Ziccardi Vincent B, Hullett Jason S, Gomes Julyana
Department of Oral and Maxillofacial Surgery, UMDNJ, Newark, New Jersey 07101, USA.
Quintessence Int. 2009 Jul-Aug;40(7):603-9.
To provide a preliminary comparison of traditional clinical neurosensory examination (CNE) and current perception threshold (CPT).
This is a retrospective chart audit of patients with trigeminal nerve injuries related to dental treatment who were evaluated with both CNE and CPT assessments (electrical stimulus tests) after presenting with altered sensation involving either the inferior alveolar nerve (IAN) or lingual nerve (LN) distributions. The tests were performed on the anterior two-thirds of the tongue for LN injuries and the lower lip and chin for IAN injuries. Results were defined as hyper-, hypo-, or normal sensory response.
Twelve charts were reviewed; 10 of the 12 nerve injuries occurred secondary to mandibular third molar extraction affecting 7 LN and 5 IAN branches. Following LN injuries, the C, and A-delta fibers assessment demonstrated hyposensitivity in the affected nerve territory in CPT and the CNE tests with the exception of 1 normal nerve response in 5-Hz CPT. Within the LN injury group, good correlation was observed between the CNE and CPT tests with the exception of brush stroke and 250-Hz CPT stimuli. Following IAN injuries, sensory testing results were more varied. A-beta fiber evaluation demonstrated hyposensitivity to VF in all patients and in 4 of 5 for brush test. One patient was hypersensitive for the brush test. The response to 2,000-Hz electrical stimulus demonstrated hyposensitivity in 3 patients, hypersensitivity in 1 (the same patient that was hypersensitive for brush), and normal sensitivity in 1 patient. Good correlations were found only between the CPT 5-Hz and heat and cold tests. Only 1 patient (IAN injury) reported pain that was hypersensitive for heat, cold, pinprick, brush, and 250-Hz and 2,000-Hz stimuli.
Following LN injuries, CNE and CPT tests provided similar findings. More disparity was observed between the CNE and CPT methods in the IAN injury evaluation. For LN injury assessments, CNE alone appears to be adequate for assessing nerve injuries.
对传统临床神经感觉检查（CNE）和电流感觉阈值（CPT）进行初步比较。
这是一项对因牙科治疗导致三叉神经损伤患者的回顾性病历审核。这些患者在出现下牙槽神经（IAN）或舌神经（LN）分布区域感觉改变后，接受了CNE和CPT评估（电刺激测试）。对于LN损伤，测试在舌前三分之二进行；对于IAN损伤，测试在下唇和下巴进行。结果定义为感觉过敏、感觉减退或正常感觉反应。
共审核了12份病历；12例神经损伤中有10例继发于下颌第三磨牙拔除，影响7条LN和5条IAN分支。LN损伤后，C纤维和A-δ纤维评估显示，在CPT和CNE测试中，受影响神经区域存在感觉减退，但在5-Hz CPT中有1例神经反应正常。在LN损伤组中，除笔触和250-Hz CPT刺激外，CNE和CPT测试之间观察到良好的相关性。IAN损伤后，感觉测试结果差异更大。A-β纤维评估显示，所有患者对VF均感觉减退，5例患者中有4例对刷拭测试感觉减退。1例患者对刷拭测试感觉过敏。对2000-Hz电刺激的反应显示，3例患者感觉减退，1例（与对刷拭测试感觉过敏的患者相同）感觉过敏，1例患者感觉正常。仅在CPT 5-Hz与冷热测试之间发现良好的相关性。只有1例患者（IAN损伤）报告对热、冷、针刺、刷拭、250-Hz和2000-Hz刺激疼痛感觉过敏。
LN损伤后，CNE和CPT测试结果相似。在IAN损伤评估中观察到CNE和CPT方法之间存在更多差异。对于LN损伤评估，仅CNE似乎足以评估神经损伤。
