Longitudinal outcomes of lingual nerve repair after lower third molar removal

This retrospective cohort study aimed to evaluate the success of microsurgical repair of lingual nerve injuries following lower third molar removal based on subjective and objective outcomes. Subjective (paraesthesia, hyperaesthesia, pain, speech and taste deficits, social life impact) and objective (static two-point discrimination, static light touch, pain threshold, taste sensation) outcomes were assessed. Demographics (sex, age, American Society of Anesthesiologists classification, side of injury, diagnosis), operative (time interval between nerve injury and surgical repair, presence and length of neuroma) and postoperative (taste change, Medical Research Council Scale (MRCS) score and functional sensory recovery at 1 year postoperatively) variables were collated. Twenty-six patients (21 females, 5 males) were included in this study. Mean ± SD age was 31.5 ± 10.5 years, 73.1% (n = 19) of injuries were Sunderland class IV and 26.9% (n = 7) Sunderland class V. Mean ± SD time interval from nerve injury to surgical repair was 7.6 ± 8.9 months. Neuroma was present in 84.6% of patients (n = 22) with a mean ± SD length of 10.8 ± 4.5 mm. At 1 year postoperatively, 63.6% of patients (n = 14) had an improvement in taste sensation; postoperative MRCS scores were: 12.5% S2 (n = 3), 33.3% S2+ (n = 8), 4.2% S3 (n = 1), 33.3% S3+ (n = 8) and 16.7% S4 (n = 4); and functional sensory recovery was achieved in 54.2% of patients (n = 13). Overall, microsurgical lingual nerve repair offers significant improvements in subjective and objective neurosensory parameters.