双颌矢状劈开截骨术手术技术对术后下牙槽神经感觉减退的影响：文献系统评价
Influence of BSSO surgical technique on postoperative inferior alveolar nerve hypoesthesia: a systematic review of the literature.
作者信息
Mensink Gertjan, Gooris Peter J J, Bergsma J Eelco, van Hooft Erik, van Merkesteyn J P Richard
机构信息
Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, The Netherlands; Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. J.P.R. van Merkesteyn), Leiden University Medical Centre, Leiden, The Netherlands.
Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, The Netherlands; Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. D. Bloomquist), University of Washington, Seattle, USA; Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. J. de Lange), Amsterdam Medical Centre, Amsterdam, The Netherlands.
出版信息
J Craniomaxillofac Surg. 2014 Sep;42(6):976-82. doi: 10.1016/j.jcms.2014.01.019. Epub 2014 Jan 14.
OBJECTIVE
The aim of this study was to evaluate the influence of different splitting techniques, namely, "mallet and chisel" versus "spreading and prying", used during bilateral sagittal split osteotomy (BSSO) on postoperative hypoesthesia outcomes.
STUDY DESIGN
We systematically searched the PubMed and Cochrane databases (from January 1957 to November 2012) for studies that examined postoperative neurosensory disturbance (NSD) of the inferior alveolar nerve (IAN) after BSSO.
RESULTS
Our initial PubMed search identified 673 studies, of which, 14 met our inclusion criteria. From these 14 studies, 3 groups were defined: (1) no chisel use (4.1% NSD/site), (2) undefined chisel use (18.4% NSD/site), and (3) explicit chisel use along the buccal cortex (37.3% NSD/site).
CONCLUSION
Study heterogeneity and a frequent lack of surgical detail impeded our ability to make precise comparisons between studies. However, the group of studies explicitly describing chisel use along the buccal cortex showed the highest incidence of NSD. Moreover, comparison of the study that did not use chisels with the 2 studies that explicitly described chisel use revealed a possible disadvantage of the "mallet and chisel" group (4.1% versus 37.3% NSD/site). These results suggest that chisel use increases NSD risk after BSSO.
目的
本研究旨在评估双侧矢状劈开截骨术（BSSO）中使用的不同劈开技术，即“锤凿法”与“撑开撬拨法”对术后感觉减退结果的影响。
研究设计
我们系统检索了PubMed和Cochrane数据库（1957年1月至2012年11月），以查找研究BSSO术后下牙槽神经（IAN）神经感觉障碍（NSD）的研究。
结果
我们最初在PubMed上的检索识别出673项研究，其中14项符合我们的纳入标准。从这14项研究中，定义了3组：（1）未使用凿子（NSD/部位发生率为4.1%），（2）凿子使用情况未明确（NSD/部位发生率为18.4%），以及（3）沿颊侧皮质明确使用凿子（NSD/部位发生率为37.3%）。
结论
研究的异质性以及手术细节常常缺乏阻碍了我们在研究之间进行精确比较的能力。然而，明确描述沿颊侧皮质使用凿子的研究组显示NSD发生率最高。此外，将未使用凿子的研究与明确描述使用凿子的2项研究进行比较，发现“锤凿法”组可能存在劣势（NSD/部位发生率为4.1%对37.3%）。这些结果表明，使用凿子会增加BSSO术后NSD的风险。
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