Secondary Inferior Alveolar Nerve Repair During Revisional Orthognathic Surgery.
Yoshitsugu Hattori1,2, Takahiro Yamamoto1, Takanobu Mashiko2
1Contour Clinic Tokyo, Chuo-ku.
The Journal of Craniofacial Surgery
|May 26, 2026
Summary
Revisional orthognathic surgery can improve facial aesthetics and nerve function after initial jaw surgery. Simultaneous repair of the inferior alveolar nerve (IAN) during revisional surgery may enhance sensory recovery and patient satisfaction.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- Neurosurgery
Background:
- Revisional orthognathic surgery is common for patients unsatisfied with primary results.
- Inferior alveolar nerve (IAN) injury is a known complication of sagittal split ramus osteotomy (SSRO).
- Untreated IAN transection can lead to permanent neurosensory deficits.
Purpose of the Study:
- To report a case of successful revisional orthognathic surgery with simultaneous secondary repair of the inferior alveolar nerve (IAN).
- To evaluate the functional and aesthetic outcomes of this combined approach.
Main Methods:
- A 41-year-old female patient underwent revisional orthognathic surgery (maxillomandibular complex rotation) with secondary IAN repair.
- Preoperative CT confirmed IAN discontinuity from prior SSRO.
- Surgical repair of the IAN was performed concurrently with the orthognathic procedure.
Main Results:
- The patient experienced significant improvement in facial profile and left lower lip sensation.
- High patient satisfaction was reported postoperatively.
- Computed tomography confirmed successful IAN repair and continuity.
Conclusions:
- Secondary IAN repair during revisional orthognathic surgery can restore neurosensory function.
- This combined approach yields favorable functional and aesthetic outcomes.
- It offers a viable solution for patients with persistent neurosensory deficits after primary orthognathic surgery.
