Schmidt Brian L, Pogrel M A
Department of Oral and Maxillofacial Surgery, University of California-San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143-0440, USA.
J Oral Maxillofac Surg. 2004 Oct;62(10):1183-7. doi: 10.1016/j.joms.2004.03.012.
The study goal was to evaluate neurosensory changes after liquid nitrogen cryotherapy in the management of mandibular lesions in close proximity to the inferior alveolar nerve.
The design of the study was a retrospective review. Sixteen patients with posterior mandibular lesions (15 odontogenic keratocysts and 1 fibromyxoma) in close proximity to the inferior alveolar nerve were treated with a standardized enucleation and cryotherapy technique. Postoperative evaluation included patients report of symptoms and formal neurosensory testing.
All patients had altered sensation in the distribution of the inferior alveolar nerve immediately after cryotherapy. Two patients experienced anesthesia, and the remaining 14 patients showed paresthesia. The average time for return or improvement in sensation was 91 days (range, 6 to 235 days). The average time of follow-up was 2.6 years (range, 0.5 to 7.3 years). At the time of last follow-up, no patients had anesthesia or dysesthesia. Four patients had full return of sensation and 12 patients had paresthesia. No patients reported significant difficulty from abnormal nerve function. All 16 patients experienced some return of sensation; 9 patients had full or near full return of sensation.
Based on these results, the combination of enucleation and liquid nitrogen cryotherapy produces minimal alteration of inferior alveolar nerve function.
本研究的目标是评估在下颌骨病变紧邻下牙槽神经时，液氮冷冻治疗后的神经感觉变化。
本研究设计为回顾性研究。16例下颌骨后部病变（15例牙源性角化囊肿和1例纤维黏液瘤）紧邻下牙槽神经的患者，采用标准化的摘除术和冷冻治疗技术进行治疗。术后评估包括患者症状报告和正式的神经感觉测试。
所有患者在冷冻治疗后立即出现下牙槽神经分布区域的感觉改变。2例患者出现麻醉，其余14例患者表现为感觉异常。感觉恢复或改善的平均时间为91天（范围6至235天）。平均随访时间为2.6年（范围0.5至7.3年）。在最后一次随访时，没有患者出现麻醉或感觉障碍。4例患者感觉完全恢复，12例患者仍有感觉异常。没有患者报告因神经功能异常而出现明显困难。所有16例患者均有一定程度的感觉恢复；9例患者感觉完全或接近完全恢复。
基于这些结果，摘除术与液氮冷冻治疗相结合对下牙槽神经功能的影响最小。
