[Inferior alveolar nerve reconstruction after segmental resection of the mandible]
R Taraquois1, A Joly2, A Sallot3
1Service de chirurgie maxillo-faciale et plastique de la face, CHU Trousseau, avenue de la République, 37170 Chambray-lès-Tours, France; Service de plastique reconstructrice et esthétique, CHU Trousseau, avenue de la République, 37170 Chambray-lès-Tours, France.
Introduction:
The sacrifice of inferior alveolar nerve (IAN) is usual in case of resection of mandibular tumors and is responsible for disabling sensory disorders, drooling and lip incompetence. We report the case of a reconstruction of the IAN by means of an autologous nerve graft after segmental resection of the mandible.
Observation:
A 27-year-old man presented with a recurrence of mandibular ameloblastoma. Treatment consisted in segmental mandibulectomy with resection of the IAN. Bone reconstruction was performed with a fibula free flap and IAN reconstruction was obtained by mean of a 7-cm nerve graft obtained from the greater auricular nerve (GAN). At the 6th postoperative month, the patient had recovered a normal sensitivity of his lower lip and chin. Latency of somatosensory evoked potentials was similar for both sides.
Discussion:
The repair of the IAN by nerve autograft is a simple procedure that allows for good sensitive rehabilitation. The use of the GAN is well suited from its anatomy and from the moderate ear sensory sequelae.
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