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Sliding genioplasty, avoiding mental nerve injuries

D K Ousterhout

    The Journal of Craniofacial Surgery
    |July 1, 1996
    PubMed
    Summary

    Sliding genioplasty can cause mental nerve injuries. Maintaining a 6 mm distance during surgery significantly reduces the risk of permanent nerve damage, making it a crucial safety measure.

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    Area of Science:

    • Oral and Maxillofacial Surgery
    • Neurosurgery
    • Plastic Surgery

    Background:

    • Mental nerve injuries are a known complication of sliding genioplasty.
    • Previous anatomical studies informed a new surgical approach to prevent these injuries.

    Purpose of the Study:

    • To prospectively evaluate a surgical technique designed to minimize mental nerve injuries during sliding genioplasty.
    • To compare nerve injury rates between a prospective group and a historical control group.

    Main Methods:

    • Fifty consecutive sliding genioplasties were performed using a technique maintaining at least 6 mm between the osteotomy and the mental nerve canal.
    • Sensation testing (multiple finger touches) was conducted on the lower lip and chin in both prospective and retrospective groups.

    Main Results:

    • No permanent mental nerve injuries occurred in the 50 prospective cases.
    • The historical control group experienced three permanent nerve injuries (one bilateral, two unilateral).
    • Anatomical findings indicated the inferior alveolar nerve canal rarely dips below 5.5 mm from the inferior border of the mental nerve canal.

    Conclusions:

    • Maintaining a minimum 6 mm distance between the osteotomy and the mental nerve canal during sliding genioplasty appears to significantly reduce the incidence of permanent mental nerve injuries.
    • While not an absolute guarantee, this distance is advisable to minimize nerve injury risk.
    • Prioritizing nerve protection is an obligatory goal in sliding genioplasty, with greater distances considered if aesthetically feasible.

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