DANG (Depth-Adjusted Nerve Guide) - A Technical Note

Traditional surgical approaches to the inferior alveolar nerve (IAN) pose a technical challenge and risk iatrogenic damage to healthy, uninvolved nerve tissue. The use of computer-assisted virtual surgical planning and fabrication of surgical guides has shown efficacy in various craniomaxillofacial surgical procedures, and may provide greater precision in accessing the inferior alveolar canal and allow for a more conservative approach. The addition of a depth control feature to a tooth-borne and bone-borne surgical guide, with the use of a standard contra-angle handpiece, provides safe and efficient access for IAN repair. This report describes this novel technique involving a guided transoral approach to the IAN for excision of a neurofibroma of the inferior alveolar nerve, with immediate peripheral nerve allograft IAN reconstruction.