Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
J Craniomaxillofac Surg. 2012 Dec;40(8):763-7. doi: 10.1016/j.jcms.2012.02.003. Epub 2012 Mar 20.
Bilateral sagittal split osteotomy (BSSO) is an effective and commonly used treatment to correct mandibular hypo- and hyperplasia. Hypoesthesia of the inferior alveolar nerve (IAN) is a common complication of this surgical procedure. This prospective multi-centre study aimed to determine the incidence of neurosensory disturbances of the IAN after BSSO procedures performed without the use of chisels. Our study group comprised 158 patients, with a follow-up period of 1 year, who underwent BSSO (with or without Le Fort I) that incorporated the use of sagittal split separators and splitters but no chisels. The percentage of BSSO split procedures that resulted in IAN damage was 5.1%. The percentage of patients (without genioplasty) who experienced IAN damage was 8.9%. The concomitant genioplasty in combination with BSSO was significantly associated with hypoesthesia. Peri-operative removal of the wisdom tooth or a Le Fort I procedure did not influence post-operative hypoesthesia. We believe that the use of splitting forceps and elevators without chisels leads to a lower incidence of persistent post-operative hypoesthesia 1 year after BSSO of the mandible, without increasing the risk of a bad split.
双侧矢状劈开截骨术（Bilateral Sagittal Split Osteotomy，BSSO）是一种有效且常用的治疗下颌骨发育不良和过度发育的方法。下牙槽神经（Inferior Alveolar Nerve，IAN）感觉减退是该手术的常见并发症。本前瞻性多中心研究旨在确定在不使用凿子的情况下进行 BSSO 手术后 IAN 神经感觉障碍的发生率。我们的研究组包括 158 名患者，随访时间为 1 年，这些患者接受了 BSSO（伴或不伴 Le Fort I）手术，包括使用矢状劈开分离器和分裂器，但不使用凿子。导致 IAN 损伤的 BSSO 分裂手术的百分比为 5.1%。发生 IAN 损伤的患者（无颏成形术）的百分比为 8.9%。同时进行颏成形术和 BSSO 与感觉减退显著相关。术中拔除智齿或 Le Fort I 手术并不影响术后感觉减退。我们认为，在不使用凿子的情况下使用分裂钳和骨挺会导致下颌骨 BSSO 术后 1 年持续性术后感觉减退的发生率降低，而不会增加不良分裂的风险。
