Sliding genioplasty, avoiding mental nerve injuries

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.