Hashiba Yukari, Ueki Koichiro, Marukawa Kohei, Nakagawa Kiyomasa, Yamamoto Etsuhide, Matsubara Kosuke
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Jan;105(1):11-5. doi: 10.1016/j.tripleo.2007.04.006. Epub 2007 Aug 30.
The purpose of this study was to objectively evaluate the relationship between recovery of hypoesthesia of the lower lip after sagittal split ramus osteotomy (SSRO) with trigeminal somatosensory evoked potential (TSEP) and sagittal split area or plate screw position, using postoperative computerized tomography (CT).
The subjects consisted of 58 patients (116 sides) with mandibular prognathism who underwent SSRO. The patients were divided into 2 groups. The Ob group, consisting of 62 sides, underwent the Obwegeser method. The OD group, consisting of 54 sides, underwent the Obwegeser-Dal Pont method. Trigeminal nerve hypoesthesia at the region of the lower lip was assessed bilaterally by the TSEP method. An electroencephalograph recording system (Neuropack Sigma; Nihon Koden, 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. Postoperative CT was performed in all cases to measure the sagittal split area (SSA) as well as the distance between the plate (the most medial point of screw) and the mental foramen (PM). Then comparisons between the 2 groups in recovery period of the lower lip, SSA, and PM were performed. Furthermore, the relationships between recovery period of hypoesthesia of the lower lip and SSA or PM were evaluated statistically.
The average measurable period and standard deviation of TSEP of the lower lip was 3.4 +/- 5.5 weeks in the Ob group and 11.3 +/- 13.7 weeks in the OD group. There were significant differences between the Ob group and the OD group (P < .0001). The OD group showed significantly greater SSA and PM than the Ob group (P < 0.0001).
This study suggested that recovery period of hypoesthesia of the lower lip after SSRO was strongly associated with SSA and PM.
本研究旨在利用术后计算机断层扫描（CT），客观评估矢状劈开下颌支截骨术（SSRO）后下唇感觉减退的恢复情况与三叉神经体感诱发电位（TSEP）以及矢状劈开面积或接骨板螺钉位置之间的关系。
研究对象为58例接受SSRO的下颌前突患者（116侧）。患者分为2组。Ob组共62侧，采用Obwegeser法。OD组共54侧，采用Obwegeser-Dal Pont法。采用TSEP法双侧评估下唇区域的三叉神经感觉减退情况。使用脑电图记录系统（Neuropack Sigma；日本东京光电）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。所有病例均进行术后CT检查，以测量矢状劈开面积（SSA）以及接骨板（螺钉最内侧点）与颏孔（PM）之间的距离。然后对两组在下唇恢复期、SSA和PM方面进行比较。此外，对下唇感觉减退恢复期与SSA或PM之间的关系进行统计学评估。
Ob组下唇TSEP的平均可测量期和标准差为3.4±5.5周，OD组为11.3±13.7周。Ob组和OD组之间存在显著差异（P <.0001）。OD组的SSA和PM显著大于Ob组（P < 0.0001）。
本研究表明，SSRO后下唇感觉减退的恢复期与SSA和PM密切相关。
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