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Cranial Nerves: Types Part II01:22

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How Many Oral Surgeons Does It Take to Classify a Nerve Injury?

Michael Miloro1, John R Zuniga2, Roger A Meyer3

  • 1Professor and Head, Oral and Maxillofacial Surgery, University of Illinois, Chicago, IL.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|February 14, 2021
PubMed
Summary
This summary is machine-generated.

Oral and maxillofacial surgeons report inconsistent grading of trigeminal nerve (TN5) injuries. A unified classification system and standardized neurosensory testing are needed for better patient care and research outcomes.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Neurosurgery
  • Nerve Injury Classification

Background:

  • Clinical grading of peripheral trigeminal nerve (TN5) injuries lacks consistency, impacting patient care.
  • Oral and maxillofacial surgeons (OMSs) face challenges in evaluating and classifying TN5 injuries.

Purpose of the Study:

  • To assess the current practices of OMSs in evaluating and classifying TN5 injuries.
  • To identify inconsistencies in diagnostic methods and treatment protocols for TN5 injuries.

Main Methods:

  • A cross-sectional study utilizing an electronic survey distributed to 100 OMSs.
  • Survey assessed clinical practices, neurosensory testing, confidence levels, and response to a hypothetical TN5 injury case.

Main Results:

  • 90 OMSs responded, revealing varied use of classification systems (Seddon, Sunderland, Medical Research Council Scale).
  • Neurosensory testing protocols were inconsistent; grading of a sample case yielded inaccurate results.
  • Lack of consensus on TN5 injury management and repair timing; many OMSs feel unprepared to assess these injuries.

Conclusions:

  • OMSs experienced in TN5 injuries lack confidence in assessment due to inconsistent evaluation methods.
  • A unified TN5 injury classification system is deemed necessary for improved patient evaluation and literature reporting.
  • The Medical Research Council Scale and clinical neurosensory testing are preferred for TN5 injury evaluation.