Morphological and quantitative study of the inferior alveolar nerve canal in hemifacial microsomia
Xin Li1, Xiaojun Chen1, Ziwei Zhang1
1Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China.
Abstract:
This study aimed to probe into the anatomic course of inferior alveolar nerve canal (IANC) in hemifacial microsomia (HFM) on a large scale, morphological observations and further quantitative study were performed. Patients were classified by Pruzansky-Kaban classification. The anatomic course of IANC was analyzed morphologically with three-dimensional (3D) imaging software among 248 patients. Seven distances between fixed landmarks on both sides were measured for 236 patients. The differences between affected and unaffected sides were compared. Significant differences were found in the entrance (P < 0.001), route (P < 0.001), and exit (P < 0.05) of IANC in type IIb and III HFM. The higher the degree of mandibular deformity was, the higher the incidence of IANC variation was (P < 0.05). The distances in the horizontal aspect of IANC including from mandibular foramen to mental foramen (P < 0.05) and from mental foramen to gonion (P < 0.05) were significantly shorter on the affected side. Abnormalities of the anatomical course of IANC exist in patients with Pruzansky-Kaban type IIb and type III HFM. The reduction of IANC on the affected side in the horizontal distance is more obvious. Three-dimensional imaging assessment is recommended before surgery.
Insights
This study reveals significant anatomical variations in the inferior alveolar nerve canal (IANC) in hemifacial microsomia (HFM) patients, particularly in types IIb and III. Three-dimensional imaging is recommended for surgical planning.
Area of Science:
- Anatomy
- Oral and Maxillofacial Surgery
- Medical Imaging
Background:
- Hemifacial microsomia (HFM) presents with significant craniofacial asymmetry.
- Understanding the anatomical variations of the inferior alveolar nerve canal (IANC) is crucial for surgical interventions.
Purpose of the Study:
- To investigate the anatomical course and variations of the IANC in patients with HFM using large-scale 3D imaging.
- To correlate IANC morphology with the severity of mandibular deformity based on the Pruzansky-Kaban classification.
Main Methods:
- Morphological analysis of the IANC in 248 HFM patients using 3D imaging software.
- Quantitative measurements of seven distances between landmarks on the IANC in 236 patients.
- Comparison of IANC anatomy between affected and unaffected sides and correlation with HFM type.
Main Results:
- Significant differences in IANC entrance, route, and exit were observed in Pruzansky-Kaban type IIb and III HFM.
- A higher incidence of IANC variation was associated with increased mandibular deformity.
- Horizontal distances of the IANC, including mandibular foramen to mental foramen and mental foramen to gonion, were significantly shorter on the affected side.
Conclusions:
- Abnormalities in the anatomical course of the IANC are prevalent in Pruzansky-Kaban type IIb and III HFM.
- The reduction in horizontal IANC distance is a notable finding on the affected side.
- Preoperative 3D imaging assessment is recommended for patients with HFM.
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