Department of Oral and Maxillofacial Diseases, Turku University Hospital, Lemminkäisenkatu 2, 20520, Turku, Finland.
Department of Oral and Maxillofacial surgery, Institute of Dentistry, University of Turku, Turku, Finland.
Muscle Nerve. 2019 Mar;59(3):342-347. doi: 10.1002/mus.26400. Epub 2019 Jan 6.
We evaluated diagnostic value of sensory tests during recovery from iatrogenic sensory neuropathy using intraoperatively verified nerve injury with subjective symptoms as gold standard.
Inferior alveolar nerves were monitored neurophysiologically throughout mandibular osteotomy in 19 patients. Sensory disturbance was registered and sensation tested using clinical and quantitative sensory (QST) and neurophysiologic tests postoperatively at 1, 3, 6, and 12 months. Sensitivity, specificity, and predictive values were calculated for all tests.
The sensitivity of clinical tests was at best 37%, with 100% specificity, but they lost diagnostic value at chronic stages. Best diagnostic accuracy (highest combination of sensitivity and specificity) at different time points was achieved by combining neurophysiologic and thermal QST or tactile and thermal QST. The single most accurate test was sensory neurography.
Neurography or combinations of neurophysiologic and quantitative tests enables most reliable early and late diagnosis. Clinical sensory examination is inadequate for accurate diagnosis. Muscle Nerve 59:342-347, 2019.
我们使用术中证实的神经损伤（伴有主观症状）作为金标准，评估了感觉神经病变恢复过程中感觉测试的诊断价值。
在 19 例患者的下颌骨切开术中，对下牙槽神经进行了神经生理学监测。术后第 1、3、6 和 12 个月，通过临床和定量感觉（QST）和神经生理学测试记录感觉障碍并进行感觉测试。计算了所有测试的敏感性、特异性和预测值。
临床测试的敏感性最高为 37%，特异性为 100%，但在慢性阶段失去了诊断价值。在不同时间点，神经生理学和热敏 QST 或触觉和热敏 QST 的结合具有最佳的诊断准确性（最高的敏感性和特异性组合）。单一最准确的测试是感觉神经图。
神经图或神经生理学和定量测试的组合可实现最可靠的早期和晚期诊断。临床感觉检查不足以进行准确的诊断。《肌肉神经》59:342-347，2019 年。
