Nerve function outcomes following inferior alveolar nerve-preserving mandibulectomy for osteoradionecrosis: a case...

Preservation of the inferior alveolar nerve (IAN) during segmental mandibulectomy for osteoradionecrosis (ORN) may improve postoperative sensory function and quality of life, yet outcomes remain poorly described. We report five patients who underwent IAN-preserving segmental mandibulectomy for Notani grade 3 ORN with immediate reconstruction with an osteocutaneous fibular free flap. Follow up ranged from 6 to 28 months. Objective sensory function was assessed across four standardised cutaneous points using light touch, pinprick, brush directional discrimination, and cold sensation testing. Subjective outcomes were evaluated using visual analogue scales (VAS) for lip biting frequency, pain, and tingling, alongside qualitative patient descriptions. Cold and pinprick sensation were the most impaired modalities, particularly in patients with shorter follow up, while mechanoreceptive function was generally preserved. Subjective symptoms mirrored objective findings and improved over time. Patients with over 17 months of follow up reported near-normal sensation with minimal functional disturbance.