Ueki Koichiro, Nakagawa Kiyomasa, Marukawa Kohei, Shimada Mayumi, Yoshida Kan, Hashiba Yukari, Shimizu Chika, Yamamoto Etsuhide
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Feb;103(2):169-74. doi: 10.1016/j.tripleo.2006.02.019. Epub 2006 Aug 10.
The purpose of this study was to objectively evaluate hypoesthesia of the upper lip following Le Fort I osteotomy in combination with mandibular osteotomy with trigeminal somatosensory evoked potential (TSEP).
The subjects consisted of 25 patients with mandibular prognathism with maxillary retrognathism mandibular prognathism with or without asymmetry, who underwent Le Fort I osteotomy in combination with sagittal split ramus osteotomy (SSRO) or intraoral vertical ramus osteotomy (IVRO). Trigeminal nerve hypoesthesia at the region of the upper lip was assessed bilaterally by the TSEP method. The electrodes were placed exactly above the highest point of the vermilion border and on the mucosa of the upper lip. An electroencephalograph recording system (Neuropack Sigma; Nihon Koden Corp., Tokyo, Japan) was used to analyze the potentials. Each patient was evaluated preoperatively and then postoperatively at 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year.
The average measurable period and standard deviation of TSEP of the upper lip was 7.8 +/- 10.7 weeks following Le Fort I osteotomy, TSEP of the lower lip was 4.6 +/- 9.2 weeks in the patients who underwent SSRO with Le Fort I osteotomy, and 1.2 +/- 0.4 weeks in the patients who underwent IVRO with Le Fort I osteotomy.
This study objectively proved that hypoesthesia could appear in the upper lips following Le Fort I osteotomy with TSEP. The measurable period for the upper lip following Le Fort I osteotomy tended to be longer than that for the lower lip in the patients who underwent SSRO and IVRO with Le Fort I osteotomy.
本研究的目的是通过三叉神经体感诱发电位（TSEP）客观评估Le Fort I型截骨术联合下颌骨截骨术后上唇感觉减退情况。
研究对象为25例下颌前突伴上颌后缩、下颌前突伴或不伴不对称的患者，他们接受了Le Fort I型截骨术联合下颌升支矢状劈开截骨术（SSRO）或口内下颌升支垂直截骨术（IVRO）。采用TSEP方法双侧评估上唇区域的三叉神经感觉减退情况。电极精确放置在唇红缘最高点上方及上唇黏膜处。使用脑电图记录系统（Neuropack Sigma；日本光电株式会社，东京，日本）分析电位。每位患者在术前以及术后1周、2周、1个月、3个月、6个月和1年进行评估。
Le Fort I型截骨术后上唇TSEP的平均可测量期及标准差为7.8±10.7周，接受Le Fort I型截骨术联合SSRO的患者下唇TSEP为4.6±9.2周，接受Le Fort I型截骨术联合IVRO的患者下唇TSEP为1.2±0.4周。
本研究客观证明，Le Fort I型截骨术后通过TSEP可发现上唇出现感觉减退。在接受Le Fort I型截骨术联合SSRO和IVRO的患者中，Le Fort I型截骨术后上唇的可测量期往往比下唇更长。
