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下颌正颌手术后神经感觉功能缺损的恢复:一项前瞻性纵向研究。

Resolution of neurosensory deficit after mandibular orthognathic surgery: A prospective longitudinal study.

作者信息

Alolayan Albraa Badr, Leung Yiu Yan

机构信息

Oral and Maxillofacial Surgery Department, Dental College and Hospital, Taibah University, Madinah, Saudi Arabia.

Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.

出版信息

J Craniomaxillofac Surg. 2017 May;45(5):755-761. doi: 10.1016/j.jcms.2017.01.032. Epub 2017 Feb 12.

DOI:10.1016/j.jcms.2017.01.032
PMID:28318920
Abstract

OBJECTIVES

To investigate the longitudinal resolution of neurosensory deficit (NSD) and the possible risk factors that might contribute to NSD following mandibular orthognathic procedures.

STUDY DESIGN

A prospective longitudinal observational study on patients who had mandibular orthognathic procedures was performed. Standardized neurosensory assessments were performed. The 2 years longitudinal resolution and risk factors of NSD including patients' age and gender, specific mandibular procedures and surgeons' experience were analyzed.

RESULTS

66 patients (44 females) with 132 sides of mandibular procedures were enrolled in the study. Surgical procedures included mandibular ramus surgery, anterior mandibular surgery, or the combination of the two. The overall occurrences of subjective NSD improved from 78.8% at postoperative 2 weeks to 13.8% at post-operative 2 years. Combinations of ramus surgery and anterior mandibular surgery increased the risk of NSD at the first three post-operative months (p < 0.05). Patients' age and gender, and surgeons' experience were not found to be risk factors of NSD after mandibular orthognathic surgery.

CONCLUSION

The occurrence of NSD after mandibular orthognathic procedures reduced progressively within the post-operative 2 years. Combination of mandibular ramus surgery and anterior mandibular surgery increased the risk of NSD in the early post-operative period.

摘要

目的

研究神经感觉功能障碍(NSD)的纵向恢复情况以及下颌正颌手术后可能导致NSD的危险因素。

研究设计

对接受下颌正颌手术的患者进行前瞻性纵向观察研究。进行标准化的神经感觉评估。分析NSD的2年纵向恢复情况及危险因素,包括患者年龄、性别、特定下颌手术及外科医生经验。

结果

66例患者(44例女性)共132侧下颌手术纳入研究。手术方式包括下颌升支手术、下颌前部手术或两者联合。主观NSD的总体发生率从术后2周时的78.8%降至术后2年时的13.8%。升支手术与下颌前部手术联合增加了术后前三个月NSD的发生风险(p<0.05)。未发现患者年龄、性别及外科医生经验是下颌正颌手术后NSD的危险因素。

结论

下颌正颌手术后NSD的发生率在术后2年内逐渐降低。下颌升支手术与下颌前部手术联合增加了术后早期NSD的发生风险。

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