Susarla Srinivas M, Kaban Leonard B, Donoff R Bruce, Dodson Thomas B
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.
J Oral Maxillofac Surg. 2007 Jun;65(6):1070-6. doi: 10.1016/j.joms.2006.10.010.
This study evaluated the relationship between timing of lingual nerve repair and functional sensory recovery.
Using a retrospective cohort study design, the investigators enrolled a sample of subjects who had lingual nerve repair. The predictor variable was time between injury and repair, categorized as early (<90 days after injury) or late (>90 days after injury). The outcome variable was the time to functional sensory recovery (FSR), measured in days. Other variables were categorized as demographic, anatomic, and operative. Uni- and multivariate Cox proportional hazards models were used to evaluate the association between the timing of the repair and time to FSR.
The study sample was composed of 64 subjects who had lingual nerve repair between January 1998 and January 2005. The mean time between injury and repair was 153.2 (31-1606) days; 21.9% of subjects had early repair. The mean age was 28.4 +/- 8.0 years, 62.5% of subjects were female; 77% of the injured nerves were repaired by direct suture, and 23% had surgical exploration with decompression/neurolysis. In bivariate analyses, early repair, method of repair, and neuroma were statistically or near-statistically associated with time to FSR (P <or= .12). In a multiple Cox proportional hazards model, early repair was associated with time to FSR (P = .02). Ninety-three percent of subjects in the early repair group achieved FSR within 1 year, compared with 62.9% in the late group (P = .05).
Early repair of lingual nerve injuries results in FSR more frequently and earlier than late repair.
本研究评估舌神经修复时机与功能性感觉恢复之间的关系。
采用回顾性队列研究设计,研究者纳入了接受舌神经修复的受试者样本。预测变量为损伤与修复之间的时间,分为早期(损伤后<90天)或晚期(损伤后>90天)。结果变量为功能性感觉恢复时间(FSR),以天数衡量。其他变量分为人口统计学、解剖学和手术相关变量。使用单变量和多变量Cox比例风险模型评估修复时机与FSR时间之间的关联。
研究样本由1998年1月至2005年1月期间接受舌神经修复的64名受试者组成。损伤与修复之间的平均时间为153.2(31 - 1606)天;21.9%的受试者接受了早期修复。平均年龄为28.4±8.0岁,62.5%的受试者为女性;77%的损伤神经通过直接缝合修复,23%进行了手术探查并减压/神经松解。在双变量分析中,早期修复、修复方法和神经瘤与FSR时间在统计学上或接近统计学上相关(P≤0.12)。在多变量Cox比例风险模型中,早期修复与FSR时间相关(P = 0.02)。早期修复组93%的受试者在1年内实现了FSR,而晚期组为62.9%(P = 0.05)。
舌神经损伤的早期修复比晚期修复更频繁且更早地导致功能性感觉恢复。