School of Dentistry, Department of Health Sciences, "Magna Græcia" University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy.
Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Allende, 84081 Baronissi SA, Italy.
J Stomatol Oral Maxillofac Surg. 2018 Nov;119(5):389-394. doi: 10.1016/j.jormas.2018.04.006. Epub 2018 Apr 20.
Numb chin syndrome (NCS) or mental neuropathy (MN) is a disorder characterized by sensory neuropathy on the distribution of the inferior alveolar nerve or mental nerve. The most frequent causes are of odontogenic origin (infections, wrong therapies). Other etiologies are related to primary tumor, metastasis, osteoradionecrosis and medication-related osteonecrosis of the jaw (MRONJ). The aim of this study is to highlight the clinical importance of NCS as one of the first symptoms of cancer or as consequence of drug therapy.
The present study was conducted from 2010 to 2016 by recruiting patients who present NCS as one of the symptoms, having excluded those in which it depends on a clear odontogenic cause, on systemic degenerative diseases or metabolic disorders. Data collection included suspected diagnosis at the time of presentation of the symptom, final diagnosis, mandibular localization, treatment performed and diagnostic delay between the first medical examination and the definitive diagnosis.
This study included 29 patients in which NCS had not a clear odontogenic cause. NCS was the first symptom of malignancy in 11 cases and the clinical sign of metastasis in 4 cases. In a single patient, it was the first symptom of an immune-mediated disease. In the remaining 13 patients, NCS represented the symptom of MRONJ.
NCS can be the first symptom of malignancy, especially in patients with a previous history of cancer, but also a prodromal sign of MRONJ. It should be recognized in order to require deeper examinations for early diagnosis of the disease.
麻木下巴综合征（NCS）或精神神经病（MN）是一种以下颌神经或颏神经分布区感觉神经病变为特征的疾病。最常见的病因是牙源性的（感染、错误的治疗）。其他病因与原发性肿瘤、转移、放射性骨坏死和药物相关性下颌骨坏死（MRONJ）有关。本研究旨在强调 NCS 的临床重要性，将其作为癌症的首发症状之一或作为药物治疗的后果。
本研究于 2010 年至 2016 年进行，通过招募出现 NCS 作为症状之一的患者进行，排除了那些明显与牙源性原因、系统性退行性疾病或代谢紊乱有关的患者。数据收集包括出现症状时的可疑诊断、最终诊断、下颌骨定位、所进行的治疗以及首次医学检查和明确诊断之间的诊断延迟。
本研究共纳入 29 例无明确牙源性病因的 NCS 患者。11 例 NCS 是恶性肿瘤的首发症状，4 例是转移的临床征象。在单个患者中，它是免疫介导性疾病的首发症状。在其余 13 例患者中，NCS 代表了 MRONJ 的症状。
NCS 可以是恶性肿瘤的首发症状，尤其是有癌症既往史的患者，但也是 MRONJ 的前驱症状。为了进行早期疾病诊断，应识别 NCS 并进行更深入的检查。
