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The brainstem, located inferior to the brain and superior to the spinal cord, serves as a bridge between the cerebrum and the spinal cord. It plays a vital role in relaying information and controlling critical life functions. It comprises three primary regions: the midbrain, pons, and medulla oblongata.
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Sensory impulses related to touch, pressure, vibration, and proprioception from various body parts, such as the limbs, trunk, neck, and posterior head, travel to the cerebral cortex through the posterior column-medial lemniscus pathway. The pathway’s name derives from the two white-matter tracts that convey the impulses: the spinal cord's posterior column and the brainstem's medial lemniscus. First-order sensory neurons extend their axons into the spinal cord, forming the...
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Effects of sagittal split osteotomy on brainstem reflexes.

Aysenur Genc1, Sabri Cemil Isler2, Cengizhan Keskin2

  • 1Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey. anuruzun@gmail.com.

Journal of Orofacial Orthopedics = Fortschritte Der Kieferorthopadie : Organ/Official Journal Deutsche Gesellschaft Fur Kieferorthopadie
|September 27, 2021
PubMed
Summary

Patients with skeletal deformities exhibit altered masseter inhibitory reflex (MIR) and blink reflex (BR). These reflexes, particularly the mental nerve reflex (MBR), showed abnormalities post-surgery, offering insights into trigeminal pathways.

Keywords:
Blink reflexDentofacial anomaliesInferior alveolar nerveMasseter inhibitory reflexMental nerve

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Area of Science:

  • Neurology
  • Oral and Maxillofacial Surgery
  • Biomedical Engineering

Background:

  • Skeletal deformities can impact neurological function.
  • Trigeminal nerve reflexes, including MIR and BR, are crucial for facial sensation and motor control.
  • Understanding reflex patterns in dentofacial abnormalities is essential for surgical planning and recovery assessment.

Purpose of the Study:

  • To determine if skeletal deformities are associated with characteristic masseter inhibitory reflex (MIR) and blink reflex (BR) patterns.
  • To investigate the changes in MIR and BR following bilateral sagittal split osteotomy (BSSO).

Main Methods:

  • Prospective study comparing 14 BSSO patients with 14 Class I controls.
  • Electrophysiological recording of MIR and BR via supraorbital (SBR) and mental nerve (MBR) stimulation.
  • Clinical assessment of sensory impairment and evaluation at three time points: pre-surgery (T0), 1 month (T1), and 6 months (T2) post-surgery.

Main Results:

  • Patients with skeletal deformities showed a significantly shorter MIR early silent period at T0.
  • Post-BSSO, sensory deficits occurred in 23 sides, with 17 recovering by T2.
  • MBR abnormalities persisted in some patients up to 6 months post-surgery, and MIR remained unrecordable on several sides at T1 and T2, with no direct correlation to clinical sensory deficits.

Conclusions:

  • A shorter MIR in patients with dentofacial abnormalities may indicate an adapted trigeminal reflex mechanism.
  • Abnormalities in MBR and MIR following BSSO do not directly parallel clinical sensory deficits.
  • The course of MBR and MIR abnormalities can provide valuable insights into disturbed trigeminal reflex pathways after surgery.