Immediate Inferior Alveolar Nerve Reconstruction With Ablative Mandibular Resection Results in Functional Sensory
Michael Miloro1, Nicholas F Callahan2, Michael R Markiewicz3
1Professor and Head, Oral and Maxillofacial Surgery, University of Illinois, Chicago, IL.
Summary
Immediate inferior alveolar nerve (IAN) allograft reconstruction effectively restores sensation after mandibular resection, with 80% achieving functional sensory recovery (FSR) at one year. This technique is particularly beneficial for pediatric patients and those with benign conditions.
Area of Science:
- Oral and Maxillofacial Surgery
- Neurosurgery
- Regenerative Medicine
Background:
- Ablative mandibular resection often necessitates sacrificing the inferior alveolar nerve (IAN), leading to sensory loss and reduced quality of life.
- Restoring sensation after IAN sacrifice is crucial for improving patient outcomes and functional recovery.
Purpose of the Study:
- To evaluate the functional sensory recovery (FSR) after immediate inferior alveolar nerve (IAN) allograft reconstruction during ablative mandibular resection.
- To assess the efficacy of IAN allograft reconstruction at one year post-surgery.
Main Methods:
- A single-center retrospective cohort study included patients with IAN discontinuity requiring mandibular reconstruction.
- Nerve allografts of ≥40 mm were used for immediate reconstruction in the predictor group.
- Functional sensory recovery (FSR) was assessed at one year using the Medical Research Council Scale, with covariates including age, sex, pathology, nerve gap length, and neuropathic pain.
Main Results:
- 80% of patients (33.5%) who received immediate IAN allograft reconstruction achieved FSR at one year.
- Patients with benign disease undergoing allograft reconstruction had a high FSR rate of 94%.
- Immediate IAN allograft reconstruction was significantly associated with achieving FSR (adjusted odds ratio = 5.52, P = .045), with younger age and benign pathology being significant positive predictors.
Conclusions:
- Immediate long-span IAN allograft reconstruction is an effective method for restoring sensation following mandibular resection.
- The study recommends considering immediate IAN reconstruction, especially for pediatric patients and those with benign pathologies, to enhance functional sensory recovery.
