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Hypoesthesia associated with mandibular movement after sagittal split ramus osteotomy.

Toru Yamamoto1, Keiko Fujii-Abe2, Haruhisa Fukayama2

  • 1Section of Anesthesiology and Clinical Physiology, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-4, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. tyamamoto-kys@umin.ac.jp.

Oral and Maxillofacial Surgery
|June 7, 2017
PubMed
Summary

Greater mandibular movement after sagittal split ramus osteotomy (SSRO) may increase early neurosensory disturbance (NSD). This finding helps surgeons counsel patients on potential postoperative hypoesthesia.

Keywords:
HypoesthesiaNeurosensory disturbanceOrthognathic surgerySagittal split osteotomy

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Neurosurgery
  • Sensory Neuroscience

Background:

  • Sagittal split ramus osteotomy (SSRO) is a common procedure for mandibular advancement.
  • Neurosensory disturbance (NSD) is a known complication following SSRO, affecting patient quality of life.
  • Understanding factors influencing NSD is crucial for surgical planning and patient counseling.

Purpose of the Study:

  • To investigate the relationship between mandibular movement distance and NSD after SSRO.
  • To assess sensory recovery in patients undergoing SSRO.
  • To evaluate the impact of SSRO on lower lip hypoesthesia.

Main Methods:

  • Retrospective study of 38 patients who underwent SSRO.
  • Patients were divided into two groups based on mandibular movement distance: 0-7 mm (S group) and 7-14 mm (L group).
  • Lower lip hypoesthesia was assessed using Visual Analog Scale (VAS), tactile-threshold (SW) test, static 2-point discrimination (s-2PD) test, and current perception threshold (CPT) test at 1 week, 1 month, and 2 months post-surgery.

Main Results:

  • No significant differences in gender or age between the S and L groups.
  • Aβ fiber results from the CPT test showed significant differences between groups at 1 week and 1 month post-surgery (P < 0.05).
  • No significant differences were observed between groups for VAS, SW, s-2PD, Aδ fiber, and C fiber of CPT throughout the study period.

Conclusions:

  • Patients with greater mandibular movement (L group) may experience a higher incidence of tactile NSD early after SSRO.
  • These findings can aid surgeons in preoperatively explaining potential postoperative hypoesthesia to patients.
  • Further research may explore long-term sensory recovery patterns in relation to mandibular advancement.