Agbaje Jimoh Olubanwo, Van de Casteele Elke, Hiel Marjolein, Verbaanderd Ciska, Lambrichts Ivo, Politis Constantinus
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.
Faculty of Medicine, Hasselt University, Diepenbeek, Belgium.
J Maxillofac Oral Surg. 2016 Sep;15(3):321-327. doi: 10.1007/s12663-015-0843-9. Epub 2015 Nov 11.
To report the incidence of trigeminal neuropathy seen among new patients in a referral center within a period of 1 year (2013). The cause of damage, method of management and treatment outcome was assessed after 1-year follow-up.
The records of all new patients visiting the oral and maxillofacial unit of the University hospital of Leuven in 2013 were screened for a history of damage to branches of the trigeminal nerve. The selected records were examined and the duration of nerve damage, received treatment as well as the outcome of the neuropathy after treatment was noted after 1-year follow-up.
56 patients (21 males, 35 females) from 7602 new patients had symptoms of damage to the trigeminal nerve branch. These symptoms persist in more than one-third of the patients [21/56 (37.5 %)] after 1-year follow-up. The least recovery is seen from oral surgery, implant placement, orthognathic surgery and tooth extraction. After 1 year 85 % (12/14) of neuropathic pain cases still have their symptoms as compared to 19 % (5/26) of patients with hypoesthesia.
This study shows a low incidence of nerve damage among the new patients presenting in oral and maxillofacial surgery clinic (<1 %); however, one-third of patients who sustain nerve damage never recover fully. Early diagnosis of the cause of neuropathy is essential. There is a need to objectively assess all patients with symptoms of trigeminal nerve damage before, during and after treatment.
报告在一个转诊中心2013年1年内新患者中三叉神经病变的发生率。在随访1年后评估损伤原因、处理方法及治疗结果。
筛查2013年就诊于鲁汶大学医院口腔颌面科的所有新患者记录，以查找三叉神经分支损伤史。检查所选记录，随访1年后记录神经损伤持续时间、接受的治疗以及治疗后神经病变的结果。
7602名新患者中有56例（男性21例，女性35例）有三叉神经分支损伤症状。随访1年后，超过三分之一的患者[21/56（37.5%）]这些症状仍持续存在。口腔外科手术、种植体植入、正颌手术和拔牙后恢复最差。1年后，85%（12/14）的神经性疼痛病例仍有症状，而感觉减退患者中这一比例为19%（5/26）。
本研究显示，在口腔颌面外科门诊的新患者中神经损伤发生率较低（<1%）；然而，三分之一的神经损伤患者从未完全康复。早期诊断神经病变的原因至关重要。有必要在治疗前、治疗期间和治疗后对所有有三叉神经损伤症状的患者进行客观评估。
