
• Improved surgical techniques can reduce the incidence of post-operative nerve complications.
• Accurate diagnosis is essential for effective management of combined TMJ and nerve pain.