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Inferior alveolar nerve function after mandibular osteotomies
A Westermark1, H Bystedt, L von Konow
1Department of Maxillofacial Surgery, Karolinska Hospital, Stockholm, Sweden.
The British Journal of Oral & Maxillofacial Surgery
|January 9, 1999
Summary
Sagittal split ramus osteotomy for jaw surgery has a high 39% rate of neurosensory deficiency. Other mandibular osteotomy types show lower rates, with intraoral vertical ramus osteotomy being the least invasive.
Area of Science:
- Oral and Maxillofacial Surgery
- Neurosurgery
- Orthognathic Surgery
Background:
- Orthognathic surgery corrects jaw discrepancies.
- Mandibular osteotomies are common procedures.
- Neurosensory disturbances are a known complication.
Purpose of the Study:
- To assess the incidence of neurosensory deficiency after various mandibular osteotomies.
- To compare complication rates between different surgical techniques.
- To evaluate the impact of additional genioplasty on neurosensory function.
Main Methods:
- Retrospective analysis of 1034 patients undergoing orthognathic surgery.
- Assessment of mental nerve neurosensory function via light touch perception.
- Categorization of patients based on specific mandibular osteotomy types (SSRO, IVRO, EVRO, genioplasty).
Main Results:
- Incidence of neurosensory deficiency: 39% (SSRO), 19% (EVRO), 12% (genioplasty), 9% (IVRO).
- Additional genioplasty increased neurosensory disturbance after IVRO.
- SSRO showed a significantly higher incidence of neurosensory disturbance compared to other methods.
Conclusions:
- Sagittal split ramus osteotomy (SSRO) presents a high rate of neurosensory deficiency, a significant drawback.
- Intraoral vertical ramus osteotomy (IVRO) demonstrates the lowest incidence of neurosensory disturbance.
- Surgical technique selection is critical for minimizing neurosensory complications in orthognathic surgery.