Prevalence of Persistent Neurosensory Disturbance After Bilateral Sagittal Split Osteotomy: A Retrospective Study

This retrospective study aimed to evaluate the long-term neurosensory function of the inferior alveolar nerve (IAN) following bilateral sagittal split osteotomy (BSSO) using both subjective and objective methods, and to determine the incidence of persistent neurosensory disturbances (NSD). A total of 102 patients who underwent BSSO between 2013 and 2024 and were reassessed at least 12 months postoperatively were included. Neurosensory function was assessed using a questionnaire-based visual analog scale (VAS) and objective tests, primarily the pin-prick test. Persistent NSD was defined as a patient-reported sensory disturbance within the IAN distribution area (lower lip and chin) that remained present for ≥12 months after BSSO. Patients were categorized according to the presence and side of sensory alteration, and statistical analysis was performed using the Fisher-Freeman-Halton exact test (p<0.05). Persistent NSD at ≥12 months was observed in 5 of 102 patients (4.9%). Within the total cohort, unilateral and bilateral postoperative sensory changes were reported by 36.2% and 30.4% of patients, respectively. The most commonly reported symptoms were hypoesthesia (35.3%) and paresthesia (32.4%), which were predominantly mild in severity. Patient-reported sensory symptoms most commonly lasted up to 6 months. Functional impairment was limited, and most patients reported minimal discomfort. Patient satisfaction (89.2%) and recommendation rates (82.4%) were high. Although neurosensory disturbances were common in the early postoperative period after BSSO, they were generally mild, with patient-reported symptoms most commonly lasting up to 6 months, while persistent deficits beyond 1 year were uncommon. Patient-reported outcomes and objective sensory testing may provide complementary information regarding different aspects of postoperative neurosensory function.