Tay A B G, Zuniga J R
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina at Chapel Hill, CB #7450, Chapel Hill, NC 27599-7450, USA.
Int J Oral Maxillofac Surg. 2007 Oct;36(10):922-7. doi: 10.1016/j.ijom.2007.03.012. Epub 2007 Sep 17.
The aim of this retrospective study was to determine the aetiology and characteristics of trigeminal nerve injuries referred to a university centre with nerve injury care. Fifty-nine patients with 73 injured trigeminal nerves were referred in 10 months. The most common aetiologies were odontectomy (third molar surgery) (52.1% of nerves), local anaesthetic (LA) injections (12.3%), orthognathic surgery (12.3%) and implant surgery (11.0%). The inferior alveolar nerve (IAN) was most commonly injured nerve (64.4%), followed by the lingual nerve (LN) (28.8%). About a quarter of IAN injuries (27.3%) and half of LN injuries (57.1%) from odontectomy had severe sensory impairment. There were twice as many LN than IAN injuries from local anaesthetic injections, but all had mild or no sensory impairment. Nerve injuries from implant surgery occurred only in IAN injuries; none had severe sensory impairment. Neuropathic pain occurred in 14.9% of IAN injuries and only in those with mild or no sensory impairment. Nerve surgery was offered to 45.8% of patients; a third underwent surgery.
这项回顾性研究的目的是确定转诊至一所设有神经损伤护理中心的大学的三叉神经损伤的病因及特征。在10个月内，共转诊了59例患者，其73条三叉神经受到损伤。最常见的病因是拔牙术（第三磨牙手术）（占神经损伤的52.1%）、局部麻醉（LA）注射（12.3%）、正颌手术（12.3%）和种植手术（11.0%）。下牙槽神经（IAN）是最常受损的神经（64.4%），其次是舌神经（LN）（28.8%）。拔牙术导致的IAN损伤中约四分之一（27.3%）和LN损伤的一半（57.1%）有严重感觉障碍。局部麻醉注射导致的LN损伤数量是IAN损伤的两倍，但所有患者均有轻度感觉障碍或无感觉障碍。种植手术导致的神经损伤仅发生在IAN损伤中；均无严重感觉障碍。14.9%的IAN损伤发生神经性疼痛，且仅发生在那些有轻度感觉障碍或无感觉障碍的患者中。45.8%的患者接受了神经手术；三分之一的患者接受了手术。
