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Published on: August 28, 2018
Course of the mandibular canal in hemifacial microsomia: a retrospective computed tomography study
Zhixu Liu1, Jian Cao1, Yifeng Qian1
1Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
Objective:
The aim of this study was to evaluate the anatomic course of the mandibular canal in patients with hemifacial microsomia (HM).
Study Design:
In this retrospective study, 77 patients were included and stratified according to the Pruzansky-Kaban classification. The mandibular canal and the mandible were reconstructed on the basis of computed tomography data. The entrance, route, and exit of the mandibular canal (representing the entrance, route, and exit of the inferior alveolar nerve [IAN], respectively), and the antilingula were analyzed in different types of mandibular deformities in patients with HM.
Results:
No significant difference in the course of the mandibular canal was detected between the affected and unaffected sides in patients with type I and type IIa HM. Abnormalities were observed in some patients with type IIb and type III HM. Significant differences were found between patients with type IIb and type III HM in the entrance (P = .015) and route (P = .001) of the canals. The antilingula was identified only in patients with type IIb and type III HM and was more common in patients with type III HM than in those with type IIb HM.
Conclusions:
Variation of the anatomic course of mandibular canal exists in patients with Pruzansky-Kaban type IIb and type III HM. Evaluation of the course of the canal in patients with HM is recommended before surgical intervention to avoid IAN damage.
Insights
The mandibular canal
Area of Science:
- Anatomy
- Oral and Maxillofacial Surgery
- Medical Imaging
Background:
- Hemifacial microsomia (HM) is a congenital condition affecting facial development.
- Understanding the anatomy of the mandibular canal is crucial for surgical planning.
- The inferior alveolar nerve (IAN) runs through the mandibular canal, vital for sensation and surgical safety.
Purpose of the Study:
- To investigate the anatomical course of the mandibular canal in patients with hemifacial microsomia (HM).
- To correlate variations in the mandibular canal's anatomy with different Pruzansky-Kaban classifications of HM.
- To assess the presence and location of the antilingula in HM patients.
Main Methods:
- Retrospective analysis of 77 patients with hemifacial microsomia.
- Classification of patients based on the Pruzansky-Kaban system.
- 3D reconstruction of the mandible and mandibular canal using computed tomography (CT) data.
Main Results:
- No significant differences in mandibular canal course were found in Pruzansky-Kaban types I and IIa HM.
- Abnormalities in the mandibular canal's entrance and route were observed in types IIb and III HM.
- The antilingula was identified in types IIb and III HM, more frequently in type III.
Conclusions:
- The anatomical course of the mandibular canal varies in patients with Pruzansky-Kaban type IIb and III hemifacial microsomia.
- Pre-surgical evaluation of the mandibular canal's course is recommended in HM patients.
- This evaluation can help prevent damage to the inferior alveolar nerve (IAN) during surgical interventions.
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